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Jia R, Zhang Y, Wang Z, Hu B, Wang Z, Qiao H. Association between lipid metabolism and periodontitis in obese patients: a cross-sectional study. BMC Endocr Disord 2023; 23:119. [PMID: 37231396 DOI: 10.1186/s12902-023-01366-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 05/09/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND To investigate the association between clinical periodontal parameters of periodontitis, serum lipid metabolism markers and adipokines' levels in patients with obesity and periodontitis. METHODS A total of 112 patients admitted to Hospital of Xi'an Jiaotong University were included in this study. They were divided into normal body weight group (18.5 < body mass index, BMI < 25, n = 36), overweight group (25 ≤ BMI < 30, n = 38), and obesity group (BMI ≥ 30, n = 38) accordingly. The diagnosis of periodontitis was based on the newest international classification of periodontitis. Full-mouth clinical periodontal measurements included: plaque index, periodontal pocket depth, clinical attachment level, and bleeding on probing. Gingival crevicular fluid samples were analyzed for: Interleukin-1β, tumor necrosis factor-α, Interleukin-6 and C-reactive protein. Serum triglycerides, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol and glycosylated hemoglobin levels were measured. Visfatin, leptin, resistin, and adiponectin levels in serum were also measured. RESULTS The ratio of participants without periodontitis was significantly highest in normal weight group, and the proportion of severe periodontitis (stage III and IV) was highest in obesity group. The periodontal pocket depth, clinical attachment level, and the inflammatory cytokines in gingival crevicular fluid in obesity group and overweight group were higher than those in normal body weight group. The BMI and waist-to-hip ratio (WHR) were significantly positive correlated with periodontal pocket depth and clinical attachment level. Using a Multivariate logistic regression model, periodontitis correlates to BMI, WHR, serum levels of triglyceride, total cholesterol, low density lipoprotein, and adipokines such as visfatin, leptin, and resistin. CONCLUSIONS Obesity is positively correlated with the aggravation of periodontitis. Obesity may aggravate the damage to periodontal tissue by regulating the secretion level of adipokines.
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Affiliation(s)
- Ru Jia
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, No. 98 Xiwu Road, Xi'an, Shaanxi, 710004, China
- Department of Prosthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yuwei Zhang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, No. 98 Xiwu Road, Xi'an, Shaanxi, 710004, China
| | - Zhiyu Wang
- Department of Stomatology, Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Bo Hu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, No. 98 Xiwu Road, Xi'an, Shaanxi, 710004, China
- Department of Prosthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Zhenzhen Wang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, No. 98 Xiwu Road, Xi'an, Shaanxi, 710004, China
- Department of Prosthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Hu Qiao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, No. 98 Xiwu Road, Xi'an, Shaanxi, 710004, China.
- Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
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2
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Acute Myocardial Infarction and Periodontitis: Importance of Awareness and Prevention in Latin America. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12063131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
By 2030, non-communicable diseases will have accounted for more than three-quarters of deaths worldwide. Cardiovascular diseases (CVDs) have been the leading cause of death worldwide for several years. Acute myocardial infarction (AMI) is a CVD characterized by necrosis of the heart at the myocardial level due to prolonged ischemia caused by the reduction or sudden absence of coronary blood supply. The prevalence of AMI is higher in men at all ages. The incidence of AMI has decreased in industrialized nations; however, it has been on the rise in Latin America (LATAM) due to lifestyle changes. These changes have caused the combined incidence of CVDs and unresolved health concerns in LATAM, such as infections and malnutrition. It is well known that periodontitis, a highly prevalent chronic infectious inflammatory disease, has been associated with systemic diseases, such as diabetes, kidney diseases, and AMI. This review addresses proposed aspects of the correlation between periodontitis and AMI, explains the importance of preventing periodontitis and CVDs, and analyzes the preventative measures being implemented in LATAM, particularly in Mexico.
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Leptin in Dental Pulp and Periapical Tissues: A Narrative Review. Int J Mol Sci 2022; 23:ijms23041984. [PMID: 35216099 PMCID: PMC8880140 DOI: 10.3390/ijms23041984] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/04/2022] [Accepted: 02/07/2022] [Indexed: 12/17/2022] Open
Abstract
Leptin is a non-glycosylated 16 kDa protein synthesized mainly in adipose cells. The main function of leptin is to regulate energy homeostasis and weight control in a central manner. There is increasing evidence that leptin also has systemic effects, acting as a link between innate and acquired immune responses. The expression of leptin and its receptor in human dental pulp and periradicular tissues have already been described, as well as several stimulatory effects of leptin protein expression in dental and periodontal tissues. The aim of this paper was to review and to compile the reported scientific literature on the role and effects of leptin in the dental pulp and periapical tissues. Twelve articles accomplished the inclusion criteria, and a comprehensive narrative review was carried out. Review of the available scientific literature concluded that leptin has the following effects on pulpal and periapical physiology: 1) Stimulates odontogenic differentiation of dental pulp stem cells (DPSCs), 2) Increases the expression of dentin sialophosphoprotein (DSPP) and dentin matrix protein-1 (DMP-1), odontoblastic proteins involved in odontoblastic differentiation and dentin mineralization, 3) Stimulates vascular endothelial growth factor (VEGF) expression in human dental pulp tissue and primary cultured cells of human dental pulp (hDPCs), 4) Stimulates angiogenesis in rat dental pulp cells, and 5) Induces the expression of interleucinas 6 and 8 in human periodontal ligament cells (hPDLCs). There is evidence which suggests that leptin is implicated in the dentin mineralization process and in pulpal and periapical inflammatory and reparative responses.
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Brum RS, Duarte PM, Canto GDL, Flores-Mir C, Benfatti CAM, Porporatti AL, Zimmermann GS. Biomarkers in biological fluids in adults with periodontitis and/or obesity: A meta-analysis. J Indian Soc Periodontol 2020; 24:191-215. [PMID: 32773969 PMCID: PMC7307467 DOI: 10.4103/jisp.jisp_512_19] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 02/22/2020] [Accepted: 03/01/2020] [Indexed: 12/12/2022] Open
Abstract
Obesity and periodontal diseases have been investigated to be interconnected, but the molecular mechanism underlying this association is still not clear. The aim of this systematic review is to assess the association of serum, salivary and gingival crevicular fluid (GCF) inflammatory markers (IMs), obesity, and periodontitis. Studies that evaluated IM of adults according to obesity status (O) and periodontitis status (P) (O+P+; O-P+; O+P-) were screened on several electronic databases and grey literature up until February 2019. Risk of bias assessment and level of evidence were evaluated through Fowkes and Fulton scale and Grading of Recommendations Assessment, Development and Evaluation (GRADE). Meta-analyses were grouped according to the biological matrix studied (serum/GCF) and groups (O+P+ vs. O−P+/O+P+ vs. O+P−). Out of the 832 studies screened, 21 were considered in qualitative synthesis and 15 in quantitative synthesis (meta-analysis). Although included studies showed mostly “no” or “minor” problems during the quality assessment, GRADE assessment indicated very low to moderate level of evidence based on the question answered. O+P+ adults exhibited significantly higher serum levels of C-reactive protein (CRP), interleukin 6 (IL-6), leptin, and tumor necrosis factor-α (TNF-alpha) and higher resistin GCF levels than O−P+. O+P+ adults showed significantly higher serum levels of IL-6 and leptin and lower adiponectin serum levels than O+P−. Only qualitative information could be obtained of the IM vaspin, omentin-1, chemerin, IL-10, progranulin, MCP-4, IL-1β, and interferon-γ (IFN-γ). Obesity and periodontitis, together or separately, are associated with altered serum and GCF levels of CRP, IL-6, leptin, TNF-alpha, adiponectin, and resistin. It was not possible to evaluate the association between obesity and periodontitis at salivary levels. The role of recently investigated biomarkers as vaspin, omentin-1, chemerin, IL-10, progranulin, MCP-4, IL-1β, and IFN-γ, which can be key points underlying the association between obesity and periodontitis, remains to be further investigated.
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Affiliation(s)
- Renata Scheeren Brum
- Department of Dentistry, Centre of Education and Research on Dental Implants (CEPID), Federal University of Santa Catarina, Florianópolis, Brazil
| | - Poliana Mendes Duarte
- Department of Dentistry, University of Guarulhos, Guarulhos, Brazil.,Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Graziela De Luca Canto
- Department of Dentistry, Brazilian Centre for Evidence-Based Research, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Carlos Flores-Mir
- Department of Orthodontics, School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - César Augusto Magalhães Benfatti
- Department of Dentistry, Centre of Education and Research on Dental Implants (CEPID), Federal University of Santa Catarina, Florianópolis, Brazil
| | - André Luís Porporatti
- Department of Dentistry, Brazilian Centre for Evidence-Based Research, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Gláucia Santos Zimmermann
- Department of Dentistry, Brazilian Centre for Evidence-Based Research, Federal University of Santa Catarina, Florianópolis, Brazil
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Mourouzis K, Oikonomou E, Siasos G, Tsalamadris S, Vogiatzi G, Antonopoulos A, Fountoulakis P, Goliopoulou A, Papaioannou S, Tousoulis D. Pro-inflammatory Cytokines in Acute Coronary Syndromes. Curr Pharm Des 2020; 26:4624-4647. [PMID: 32282296 DOI: 10.2174/1381612826666200413082353] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 04/01/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Over the last decades, the role of inflammation and immune system activation in the initiation and progression of coronary artery disease (CAD) has been established. OBJECTIVES The study aimed to present the interplay between cytokines and their actions preceding and shortly after ACS. METHODS We searched in a systemic manner the most relevant articles to the topic of inflammation, cytokines, vulnerable plaque and myocardial infarction in MEDLINE, COCHRANE and EMBASE databases. RESULTS Different classes of cytokines (intereleukin [IL]-1 family, Tumor necrosis factor-alpha (TNF-α) family, chemokines, adipokines, interferons) are implicated in the entire process leading to destabilization of the atherosclerotic plaque, and consequently, to the incidence of myocardial infarction. Especially IL-1 and TNF-α family are involved in inflammatory cell accumulation, vulnerable plaque formation, platelet aggregation, cardiomyocyte apoptosis and adverse remodeling following the myocardial infarction. Several cytokines such as IL-6, adiponectin, interferon-γ, appear with significant prognostic value in ACS patients. Thus, research interest focuses on the modulation of inflammation in ACS to improve clinical outcomes. CONCLUSION Understanding the unique characteristics that accompany each cytokine-cytokine receptor interaction could illuminate the signaling pathways involved in plaque destabilization and indicate future treatment strategies to improve cardiovascular prognosis in ACS patients.
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Affiliation(s)
- Konstantinos Mourouzis
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Evangelos Oikonomou
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Gerasimos Siasos
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Sotiris Tsalamadris
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Georgia Vogiatzi
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Alexios Antonopoulos
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Petros Fountoulakis
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Athina Goliopoulou
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Spyridon Papaioannou
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Dimitris Tousoulis
- 1st Department of Cardiology, 'Hippokration' Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
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Caillet J, Mignan S, Pham-Dang N, Devoize L. Analysis of leptin concentrations in oral fluids (saliva and crevicular gingival fluid) and blood in patients with chronic periodontal disease: systematic review of literature. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2020. [DOI: 10.1051/mbcb/2019037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Objective: The objective of this systematic analysis was to perform a qualitative and quantitative synthesis of the literature concerning salivary and serum leptin variations in patients with chronic periodontitis (CP) compared with healthy subjects. Saliva leptin concentration analysis could be a relevant and non-invasive biological test for the evaluation of periodontal disease in both medical and clinical trials, beyond the clinical and radiographic elements. Material and Method: Querying the PubMed and Web of Science databases identified articles that met our inclusion criteria. Quantitative analysis of the literature data was performed with the Review Manager 5.3 software. Results: The qualitative analysis included 14 articles and showed a decrease of salivary leptin (5 studies out of 5) and an increase of serum leptin (11 of 12 studies) in patients with CP compared to unaffected subjects of CP. Quantitative analysis was performed on 4 trials. For salivary leptin, we confirmed a decrease in its level in patients with CP with a standardized mean difference (SMD) of −2.27, 95% CI [−2.68, −1.86]. The difference was highly significant but we detected a very important heterogeneity in this dataset (I2 = 94%). For serum leptin, we also confirmed an increase in its rate in patients with CP with an SMD of 2.18, 95% CI [1.75, 2.61]. The difference was highly significant but the heterogeneity measured in this dataset was also too high (I2 = 95%). Conclusion: The current level of evidence was insufficient to assert an increase in serum leptin and a decrease in salivary leptin in CP patients compared to healthy controls due to a great heterogeneity of the values measured in the studies.
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Kumari M, Patthi B, Jankiram C, Singla A, Malhi R, Rajeev A. Risk of having myocardial infarction in periodontal disease patients: A systematic review. JOURNAL OF INDIAN ASSOCIATION OF PUBLIC HEALTH DENTISTRY 2019. [DOI: 10.4103/jiaphd.jiaphd_15_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Leira Y, Ameijeira P, Domínguez C, Leira R, Blanco J. The role of leptin as a biomarker in the relationship between periodontitis and chronic migraine. J Clin Periodontol 2017; 44:1208-1214. [PMID: 28922461 DOI: 10.1111/jcpe.12819] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2017] [Indexed: 01/03/2023]
Abstract
AIM To evaluate the prevalence of periodontitis (CP) and its contribution to serum leptin levels in chronic migraine (CM). MATERIAL AND METHODS In this case-control study, we included 150 subjects divided into healthy controls (n = 58) and CM patients (n = 92). Demographic, neurological, clinical data as well as full-mouth periodontal records were obtained. Serum leptin levels were measured by ELISA technique. RESULTS Both the prevalence of CP and mean serum leptin levels were significantly higher in patients with CM in comparison with controls (57.6% versus 36.2%, p = .01 and 16.4 versus 7.2 ng/ml, p < .0001, respectively). Patients from the CM group who had CP showed significantly higher leptin concentrations than CM patients without CP (19.8 versus 11.8 ng/ml, p < .0001). Multivariable linear regression analysis showed that CP was an independent contributor to raised leptin levels in CM patients (R2 = 0.270, p = 0.013). CONCLUSIONS CP is prevalent in CM patients and when present it contributes to elevated serum leptin levels, independently of other confounding factors. Therefore, it seems that CP via leptin could be involved in the process of migraine chronification.
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Affiliation(s)
- Yago Leira
- Periodontology Unit, Faculty of Medicine and Odontology, University of Santiago de Compostela, Santiago de Compostela, Spain.,Odontología Médico-Quirúrgica (OMEQUI) Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Pablo Ameijeira
- Periodontology Unit, Faculty of Medicine and Odontology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Clara Domínguez
- Service of Neurology, Headache Unit, Hospital Clínico Universitario, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Rogelio Leira
- Service of Neurology, Headache Unit, Hospital Clínico Universitario, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Juan Blanco
- Periodontology Unit, Faculty of Medicine and Odontology, University of Santiago de Compostela, Santiago de Compostela, Spain.,Odontología Médico-Quirúrgica (OMEQUI) Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
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Zhu J, Guo B, Gan X, Zhang L, He Y, Liu B, Chen X, Zhang S, Yu H. Association of circulating leptin and adiponectin with periodontitis: a systematic review and meta-analysis. BMC Oral Health 2017; 17:104. [PMID: 28662701 PMCID: PMC5492908 DOI: 10.1186/s12903-017-0395-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 06/19/2017] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND This study aimed to assess the difference in serum levels of leptin and adiponectin in patients with periodontitis and in periodontally healthy individuals and evaluate the changes in circulating leptin and adiponectin after periodontal therapy. Leptin and adiponectin are the most generally studied adipokines that function as inflammatory cytokines. Although the association between periodontitis and serum levels of leptin and adiponectin has been studied extensively, the results were not consistent. METHODS A systematic search of the Pubmed, Embase, Web of Science, and Cochrane Library up to September 2016 was conducted. The studies were screened and selected by two writers according to the specific eligibility criteria. The quality of included cross-sectional studies was assessed using the quality assessment form recommended by the Agency for Healthcare Research and Quality and Methodological Index for Nonrandomized Studies. The meta-analyses were conducted using the STATA 12.0 software. RESULTS A total of 399 manuscripts were yielded and 25 studies were included in the present meta-analysis. Significantly elevated serum levels of leptin and decreased serum levels of adiponectin in patients with periodontitis were observed in the subgroup analysis of body mass index (BMI) <30. The overall and subgroup analyses showed no significant change in the serum levels of leptin in patients with periodontitis after periodontal treatment. The subgroup analysis of systemically healthy patients showed no significant change in serum levels of adiponectin in patients with periodontitis after periodontal treatment. CONCLUSIONS The present meta-analysis supported elevated serum levels of leptin and decreased serum levels of adiponectin in patients with periodontitis compared with controls in the BMI <30 population. In systemically healthy patients with periodontitis, serum levels of leptin and adiponectin do not significantly change after periodontal treatment.
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Affiliation(s)
- Junfei Zhu
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, 610041 China
| | - Bin Guo
- Institute of Stomatology of Chinese PLA General Hospital, 28 Fuxing Road,Haidian District, Beijing, 100853 People’s Republic of China
| | - Xueqi Gan
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, 610041 China
| | - Ling Zhang
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, 610041 China
| | - Yuting He
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, 610041 China
| | - Beilei Liu
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, 610041 China
| | - Xin Chen
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, 610041 China
| | - Suhan Zhang
- West China Medical School, Sichuan University, Chengdu, 610041 China
| | - Haiyang Yu
- Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041 China
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Different Intestinal Microbial Profile in Over-Weight and Obese Subjects Consuming a Diet with Low Content of Fiber and Antioxidants. Nutrients 2017; 9:nu9060551. [PMID: 28555008 PMCID: PMC5490530 DOI: 10.3390/nu9060551] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 05/18/2017] [Accepted: 05/23/2017] [Indexed: 02/06/2023] Open
Abstract
Obesity has been related to an increased risk of multiple diseases in which oxidative stress and inflammation play a role. Gut microbiota has emerged as a mediator in this interaction, providing new mechanistic insights at the interface between fat metabolism dysregulation and obesity development. Our aim was to analyze the interrelationship among obesity, diet, oxidative stress, inflammation and the intestinal microbiota in 68 healthy adults (29.4% normal-weight). Diet was assessed through a food frequency questionnaire and converted into nutrients and dietary compounds using food composition tables. The intestinal microbiota was assessed by quantitative PCR, fecal short chain fatty acids by gas chromatography and serum biomarkers by standard protocols. Higher levels of malondialdehyde (MDA), C reactive protein (CRP), serum leptin, glucose, fat percentage and the intestinal Lactobacillus group were found in the obese people. Cluster analysis of body mass index, fat mass, glucose, LDL/HDL ratio, leptin, MDA and CRP classified the subjects into two groups. The levels of the intestinal Bacteroides-Prevotella-Porphyromonas group were lower in the cluster and linked to a higher pro-oxidant and pro-inflammatory status, whose individuals also had lower intake of fruits, dried fruits, and fish. These results could be useful for designing strategies targeted to obesity prevention.
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Pérez-Pérez A, Vilariño-García T, Fernández-Riejos P, Martín-González J, Segura-Egea JJ, Sánchez-Margalet V. Role of leptin as a link between metabolism and the immune system. Cytokine Growth Factor Rev 2017; 35:71-84. [PMID: 28285098 DOI: 10.1016/j.cytogfr.2017.03.001] [Citation(s) in RCA: 173] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 03/01/2017] [Accepted: 03/02/2017] [Indexed: 12/24/2022]
Abstract
Leptin is an adipocyte-derived hormone not only with an important role in the central control of energy metabolism, but also with many pleiotropic effects in different physiological systems. One of these peripheral functions of leptin is a regulatory role in the interplay between energy metabolism and the immune system, being a cornerstone of the new field of immunometabolism. Leptin receptor is expressed throughout the immune system and the regulatory effects of leptin include cells from both the innate and adaptive immune system. Leptin is one of the adipokines responsible for the inflammatory state found in obesity that predisposes not only to type 2 diabetes, metabolic syndrome and cardiovascular disease, but also to autoimmune and allergic diseases. Leptin is an important mediator of the immunosuppressive state in undernutrition status. Placenta is the second source of leptin and it may play a role in the immunomodulation during pregnancy. Finally, recent work has pointed to the participation of leptin and leptin receptor in the pathophysiology of inflammation in oral biology. Therefore, leptin and leptin receptor should be considered for investigation as a marker of inflammation and immune activation in the frontier of innate-adaptive system, and as possible targets for intervention in the immunometabolic mediated pathophysiology.
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Affiliation(s)
- Antonio Pérez-Pérez
- Department of Medical Biochemistry and Molecular Biology and Immunology, Medical School and Department of Clinical Biochemistry, Virgen Macarena University Hospital, University of Seville, Spain
| | - Teresa Vilariño-García
- Department of Medical Biochemistry and Molecular Biology and Immunology, Medical School and Department of Clinical Biochemistry, Virgen Macarena University Hospital, University of Seville, Spain
| | - Patricia Fernández-Riejos
- Department of Medical Biochemistry and Molecular Biology and Immunology, Medical School and Department of Clinical Biochemistry, Virgen Macarena University Hospital, University of Seville, Spain
| | - Jenifer Martín-González
- Department of Stomatology (Endodontics Section), School of Dentistry, University of Seville, Seville, Spain
| | - Juan José Segura-Egea
- Department of Stomatology (Endodontics Section), School of Dentistry, University of Seville, Seville, Spain
| | - Víctor Sánchez-Margalet
- Department of Medical Biochemistry and Molecular Biology and Immunology, Medical School and Department of Clinical Biochemistry, Virgen Macarena University Hospital, University of Seville, Spain.
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Luo S, Yang X, Wang D, Ni J, Wu J, Xu Z, Xuan D, Zhang J. Periodontitis contributes to aberrant metabolism in type 2 diabetes mellitus rats by stimulating the expression of adipokines. J Periodontal Res 2015; 51:453-61. [PMID: 26456152 DOI: 10.1111/jre.12322] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2015] [Indexed: 12/16/2022]
Affiliation(s)
- S. Luo
- Department of Periodontology; Guangdong Provincial Stomatological Hospital; Southern Medical University; Haizhu District Guangzhou China
| | - X. Yang
- Department of Periodontology; Guangdong Provincial Stomatological Hospital; Southern Medical University; Haizhu District Guangzhou China
| | - D. Wang
- Department of Periodontology; Guangdong Provincial Stomatological Hospital; Southern Medical University; Haizhu District Guangzhou China
| | - J. Ni
- Department of Periodontology; Guangdong Provincial Stomatological Hospital; Southern Medical University; Haizhu District Guangzhou China
| | - J. Wu
- Department of Periodontology; Guangdong Provincial Stomatological Hospital; Southern Medical University; Haizhu District Guangzhou China
| | - Z. Xu
- Department of Periodontology; Guangdong Provincial Stomatological Hospital; Southern Medical University; Haizhu District Guangzhou China
| | - D. Xuan
- Department of Periodontology; Guangdong Provincial Stomatological Hospital; Southern Medical University; Haizhu District Guangzhou China
| | - J. Zhang
- Department of Periodontology; Guangdong Provincial Stomatological Hospital; Southern Medical University; Haizhu District Guangzhou China
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13
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Shi D, Liu YY, Li W, Zhang X, Sun XJ, Xu L, Zhang L, Chen ZB, Meng HX. Association between plasma leptin level and systemic inflammatory markers in patients with aggressive periodontitis. Chin Med J (Engl) 2015; 128:528-32. [PMID: 25673458 PMCID: PMC4836259 DOI: 10.4103/0366-6999.151110] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background: Increasing evidence supports an association between periodontitis and systemic diseases. Leptin is involved both in the energy metabolism and inflammatory processes and is suggested to be a link between periodontal infection and systemic health. The present study aimed to evaluate the peripheral leptin concentration in patients with aggressive periodontitis (AgP) and to explore the relationship between leptin and systemic inflammation. Methods: Ninety patients with AgP visiting the Clinic of the Periodontology Department, Peking University School and Hospital of Stomatology between July 2001 and May 2006, and 44 healthy controls (staff and student volunteers in the same institute) were recruited. Plasma levels of leptin and inflammatory cytokines including interleukin (IL)-1β, IL-6, tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) were measured by enzyme-linked immunosorbent assay. Correlation and multiple linear regression analysis were performed to analyze the association between plasma leptin level and other variables. Results: Plasma leptin level of AgP group was significantly higher than that of the control group (19.7 ± 4.4 ng/ml vs. 7.5 ± 1.3 ng/ml, P < 0.01). After controlling for age, gender, and body mass index, positive correlation was observed between plasma leptin concentration and log-transformed levels of pro-inflammatory cytokines (IL-1β, IL-6, TNF-α and CRP), and the partial correlation coefficients ranged from 0.199 to 0.376 (P < 0.05). Log-transformed IL-1β and IL-6 levels entered the final regression model (standardized β were 0.422 and 0.461 respectively, P < 0.01). Conclusions: Elevated plasma leptin concentration may be associated with increased systemic levels of inflammatory markers in AgP patients.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Huan-Xin Meng
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China
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Selvarajan S, Perumalsamy R, Emmadi P, Thiagarajan R, Namasivayam A. Association Between Gingival Crevicular Fluid Leptin Levels and Periodontal Status - A Biochemical Study on Indian Patients. J Clin Diagn Res 2015; 9:ZC48-53. [PMID: 26155562 PMCID: PMC4484154 DOI: 10.7860/jcdr/2015/12335.5941] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 03/16/2015] [Indexed: 02/04/2023]
Abstract
AIM The present study was carried out to evaluate and compare the gingival crevicular fluid (GCF) concentrations of leptin in periodontally healthy and diseased subjects, to compare GCF leptin levels with respect to Body Mass Index (BMI) among the study groups and essentially to obtain an insight into leptin's possible role in the initiation and progression of periodontal disease. MATERIALS AND METHODS A total of 60 subjects; both males and females, based on their body mass index were selected for the study. They were categorized into three groups of 20 subjects each, based on their periodontal status, as follows: Group I (clinically healthy periodontium); Group II (gingivitis); Group III (chronic periodontitis). GCF samples of 1 μl were collected extra-crevicularly using black color-coded 1-5 μl calibrated volumetric microcapillary pipettes from one site in each person, and samples were analyzed for leptin using a commercially available ELISA kit. RESULTS The concentration of leptin in GCF of patients in Group I (2272.25 pg/mL) was statistically higher (p < 0.001) than in those of Group II (1421.86 pg/mL) and Group III (1160.67 pg/mL). No statistically significant difference was found when comparing the mean values of leptin between BMI groups in each study group. CONCLUSION As periodontal disease progressed, there was a substantial decrease in the gingival crevicular fluid leptin concentration. This suggests a protective role of leptin with regard to periodontal health.
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Affiliation(s)
- Shalini Selvarajan
- Senior Lecturer, Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Alapakkam Main Road, Maduaravoyal, Chennai, India
| | - Rajapriya Perumalsamy
- Senior Lecturer, Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Alapakkam Main Road, Maduaravoyal, Chennai, India
| | - Pamela Emmadi
- Professor, Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Alapakkam Main Road, Maduaravoyal, Chennai, India
| | - Ramakrishnan Thiagarajan
- Professor, Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Alapakkam Main Road, Maduaravoyal, Chennai, India
| | - Ambalavanan Namasivayam
- Professor & HOD, Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Alapakkam Main Road, Maduaravoyal, Chennai, India
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15
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Purwar P, Khan MA, Gupta A, Mahdi AA, Pandey S, Singh B, Dixit J, Rai P. The effects of periodontal therapy on serum and salivary leptin levels in chronic periodontitis patients with normal body mass index. Acta Odontol Scand 2015; 73:633-41. [PMID: 25854413 DOI: 10.3109/00016357.2015.1030768] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
SUMMARY Leptin concentrations are altered in favour of pro health after periodontal therapy. BACKGROUND Leptin, a non-glycosylated peptide hormone, not only maintains fat stores, but is also an integral part of host defense repertoire. Leptin levels have been found to be altered in an array of inflammatory diseases including chronic periodontitis (CP), but the role of non-surgical periodontal therapy (NSPT) in altering the leptin concentrations in saliva and serum of CP patients is yet to be ascertained. The aim of the present study is to quantify leptin levels in CP patients having normal body mass index (BMI) pre-therapy as compared to periodontally healthy controls and to address whether successful NSPT alters leptin concentration in serum and saliva. MATERIALS AND METHODS Twenty-two saliva (modified draining method) and serum samples (by venipuncture) were collected from CP patients with normal BMI (n = 22), before and at 4 and 12 weeks after completion of NSPT, and periodontally healthy, age- and gender-matched controls (n = 22). Leptin levels were estimated using enzyme linked immunosorbent assay kits. RESULTS At baseline, CP patients had significantly different periodontal clinical parameters and the leptin concentrations in saliva of CP patients were found to be significantly lower than periodontally healthy volunteers (4710.10 ± 1133.21 vs 8721.10 ± 1019.58 pg/ml) (p < 0.05), whereas in serum the leptin concentrations were significantly higher than healthy controls (10749 ± 2062.24 vs 8085.00 ± 2859.68 pg/ml). Significant improvement in periodontal parameters, serum and salivary leptin levels were observed in CP patients at 4 and 12 weeks post-therapy (p < 0.01). CONCLUSION Altered concentrations of leptin in serum and saliva are observed in CP patients which can be restored in favor of health after periodontal therapy.
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Affiliation(s)
- Parth Purwar
- Department of Periodontology, Faculty of Dental Sciences, King George's Medical University , Lucknow, Uttar Pradesh , India
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16
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Zeigler CC, Wondimu B, Marcus C, Modéer T. Pathological periodontal pockets are associated with raised diastolic blood pressure in obese adolescents. BMC Oral Health 2015; 15:41. [PMID: 25884594 PMCID: PMC4373518 DOI: 10.1186/s12903-015-0026-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 03/10/2015] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Obesity, a well-known risk factor for developing cardiovascular disease (CVD), is associated with chronic periodontitis in adults. This cross-sectional pilot study on obese adolescents was designed to investigate whether periodontal disease in terms of pathological periodontal pockets is associated with raised blood pressure and other risk markers for CVD. METHODS The study included 75 obese subjects between 12 to 18 years of age, mean 14.5. Subjects answered a questionnaire regarding health, oral hygiene habits and sociodemographic factors. A clinical examination included Visible Plaque Index (VPI %), Gingival inflammation (BOP %) and the occurrence of pathological pockets exceeding 4 mm (PD ≥ 4 mm). Blood serum were collected and analyzed. The systolic and diastolic blood pressures were registered. RESULTS Adolescents with pathological periodontal pockets (PD ≥ 4 mm; n = 14) had significantly higher BOP >25% (P = 0.002), higher diastolic blood pressure (P = 0.008), higher levels of Interleukin (IL)-6 (P < 0.001), Leptin (P = 0.018), Macrophage Chemoattractant Protein-1 (MCP-1) (P = 0.049) and thyroid stimulating hormone (TSH) (P = 0.004) in blood serum compared with subjects without pathological periodontal pockets (PD ≥ 4 mm; n = 61). The bivariate linear regression analysis demonstrated that PD ≥ 4 mm (P = 0.008) and systolic blood pressure (P < 0.001) were significantly associated with the dependent variable "diastolic blood pressure". The association between PD ≥ 4 mm and diastolic blood pressure remained significant (P = 0.006) even after adjusting for potential confounders BMI-sds, age, gender, mother's country of birth, BOP >25%, IL-6, IL-8, Leptin, MCP-1, TSH and total cholesterol in the multiple regression analysis. CONCLUSION In conclusion, this study indicates an association between pathological periodontal pockets and diastolic blood pressure in obese adolescents. The association was unaffected by other risk markers for cardiovascular events or periodontal disease. The results call for collaboration between pediatric dentists and medical physicians in preventing obesity development and its associated disorders.
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Affiliation(s)
- Cecilia C Zeigler
- Division of Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Box 4064, SE-141 04, Huddinge, Stockholm, Sweden.
| | - Biniyam Wondimu
- Division of Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Box 4064, SE-141 04, Huddinge, Stockholm, Sweden.
| | - Claude Marcus
- National Childhood Obesity Centre, Division of Pediatrics Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
| | - Thomas Modéer
- Division of Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Box 4064, SE-141 04, Huddinge, Stockholm, Sweden.
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Purwar P, Khan MA, Mahdi AA, Pandey S, Singh B, Dixit J, Sareen S. Salivary and serum leptin concentrations in patients with chronic periodontitis. J Periodontol 2014; 86:588-94. [PMID: 25537001 DOI: 10.1902/jop.2014.140581] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND The discovery of leptin has led to the elucidation of a robust physiologic system that not only maintains fat stores but is also an integral part of the host defense mechanism. However, leptin concentrations in the saliva of patients with chronic periodontitis (CP) has not been explored despite the potential role of salivary biomarkers in determining the presence, risk, and progression of periodontal disease. METHODS Eighty-four participants (44 with generalized severe CP and 40 without periodontitis) were enrolled. For each patient, the values of periodontal parameters were recorded, such as plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment loss (AL), and percentage of sites with bleeding on probing (BOP) and clinical AL ≥5 mm. Saliva and serum samples were collected to estimate the leptin concentrations using enzyme-linked immunosorbent assay kits. Statistical analysis was performed using software. RESULTS Participants with CP demonstrated significantly higher BOP, PI, GI, and percentage of sites with clinical AL >5 mm (P <0.05). Leptin was detectable in all the clinical samples. Salivary leptin concentrations in patients with CP were significantly lower than in healthy volunteers (6,200.61 ± 2,322.11 versus 8,799.60 ± 901.70 pg/mL), whereas serum leptin concentrations were significantly higher in patients with CP than in healthy volunteers (11,600.00 ± 1,705.01 versus 7,616.62 ± 1,169.83 pg/mL). In addition, the results reflected a significant negative correlation of salivary leptin and a positive correlation of serum leptin with PD (P <0.05). CONCLUSION The results suggest that leptin concentrations in saliva and serum are significantly altered in CP and relate closely to current disease activity; however, further studies are needed to confirm the findings.
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Affiliation(s)
- Parth Purwar
- Department of Periodontology, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
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18
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Nokhbehsaim M, Keser S, Nogueira AVB, Jäger A, Jepsen S, Cirelli JA, Bourauel C, Eick S, Deschner J. Leptin effects on the regenerative capacity of human periodontal cells. Int J Endocrinol 2014; 2014:180304. [PMID: 25136363 PMCID: PMC4129942 DOI: 10.1155/2014/180304] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 06/26/2014] [Accepted: 07/04/2014] [Indexed: 01/10/2023] Open
Abstract
Obesity is increasing throughout the globe and characterized by excess adipose tissue, which represents a complex endocrine organ. Adipose tissue secrets bioactive molecules called adipokines, which act at endocrine, paracrine, and autocrine levels. Obesity has recently been shown to be associated with periodontitis, a disease characterized by the irreversible destruction of the tooth-supporting tissues, that is, periodontium, and also with compromised periodontal healing. Although the underlying mechanisms for these associations are not clear yet, increased levels of proinflammatory adipokines, such as leptin, as found in obese individuals, might be a critical pathomechanistic link. The objective of this study was to examine the impact of leptin on the regenerative capacity of human periodontal ligament (PDL) cells and also to study the local leptin production by these cells. Leptin caused a significant downregulation of growth (TGFβ1, and VEGFA) and transcription (RUNX2) factors as well as matrix molecules (collagen, and periostin) and inhibited SMAD signaling under regenerative conditions. Moreover, the local expression of leptin and its full-length receptor was significantly downregulated by inflammatory, microbial, and biomechanical signals. This study demonstrates that the hormone leptin negatively interferes with the regenerative capacity of PDL cells, suggesting leptin as a pathomechanistic link between obesity and compromised periodontal healing.
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Affiliation(s)
- Marjan Nokhbehsaim
- Experimental Dento-Maxillo-Facial Medicine, University of Bonn, 53111 Bonn, Germany
- Clinical Research Unit 208, University of Bonn, 53111 Bonn, Germany
| | - Sema Keser
- Clinical Research Unit 208, University of Bonn, 53111 Bonn, Germany
| | - Andressa Vilas Boas Nogueira
- Clinical Research Unit 208, University of Bonn, 53111 Bonn, Germany
- Department of Diagnosis and Surgery, School of Dentistry, UNESP, 14801-903 Araraquara, SP, Brazil
| | - Andreas Jäger
- Clinical Research Unit 208, University of Bonn, 53111 Bonn, Germany
- Department of Orthodontics, University of Bonn, 53111 Bonn, Germany
| | - Søren Jepsen
- Clinical Research Unit 208, University of Bonn, 53111 Bonn, Germany
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, 53111 Bonn, Germany
| | - Joni Augusto Cirelli
- Department of Diagnosis and Surgery, School of Dentistry, UNESP, 14801-903 Araraquara, SP, Brazil
| | - Christoph Bourauel
- Clinical Research Unit 208, University of Bonn, 53111 Bonn, Germany
- Oral Technology, Center of Dento-Maxillo-Facial Medicine, University of Bonn, 53111 Bonn, Germany
| | - Sigrun Eick
- Department of Periodontology, Laboratory of Oral Microbiology, University of Bern, 3010 Bern, Switzerland
| | - James Deschner
- Experimental Dento-Maxillo-Facial Medicine, University of Bonn, 53111 Bonn, Germany
- Clinical Research Unit 208, University of Bonn, 53111 Bonn, Germany
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Martín-González J, Sánchez-Jiménez F, Pérez-Pérez A, Carmona-Fernández A, Sánchez-Margalet V, Segura-Egea JJ. Leptin expression in healthy and inflamed human dental pulp. Int Endod J 2012; 46:442-8. [DOI: 10.1111/iej.12009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Accepted: 09/04/2012] [Indexed: 01/03/2023]
Affiliation(s)
- J. Martín-González
- Department of Stomatology (Endodontics section); School of Dentistry,; University of Sevilla,; Sevilla; Spain
| | - F. Sánchez-Jiménez
- Department of Medical Biochemistry and Molecular Biology; Virgen Macarena Hospital,; University of Sevilla,; Sevilla; Spain
| | - A. Pérez-Pérez
- Department of Medical Biochemistry and Molecular Biology; Virgen Macarena Hospital,; University of Sevilla,; Sevilla; Spain
| | - A. Carmona-Fernández
- Department of Medical Biochemistry and Molecular Biology; Virgen Macarena Hospital,; University of Sevilla,; Sevilla; Spain
| | - V. Sánchez-Margalet
- Department of Medical Biochemistry and Molecular Biology; Virgen Macarena Hospital,; University of Sevilla,; Sevilla; Spain
| | - J. J. Segura-Egea
- Department of Stomatology (Endodontics section); School of Dentistry,; University of Sevilla,; Sevilla; Spain
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