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Kudiyirickal MG, Pappachan JM. Periodontitis: An often-neglected complication of diabetes. World J Diabetes 2024; 15:318-325. [PMID: 38591080 PMCID: PMC10999051 DOI: 10.4239/wjd.v15.i3.318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/15/2024] [Accepted: 02/07/2024] [Indexed: 03/15/2024] Open
Abstract
The bidirectional association between type 2 diabetes mellitus (T2DM) and periodontitis is now well established, resulting in periodontal disease being considered as the 6th major complication of diabetes mellitus (DM) after car-diovascular disease, eye disease, neuropathy, nephropathy, and peripheral vascular disease. DM can worsen the virulence and invasiveness of pathogenic oral microbial flora aggravating the local inflammation and infection in those with periodontal disease. On the other hand, the chemical and immunological mediators released into the circulation as part of periodontal inflammation worsen the systemic insulin resistance with worsening of T2DM. Periodontitis if undiagnosed or left untreated can also result in eventual tooth loss. A study by Xu et al in the World Journal of Diabetes examined the predictive factors associated with periodontitis in Chinese patients with T2DM. The prevalence of periodontitis was found to be 75.7% in this study. Based on logistic regression analysis, the predictive factors for higher risk were low tooth brushing frequency [odds ratio (OR) = 4.3], high triglycerides (TG; OR = 3.31), high total cholesterol (TC; OR = 2.87), higher glycated hemoglobin (HbA1c; OR = 2.55), and higher age (OR = 1.05) while higher education level was protective (OR = 0.53). However, the most influential variables were HbA1c followed by age, TC, TG, low education level, brushing frequency, and sex on the random forest model (this model showed higher sensitivity for predicting the risk). A good understanding of the predictors for periodontitis in T2DM patients is important in prevention, early detection of susceptible patients, and intervention to improve periodontal health and enable long-term glycaemic control as observed by Xu et al.
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Affiliation(s)
| | - Joseph M Pappachan
- Department of Endocrinology and Metabolism, Lancashire Teaching Hospitals NHS Trust, Preston PR2 9HT, United Kingdom
- Faculty of Science, Manchester Metropolitan University, Manchester M15 6BH, United Kingdom
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, United Kingdom
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Lu H, Sun J, Sun J. Identification of potential crosstalk genes and mechanisms between periodontitis and diabetic nephropathy through bioinformatic analysis. Medicine (Baltimore) 2023; 102:e36802. [PMID: 38206700 PMCID: PMC10754619 DOI: 10.1097/md.0000000000036802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 12/06/2023] [Indexed: 01/13/2024] Open
Abstract
Periodontitis and diabetic nephropathy are significant public health concerns globally and are closely related with each other. This study aimed to identify potential crosstalk genes, pathways, and mechanisms associated with the interaction between periodontitis and diabetic nephropathy. Expression profiles of periodontitis and diabetic nephropathy were retrieved from the Gene expression omnibus gene expression omnibus database, and differentially expressed genes (DEGs) were screened, followed by identification of co-expressed differential genes. Gene ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed using R software. A protein-protein interaction network was constructed via STRING website, and key crosstalk genes were selected using Cytoscape. Subsequent gene ontology and KEGG analyses were conducted for the key genes, and a validation dataset was obtained from the gene expression omnibus database for differential gene validation. The TRRUST website was employed to identify transcription factors (TFs) associated with the key crosstalk genes between periodontitis and diabetic nephropathy, followed by differential analysis of TFs. A total of 17 crosstalk genes were obtained. Among them, SAMSN1, BCL2A1, interleukin-19, IL1B, RGS1, CXCL3, CCR1, CXCR4, CXCL1, and PTGS2 were identified as key crosstalk genes between periodontitis and diabetic nephropathy. Additionally, 16 key TFs were discovered. This bioinformatic analysis revealed potential crosstalk genes between periodontitis and diabetic nephropathy. The identified key genes participate in signaling pathways, including cytokine signaling and chemokine signaling transduction, which might collectively influence these 2 diseases. These genes may serve as potential biomarkers guiding future research in this field.
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Affiliation(s)
- Huijuan Lu
- Department of Nephrology, First People’s Hospital of Linping District, Hangzhou, China
| | - Jia Sun
- Department of Nephrology, First People’s Hospital of Linping District, Hangzhou, China
| | - Jieqiong Sun
- Department of Nephrology, First People’s Hospital of Linping District, Hangzhou, China
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Shah M, Poojari M, Nadig P, Kakkad D, Dutta SB, Sinha S, Chowdhury K, Dagli N, Haque M, Kumar S. Vitamin D and Periodontal Health: A Systematic Review. Cureus 2023; 15:e47773. [PMID: 37899906 PMCID: PMC10612541 DOI: 10.7759/cureus.47773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2023] [Indexed: 10/31/2023] Open
Abstract
The role of vitamin D in maintaining gum well-being is crucial. However, scientific research reported that the connotations of cholecalciferol and periodontal health have been divested in the present literature. However, there is enormous heterogeneity in the data available. The current review aims to systematically review and appraise the available literature investigating the role of vitamin D in maintaining periodontal health. Studies included randomized controlled trials and clinical trials following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and cohort studies reporting associations between vitamin D and oral health in systemically healthy patients. Databases such as PubMed, Google Scholar, Scopus, Embase, and other sources, including hand search, were searched until May 2023 using together-equipped search sequences. Altogether, scientific articles that conform to the inclusion principles underwent a thorough eminence evaluation. All papers meeting inclusion criteria were subject to quality assessment, and the method used to assess the risk of bias was the Cochrane risk of bias tool. The search identified 1883 papers, among which 1435 were excluded after title evaluation. After abstract and title screening, 455 were excluded, and six full texts were assessed. After full-text evaluation, two articles were excluded, and only four were included. The data shows vitamin D's association with oral health maintenance. Along with its action on bone metabolism, it has extended function, which provides for its action as an anti-inflammatory agent and production of anti-microbial peptides, which help maintain oral health. Although the literature available is immense, there is enormous heterogenicity in the papers conducted to appraise the association between vitamin D and oral health. This systematic review has filtered all the data to review a few essential aspects of the role of vitamin D in maintaining oral physiology. Vitamin D has a linear relationship with periodontal health; however, the evidence is insufficient, and further studies must be done.
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Affiliation(s)
- Monali Shah
- Periodontology, KM Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, IND
| | - Megha Poojari
- Periodontology, KM Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, IND
| | - Prasad Nadig
- Periodontology, KM Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, IND
| | - Dinta Kakkad
- Public Health Dentistry, Gujarat University, Ahmedabad, IND
| | | | - Susmita Sinha
- Physiology, Khulna City Medical College and Hospital, Khulna, BGD
| | - Kona Chowdhury
- Pediatrics, Gonoshasthaya Samaj Vittik Medical College, Dhaka, BGD
| | - Namrata Dagli
- Dental Research, Karnavati School of Dentistry, Karnavati University, Gandhinagar, IND
| | - Mainul Haque
- Research, Karnavati School of Dentistry, Karnavati University, Gandhinagar, IND
- Pharmacology and Therapeutics, National Defence University of Malaysia, Kuala Lumpur, MYS
| | - Santosh Kumar
- Periodontology and Implantology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, IND
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Gibson AA, Cox E, Gale J, Craig ME, King S, Chow CK, Colagiuri S, Nassar N. Association of oral health with risk of incident micro and macrovascular complications: A prospective cohort study of 24,862 people with diabetes. Diabetes Res Clin Pract 2023; 203:110857. [PMID: 37563015 DOI: 10.1016/j.diabres.2023.110857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/20/2023] [Accepted: 07/26/2023] [Indexed: 08/12/2023]
Abstract
AIMS To investigate the association between self-reported oral health and incident micro and macrovascular diabetes complications. METHODS This prospective cohort study linked data from the 45 and Up Study, Australia, to administrative health records. The participants were 24,862 men and women, aged ≥45 years, with diabetes at baseline (2006-2009). The oral health of participants was assessed by questionnaire. Incident diabetes complications were determined using hospitalisation data and claims for medical services up until 2019. Hazard ratios for the association between oral health and incident complications were calculated using multivariable cox proportional hazards models. RESULTS Almost 60 % of participants had <20 teeth, and 38 % rated their teeth and gums as fair or poor. Compared with those with ≥20 teeth, those with 0 teeth had an increased risk of cardiovascular disease (aHR 1.24, 95 % CI: 1.15, 1.35), lower limb (aHR 1.22, 95 % CI: 1.11, 1.33) and kidney (aHR 1.19, 95 % CI: 1.11, 1.29) complications. Individuals with 1-9 teeth had an increased risk of eye complications (aHR 1.14, 95 % CI: 1.07, 1.22). The associations were generally consistent for poor self-rated teeth and gums. CONCLUSIONS Self-reported oral health measures may be a marker of elevated risk of complications in people with diabetes.
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Affiliation(s)
- Alice A Gibson
- Menzies Centre for Health Policy and Economics, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; Charles Perkins Centre, The University of Sydney, NSW, Australia.
| | - Emma Cox
- Menzies Centre for Health Policy and Economics, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; Charles Perkins Centre, The University of Sydney, NSW, Australia
| | - Joanne Gale
- Menzies Centre for Health Policy and Economics, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Maria E Craig
- Charles Perkins Centre, The University of Sydney, NSW, Australia; Discipline of Paediatrics & Child Health, School of Clinical Medicine, UNSW Medicine & Health, Sydney, NSW, Australia
| | - Shalinie King
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; Sydney Dental School, Faculty of Medicine and Heath, The University of Sydney, NSW, Australia
| | - Clara K Chow
- Charles Perkins Centre, The University of Sydney, NSW, Australia; Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; Department of Cardiology, Westmead Hospital, NSW, Australia
| | - Stephen Colagiuri
- Charles Perkins Centre, The University of Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Natasha Nassar
- Menzies Centre for Health Policy and Economics, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; Charles Perkins Centre, The University of Sydney, NSW, Australia; Child Population and Translational Health Research, The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
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Aroonrangsee T, Chairatnathrongporn R, Surarit R, Tansriratanawong K, Santiprabhob J, Boriboonhirunsarn C, Promsudthi A. Salivary Oxidative Stress Biomarkers in Thai Adolescents and Young Adults with Type 1 Diabetes Mellitus: A Cross-Sectional Study. J Int Soc Prev Community Dent 2023; 13:333-341. [PMID: 37876587 PMCID: PMC10593366 DOI: 10.4103/jispcd.jispcd_38_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 07/23/2023] [Accepted: 07/25/2023] [Indexed: 10/26/2023] Open
Abstract
Aims and Objectives The primary objectives of this study were to compare salivary oxidative stress (OS) biomarker levels in patients with type 1 diabetes mellitus (T1DM) and without T1DM (non-T1DM) and evaluate the relationships between diabetes, periodontal status, and OS biomarker levels. Materials and Methods Twenty patients with T1DM and 20 age-matched patients without T1DM were enrolled. All participants were 15-23 years of age and had permanent dentition. Unstimulated whole saliva was collected in a sterile test tube before examination of clinical periodontal parameters, including bleeding on probing (BOP). Salivary levels of OS biomarkers-malondialdehyde, protein carbonyl, total oxidant status (TOS), and total antioxidant capacity-were determined using oxidative and antioxidative assays followed by spectrophotometric measurement at 375-532 nm. The relationships between diabetes, periodontal status, and OS biomarkers were analyzed using multiple linear regression. Results TOS was significantly lower in the T1DM group compared with the non-T1DM group (5.06 ± 0.39 vs. 6.44 ± 0.51 µmol H2O2 Eq/l, P = 0.035). After adjusting for confounding factors (age, gender, BMI, clinical periodontal parameters, BOP, or diabetes status accordingly), the multiple linear regression showed that T1DM was significantly associated with a reduction of TOS level (P = 0.008). The BOP > 30% group showed a significant correlation with increased TOS levels compared with the BOP ≤ 30% group (P = 0.002). No relationship was found between OS biomarkers and HbA1c levels. Conclusion Salivary TOS levels were related to both diabetes status and the extent of gingival inflammation. Further studies to elucidate the role of OS in relation of periodontal disease and T1DM are required.
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Affiliation(s)
- Thanwarat Aroonrangsee
- Residency Training Programs in Periodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Rachanin Chairatnathrongporn
- Residency Training Programs in Periodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
- Private Practice, Bangkok, Thailand
| | - Rudee Surarit
- Department of Oral Biology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Kallapat Tansriratanawong
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Jeerunda Santiprabhob
- Division of Endocrinology and Metabolism, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Siriraj Diabetes Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | - Ananya Promsudthi
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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