Dental and Medical Problems

Dent Med Probl
Index Copernicus (ICV 2020) – 128.41
MEiN – 70 pts
CiteScore (2021) – 2.0
JCI – 0.5
Average rejection rate (2021) – 81.35%
ISSN 1644-387X (print)
ISSN 2300-9020 (online)
Periodicity – quarterly

Download PDF

Dental and Medical Problems

2019, vol. 56, nr 1, January-March, p. 11–20

doi: 10.17219/dmp/103417

Publication type: original article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Creative Commons BY-NC-ND 3.0 Open Access

Does metabolic control affect salivary adipokines in type 2 diabetes mellitus?

Czy kontrola metaboliczna cukrzycy typu 2 ma wpływ na adipokiny w ślinie?

Elif Teke1,A,B,D, Fatma Yeşim Kırzıoğlu1,A,C,D,E,F, Hakan Korkmaz2,A,B,D,E,F, Mustafa Calapoğlu3,A,B,C, Hikmet Orhan4,C

1 Department of Periodontology, Faculty of Dentistry, Süleyman Demirel University, Isparta, Turkey

2 Department of Internal Medicine, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey

3 Department of Biochemistry, Faculty of Arts and Sciences, Süleyman Demirel University, Isparta, Turkey

4 Department of Biostatistics and Medical Informatics, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey

Abstract

Background. Adipokines produced by adipose tissue initiate pro-inflammatory events and contribute to the pathogenesis of diabetic periodontitis.
Objectives. The aim of this study was to evaluate the effect of the metabolic status on the level of salivary adipokines in type 2 diabetes mellitus (T2DM) patients.
Material and Methods. A total of 239 individuals, including 161 T2DM patients and 78 healthy (H) controls, participated in the study. The metabolic control status was evaluated in each person. Periodontal measurements were recorded. Periodontal epithelial surface area (PESA), periodontal inflamed surface area (PISA) and the total dental index (TDI) were calculated. The salivary adiponectin, tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), and vaspin levels were determined.
Results. The T2DM patients had higher periodontal parameters and adiponectin, TNF-α, IL-6, and vaspin levels as compared with the H controls (p < 0.05). As the metabolic control worsened, periodontal pocket depth (PPD) and clinical attachment level (CAL) increased. When covariates (age, gender, body mass index – BMI, education level, smoking, dental visit and tooth brushing frequency) were adjusted, only the TNF-α and vaspin levels were significantly higher in the T2DM patients (p < 0.05). In the T2DM patients, positive correlations were found between the TNF-α level and the percentage of bleeding on probing (BOP%), PPD, PESA, and PISA, and between the adiponectin level and PISA. Moreover, there was a negative relationship between the salivary volume and TDI. While the correlations IL-6–TNF-α, vaspin–triglycerides and vaspin–tooth brushing frequency were positive, the statistically significant associations vaspin–IL-6 and vaspin–low-density lipoprotein (LDL) were negative (p < 0.05).
Conclusion. The severity of periodontal disease increases as the metabolic control status worsens. The levels of salivary adipokines were changed by T2DM, while being independent from the metabolic control.

Key words

adipokines, saliva, periodontal disease, diabetes mellitus type 2, vaspin

Słowa kluczowe

adipokiny, ślina, choroba przyzębia, cukrzyca typu 2, waspina

References (30)

  1. Mealey BL, Oates TW; American Academy of Periodontology. Diabetes mellitus and periodontal diseases. J Periodontol. 2006;77(8):1289–1303.
  2. Nesse W, Linde A, Abbas F, et al. Dose–response relationship between periodontal inflamed surface area and HbA1c in type 2 diabetics. J Clin Periodontol. 2009;36(4):295–300.
  3. Susanto H, Nesse W, Dijkstra PU, et al. Periodontal inflamed surface area and C-reactive protein as predictors of HbA1c: A study in Indonesia. Clin Oral Investig. 2012;16(4):1237–1242.
  4. Sun WL, Chen LL, Zhang SZ, Ren YZ, Qin GM. Changes of adiponectin and inflammatory cytokines after periodontal intervention in type 2 diabetes patients with periodontitis. Arch Oral Biol. 2010;55(12):970–974.
  5. Preshaw PM, Alba AL, Herrera D, et al. Periodontitis and diabetes: A two-way relationship. Diabetologia. 2012;55(1):21–31.
  6. Li L, Wu LL. Adiponectin and interleukin-6 in inflammation-associated disease. Vitam Horm. 2012;90:375–395.
  7. Blüher M. Vaspin in obesity and diabetes: Pathophysiological and clinical significance. Endocrine. 2012;41(2):176–182.
  8. von Bültzingslöwen I, Sollecito TP, Fox PC, et al. Salivary dysfunction associated with systemic diseases: Systematic review and clinical management recommendations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;103(Suppl S57):e1–15.
  9. American Diabetes Association. 2. Classification and Diagnosis of Diabetes. Diab Care. 2017;40(Suppl 1):S11–24.
  10. Silness J, Löe H. Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand. 1964;22(1):121–135.
  11. Löe H, Silness J. Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scand. 1963;21(6):533–551.
  12. Mattila KJ, Nieminen MS, Valtonen VV, et al. Association between dental health and acute myocardial infarction. BMJ. 1989;298(6676):779–781.
  13. Navazesh M. Methods for collecting saliva. Ann N Y Acad Sci. 1993;694:72–77.
  14. Casanova L, Hughes FJ, Preshaw PM. Diabetes and periodontal disease: A two-way relationship. Br Dent J. 2014;217(8):433–437.
  15. Yin J, Gao H, Yang J, Xu L, Li M. Measurement of salivary resistin level in patients with type 2 diabetes. Int J Endocrinol. 2012;2012:359724.
  16. Oikarinen K, Zubaid M, Thalib L, Soikkonen K, Rashed W, Lie T. Infectious dental diseases in patients with coronary artery disease: An orthopantomographic case-control study. J Can Dent Assoc. 2009;75(1):35.
  17. Nylund KM, Meurman JH, Heikkinen AM, et al. Periodontal inflammatory burden and salivary matrix metalloproteinase-8 concentration among patients with chronic kidney disease at the predialysis stage. J Periodontol. 2015;86(11):1212–1220.
  18. Zhou X, Zhang W, Liu X, Zhang W, Li Y. Interrelationship between diabetes and periodontitis: Role of hyperlipidemia. Arch Oral Biol. 2015;60(4):667–674.
  19. Laws A, Reaven G. Evidence for an independent relationship between insulin resistance and fasting plasma HDL‐cholesterol, triglyceride and insulin concentrations. J Intern Med. 1992;231(1):25–30.
  20. Riis JL, Bryce CI, Ha T, et al. Adiponectin: Serum-saliva associations and relations with oral and systemic markers of inflammation. Peptides. 2017;91:58–64.
  21. Sun WL, Chen LL, Zhang SZ, Wu YM, Ren YZ, Qin GM. Inflammatory cytokines, adiponectin, insulin resistance and metabolic control after periodontal intervention in patients with type 2 diabetes and chronic periodontitis. Intern Med. 2011;50(15):1569–1574.
  22. Furugen R, Hayashida H, Yamaguchi N, et al. The relationship between periodontal condition and serum levels of resistin and adiponectin in elderly Japanese. J Periodontal Res. 2008;43(5):556–562.
  23. Zimmermann GS, Bastos MF, Dias Gonçalves TE, Chambrone L, Duarte PM. Local and circulating levels of adipocytokines in obese and normal weight individuals with chronic periodontitis. J Periodontol. 2013;84(5):624–633.
  24. Mahmoud F, Al-Ozairi E. Inflammatory cytokines and the risk of cardiovascular complications in type 2 diabetes. Dis Markers. 2013;35(4):235–241.
  25. Costa PP, Trevisan GL, Macedo GO, et al. Salivary interleukin-6, matrix metalloproteinase-8, and osteoprotegerin in patients with periodontitis and diabetes. J Periodontol. 2010;81(3):384–391.
  26. Yang W, Li Y, Tian T, Wang L, Lee P, Hua Q. Serum vaspin concentration in elderly patients with type 2 diabetes mellitus and macrovascular complications. BMC Endocr Dis. 2017;17:67.
  27. Balli U, Bozkurt Dogan S, Ongoz Dede F, Sertoglu E, Keles GC. The levels of visceral adipose tissue-derived serpin, omentin-1 and tumor necrosis factor-α in the gingival crevicular fluid of obese patients following periodontal therapy. J Oral Sci. 2016;58(4):465–473.
  28. Suleymanoglu S, Tascilar E, Pirgon O, Tapan S, Meral C, Abaci A. Vaspin and its correlation with insulin sensitivity indices in obese children. Diabetes Res Clin Pract. 2009;84(3):325–328.
  29. Klöting N, Kovacs P, Kern M, et al. Central vaspin administration acutely reduces food intake and has sustained blood glucose-lowering effects. Diabetologia. 2011;54(7):1819–1823.
  30. Al-Azzam SI, Alzoubi KH, Abeeleh JA, Mhaidat NM, Abu-Abeeleh M. Effect of statin therapy on vaspin levels in type 2 diabetic patients. Clin Pharmacol. 2013;5:33–38.