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Yoldaş O, Nogueira AVB, Kantar PM, Ziskoven PC, Deschner J, Buduneli N. Gingival crevicular fluid levels of apelin correlates with clinical periodontal diagnosis. Clin Oral Investig 2023; 28:50. [PMID: 38153555 DOI: 10.1007/s00784-023-05461-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 12/18/2023] [Indexed: 12/29/2023]
Abstract
OBJECTIVES Limitations of clinical periodontal measurements have led to the search for reliable biomarkers that can be used in diagnosis and monitoring of periodontal diseases. Considering the relationship of adipokines with periodontal disease, diabetes, and obesity, apelin may be a biomarker for periodontal diseases due to its modulating effects on inflammation. The present study was conducted to determine gingival crevicular fluid (GCF) apelin levels in systemically healthy individuals and to evaluate the potential of apelin as a biomarker for periodontal diagnosis. MATERIALS AND METHODS Ten individuals with clinically healthy periodontal tissues, 10 patients diagnosed with gingivitis, and 10 patients with periodontitis were included in the present study. Whole mouth clinical periodontal measurements were recorded and GCF samples were obtained from the buccal approximal regions of single-rooted teeth with features that would represent clinical periodontal diagnosis. Apelin level in the samples was determined by ELISA. Clinical and biochemical findings were statistically analyzed. Possible relationship between the variables was evaluated with Pearson correlation analysis. RESULTS Apelin level in the gingivitis group was higher than that in the clinically healthy group (p = 0.000) and lower than that in the periodontitis group (p = 0.000). A positive correlation was found between GCF apelin concentration and plaque score, bleeding on probing, and probing depth (p = 0.000). CONCLUSIONS Within the limits of this study, it can be suggested that GCF apelin concentration may be a biomarker that can distinguish between healthy periodontal tissues, gingivitis, and periodontitis patients. CLINICAL RELEVANCE Apelin concentration in the gingival crevicular fluid may aid in the diagnosis of periodontal disease.
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Affiliation(s)
- Onur Yoldaş
- Department of Periodontology, School of Dentistry, Ege University, 35100, Bornova, İzmir, Turkey
| | - Andressa V B Nogueira
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University, 55131, Mainz, Germany
| | - Pınar Meriç Kantar
- Department of Periodontology, School of Dentistry, Ege University, 35100, Bornova, İzmir, Turkey
| | - Pablo Cores Ziskoven
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University, 55131, Mainz, Germany
| | - James Deschner
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University, 55131, Mainz, Germany
| | - Nurcan Buduneli
- Department of Periodontology, School of Dentistry, Ege University, 35100, Bornova, İzmir, Turkey.
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Association between clinical measures of gingival inflammation and obesity in adults: systematic review and meta-analyses. Clin Oral Investig 2021; 25:4281-4298. [PMID: 33904994 DOI: 10.1007/s00784-021-03961-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 04/20/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE This study aimed to systematically review the literature about the association between clinical measures of gingival inflammation and obesity in adults. MATERIAL AND METHODS Searches for studies were performed in five databases (Medline-PubMed, Scopus, Web of Science, Cochrane Library, and Embase) to compile studies of any design that evaluated the association between clinical measures of gingival inflammation and obesity in adults. Selection of studies, data extraction and risk of bias analysis were performed independently by two reviewers, and a third researcher was involved to resolve disagreements. Meta-analyses were performed for measures of gingival inflammation as compared to body mass index (BMI). Independent analyses were performed for studies involving periodontitis, gingivitis, and population-based/studies that did not provide a periodontal diagnosis. Standard mean deviation (SMD) and its 95% confidence interval (95%CI) were estimated. RESULTS Ninety studies were included (cross-sectional/clinical trials [n=82], case-control [n=3], cohorts [n=5]). Most of the studies demonstrated no significant difference in the measures of gingival inflammation regardless of the comparison performed. However, meta-analysis showed that among individuals with periodontitis, significantly higher levels of gingival inflammation are observed in those with obesity (n of individuals=240) when compared to those who were not obese (n of individuals=574) (SMD:0.26; 95%CI:0.07-0.44). When considering population-based/those studies that did not provide periodontal diagnosis, significantly higher measures of gingival inflammation were observed in the groups with higher BMI. CONCLUSIONS Within the limitations of the present study, it was concluded that higher measures of gingival inflammation may be expected for those with higher BMI. CLINICAL RELEVANCE Clinicians must be aware that higher measures of gingival inflammation may be expected for individuals with higher BMI. However, there is a necessity for further longitudinal studies regarding the association between obesity and gingival inflammation.
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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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Resistin Is Increased in Periodontal Cells and Tissues: In Vitro and In Vivo Studies. Mediators Inflamm 2020; 2020:9817095. [PMID: 32410876 PMCID: PMC7201489 DOI: 10.1155/2020/9817095] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 12/30/2019] [Indexed: 12/12/2022] Open
Abstract
Resistin, a proinflammatory adipokine, is elevated in many inflammatory diseases. However, little is known about its performance in periodontitis. The present study is aimed at evaluating resistin expression and synthesis in periodontal cells and tissues under inflammatory/microbial stress in addition to its effects on the periodontium. In vivo, 24 male rats were randomly divided into two groups: control and ligature-induced periodontal disease. After 6 and 12 days, animals were sacrificed to analyze gene expression of adipokines, bone loss, inflammation, and resistin synthesis. In vitro, human periodontal ligament (PDL) fibroblasts were used to evaluate the expression of resistin after inflammatory stimuli. In addition, PDL fibroblasts were exposed to resistin to evaluate its role on soft and hard tissue metabolism markers. The periodontitis group demonstrated significant bone loss, an increase in the number of inflammatory cells and vascular structures, an increase in resistin expression and synthesis, and a decrease in the expression of adiponectin, leptin, and its functional receptor. PDL fibroblasts showed a significant increase in resistin expression and synthesis in response to the inflammatory stimulus by IL-1β. Resistin induced an increase in cytokine expression and a decrease in the regulation of some hard tissue and matrix formation genes in PDL fibroblasts. These data indicate that resistin is produced by periodontal cells and tissues, and this effect is enhanced by inflammatory stimuli. Moreover, resistin seems to interfere with soft and hard tissue metabolism during periodontitis by reducing markers related to matrix formation and bone tissue.
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Suresh S, Mahendra J, Singh G, Pradeep Kumar AR, Thilagar S, Rao N. Effect of nonsurgical periodontal therapy on plasma-reactive oxygen metabolite and gingival crevicular fluid resistin and serum resistin levels in obese and normal weight individuals with chronic periodontitis. J Indian Soc Periodontol 2018; 22:310-316. [PMID: 30131622 PMCID: PMC6077962 DOI: 10.4103/jisp.jisp_108_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background: The hyperoxidative and a modified inflammatory state in obese individuals cause higher susceptibility to bacterial infection which influences the initiation and progression of periodontal disease. Aim: Our study was aimed to evaluate the role of nonsurgical periodontal therapy on the clinical parameters such as gingival index (GI), plaque index, pocket probing depth (PPD) and clinical attachment level (CAL), plasma-reactive oxygen metabolite (ROM) levels, and gingival crevicular fluid (GCF) resistin and serum resistin levels in obese or overweight and normal weight individuals with periodontitis. Material and Methods: Sixty individuals of age between 35 and 45 years of both the sexes were selected and categorized into two groups as thirty overweight or obese individuals with chronic periodontitis (Group I) and thirty normal weight individuals with chronic periodontitis (Group II). Clinical parameters, plasma ROM levels, and serum and GCF resistin levels were assessed at baseline and 2 months after periodontal therapy in both the groups and compared. Results: Intergroup comparison of clinical parameters (GI, CAL, PPD) 2 months after therapy showed a significant difference with more reduction in Group II compared to Group I. On comparison, mean plasma ROM, GCF, and serum resistin levels at baseline was higher in Group I compared to Group II. When plasma ROM, GCF, and serum resistin levels were compared 2 months after therapy, the reduction was more in Group II compared to Group I. Conclusion: It is concluded that along with periodontal therapy, motivation of patients for weight reduction program is mandatory for obese or overweight individuals with periodontitis in order to improve periodontal health.
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Affiliation(s)
- Snophia Suresh
- Department of Periodontics, Thaimoogambigai Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Jaideep Mahendra
- Department of Periodontics, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Gurdeep Singh
- Department of Periodontics, Sree Balaji Dental College and Hospital, Chennai, Tamil Nadu, India
| | | | - Sivasankari Thilagar
- Department of Periodontics, Thaimoogambigai Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Neeharika Rao
- Department of Periodontics, Thaimoogambigai Dental College and Hospital, Chennai, Tamil Nadu, India
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Suresh S, Mahendra J, Kumar ARP, Singh G, Jayaraman S, Paul R. Comparative analysis of subgingival red complex bacteria in obese and normal weight subjects with and without chronic periodontitis. J Indian Soc Periodontol 2017; 21:186-191. [PMID: 29440783 PMCID: PMC5803872 DOI: 10.4103/jisp.jisp_241_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 10/24/2017] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Obesity is one of the systemic conditions which influence the onset and progression of periodontal disease and it is stated that the metabolic changes associated with obesity may contribute to alteration in subgingival microbial flora. AIM Our study was aimed to quantify and compare the red complex microorganisms in obese or overweight and normal weight participants with and without chronic periodontitis to identify obesity as a risk for the presence of red complex bacteria. MATERIALS AND METHODS The study group consisted of 120 participants of age between 20 and 45 years of both the sexes. According to periodontal status, the participants were categorized into four groups as follows: thirty overweight or obese individuals with generalized chronic periodontitis (Group I), thirty normal weight individuals with chronic periodontitis (Group II), thirty overweight or obese individuals with healthy periodontium (Group III), and thirty normal weight individuals with healthy periodontium (Group IV). After the assessment of periodontal parameters, subgingival plaque sample collection was carried out to quantify the red complex bacteria by real-time polymerase chain reaction. RESULTS Increase in red complex bacterial count was seen in group I compared to other groups. A positive correlation of red complex bacteria with body mass index and waist circumference was seen in Group I and III. CONCLUSION In our study, obese individuals with periodontal disease harbored increased red complex bacteria. This states that the obesity could be a risk for the colonization of red complex microorganisms, which in turn may further lead to periodontal inflammation.
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Affiliation(s)
- Snophia Suresh
- Department of Periodontics, Thaimoogambigai Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Jaideep Mahendra
- Department of Periodontics, Meenakshiammal Dental College and Hospital, Maduravoyal, Chennai, Tamil Nadu, India
| | | | - Gurdeep Singh
- Department of Periodontics, Sree Balaji Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Selvaraj Jayaraman
- Department of Central research laboratory, Meenakshiammal Dental College and Hospital, Maduravoyal, Chennai, Tamil Nadu, India
| | - Roshini Paul
- Department of Periodontics, Thaimoogambigai Dental College and Hospital, Chennai, Tamil Nadu, India
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