1
|
Chopra A, Jayasinghe TN, Eberhard J. Are Inflamed Periodontal Tissues Endogenous Source of Advanced Glycation End-Products (AGEs) in Individuals with and without Diabetes Mellitus? A Systematic Review. Biomolecules 2022; 12:biom12050642. [PMID: 35625570 PMCID: PMC9138899 DOI: 10.3390/biom12050642] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/14/2022] [Accepted: 04/27/2022] [Indexed: 12/14/2022] Open
Abstract
Advanced glycation end-products (AGEs) are heterogeneous compounds formed when excess sugars condense with the amino groups of nucleic acids and proteins. Increased AGEs are associated with insulin resistance and poor glycemic control. Recently, inflamed periodontal tissues and certain oral bacteria were observed to increase the local and systemic AGE levels in both normoglycemic and hyperglycemic individuals. Although hyperglycemia induced AGE and its effect on the periodontal tissues is known, periodontitis as an endogenous source of AGE formation is not well explored. Hence, this systematic review is aimed to explore, for the first time, whether inflamed periodontal tissues and periodontal pathogens have the capacity to modulate AGE levels in individuals with or without T2DM and how this affects the glycemic load. Six electronic databases were searched using the following keywords: (Periodontitis OR Periodontal disease OR Periodontal Inflammation) AND (Diabetes mellitus OR Hyperglycemia OR Insulin resistance) AND Advanced glycation end products. The results yielded 1140 articles, of which 13 articles were included for the review. The results showed that the mean AGE levels in gingival crevicular fluid was higher in individuals with diabetes mellitus and periodontitis (521.9 pg/mL) compared to healthy individuals with periodontitis (234.84 pg/mL). The serum AGE levels in normoglycemic subjects having periodontitis was higher compared to those without periodontitis (15.91 ng/mL vs. 6.60 ng/mL). Tannerella forsythia, a common gram-negative anaerobe periodontal pathogen in the oral biofilm, was observed to produce methylglyoxal (precursor of AGE) in the gingival tissues. Increased AGE deposition and activate of AGE receptors was noted in the presence of periodontitis in both normoglycemic and hyperglycemic individuals. Hence, it can be concluded that periodontitis can modulate the local and systemic levels of AGE levels even in absence of hyperglycemia. This explains the bidirectional relationship between periodontitis and development of prediabetes, incident diabetes, poor glycemic control, and insulin resistance.
Collapse
Affiliation(s)
- Aditi Chopra
- Department of Periodontology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal 576104, India
- Correspondence:
| | - Thilini N. Jayasinghe
- The Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia; (T.N.J.); (J.E.)
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Joerg Eberhard
- The Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia; (T.N.J.); (J.E.)
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| |
Collapse
|
2
|
Guo J, Lv W, Jiang S, Tang Y, Long Q, Yang J, Wiley JA, Parry M. Biological and sociocultural determinants of increased blood pressure among women with a history of gestational diabetes mellitus in rural China: a retrospective cohort study. BMJ Open 2022; 12:e049625. [PMID: 35063956 PMCID: PMC8785171 DOI: 10.1136/bmjopen-2021-049625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Gestational diabetes mellitus (GDM) increases the risk of hypertension and cardiovascular events among mothers later in life. This risk has not been well recognised by healthcare professionals in rural China. Our objectives were to (1) describe the proportion of rural women with increased blood pressure and a history of GDM; and (2) explore the biological and sociocultural factors associated with increased blood pressure. DESIGN A retrospective cohort study using data from a cross-sectional survey. SETTING Data were collected in two county-level hospitals in the central south of China between November 2017 and June 2018. PARTICIPANTS Postpartum women aged >18 years with a history of GDM (N=397). METHODS Biological and sociocultural variables were examined. We used bivariate analyses to examine the associations between time since delivery and 2-hour postload glucose, and logistic regression to determine the biological and sociocultural factors associated with increased postpartum blood pressure. RESULTS Approximately 20% (n=78) of women had increased blood pressure, defined as a systolic blood pressure ≥130 mm Hg and/or a diastolic blood pressure ≥85 mm Hg. The biological factors of advanced age, family history of hypertension and abnormal 2-hour postload plasma glucose levels were positively associated with increased blood pressure (p<0.05). General self-efficacy was the only sociocultural factor negatively associated with increased blood pressure (p<0.05). CONCLUSIONS One in five rural Chinese postpartum women with a history of GDM were found to have increased blood pressure. Biological and sociocultural factors were associated with increased postpartum blood pressure; women with lower general self-efficacy were more likely to have increased blood pressure. Disseminating knowledge about the high risk of developing increased blood pressure among women with prior GDM in rural China is indicated. Diabetes prevention programmes could consider adding general self-efficacy promotion strategies in this population.
Collapse
Affiliation(s)
- Jia Guo
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Wencong Lv
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Shan Jiang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Yujia Tang
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
| | - Qing Long
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Jundi Yang
- School of Nursing, The University of Hong Kong, Hong Kong, Hong Kong
| | - James Allen Wiley
- Department of Family and Community Medicine, University of California, San Francisco, California, USA
| | - Monica Parry
- Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
3
|
Pathirana MM, Lassi Z, Ali A, Arstall M, Roberts CT, Andraweera PH. Cardiovascular risk factors in women with previous gestational diabetes mellitus: A systematic review and meta-analysis. Rev Endocr Metab Disord 2021; 22:729-761. [PMID: 33106997 DOI: 10.1007/s11154-020-09587-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/26/2020] [Indexed: 12/16/2022]
Abstract
This systematic review and meta-analysis aimed to synthesize evidence on conventional cardiovascular disease (CVD) risk factors among women with previous Gestational Diabetes Mellitus (GDM). The review protocol is registered with PROSPERO (CRD42019118149). PubMed, CINAHL, SCOPUS, and EMBASE databases were searched. Studies reporting on CVD risk factors in women with previous GDM compared to women without previous GDM were selected. A total of 139 studies were eligible, of which 93 were included in the meta-analysis. Women with previous GDM have significantly higher systolic blood pressure (2.47 mmHg 95% CI 1.74 to 3.40, n = 48, 50,118 participants) diastolic blood pressure (1.89 mmHg 95% CI 1.32 to 2.46, n = 48, 49,495 participants), BMI (1.54 kg/m2 95% CI 1.32 to 2.46, n = 78, 255,308 participants), total cholesterol (0.26 SMD 95% CI 0.15 to 0.37, n = 48, 38,561 participants), LDL cholesterol (0.19 SMD 95% CI 0.08 to 0.30, n = 44, 16,980 participants), triglycerides (0.56 SMD 95% CI 0.42 to 0.70, n = 46, 13,175 participants), glucose (0.69 SMD 95% CI 0.56 to 0.81, n = 55, 127,900 participants), insulin (0.41 SMD 95% CI 0.23 to 0.59, n = 32, 8881 participants) and significantly lower HDL cholesterol (-0.28 SMD 95% CI -0.39 to -0.16, n = 56, 35,882 participants), compared to women without previous GDM. The increased blood pressure, total cholesterol, triglycerides and glucose are seen as early as <1 year post-partum.Women with previous GDM have a higher risk of CVD based on significant increases in conventional risk factors. Some risk factors are seen as early as <1 year post-partum. Women with GDM may benefit from early screening to identify modifiable CVD risk factors.
Collapse
Affiliation(s)
- Maleesa M Pathirana
- Adelaide Medical School and The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
- Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Zohra Lassi
- Adelaide Medical School and The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
- Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Anna Ali
- Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
- Basil Hetzel Institute, The Queen Elizabeth Hospital, Woodville, SA, Australia
- Adelaide G-TRAC Centre & CRE Frailty & Healthy Ageing Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Margaret Arstall
- Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, SA, Australia
| | - Claire T Roberts
- Adelaide Medical School and The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
- Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
- Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, Australia
| | - Prabha H Andraweera
- Adelaide Medical School and The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia.
- Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia.
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, SA, Australia.
| |
Collapse
|
4
|
Li J, Hu X, Liang F, Liu J, Zhou H, Liu J, Wang H, Tang H. Therapeutic effects of moxibustion simultaneously targeting Nrf2 and NF-κB in diabetic peripheral neuropathy. Appl Biochem Biotechnol 2019; 189:1167-1182. [PMID: 31209719 PMCID: PMC6882806 DOI: 10.1007/s12010-019-03052-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 05/22/2019] [Indexed: 01/09/2023]
Abstract
Moxibustion is the main alternative medicine treatment that has been beneficial to diabetic peripheral neuropathy (DPN), a common complication secondary to diabetic microvascular injury. However, the underlying protective mechanism of moxibustion against neuroinflammation remains unclear. We hypothesized that moxibustion treats DPN by regulating the balance of nuclear factor-2 erythroid-related factor-2 (Nrf2)-nuclear factor-kappa light chain enhancer of B cells (NF-кB). In vivo, diabetes was induced in rats by injecting streptozotocin (STZ; 60 mg/kg; i.p.). Moxibustion was then applied to “Zusanli” (ST 36), “Guanyuan” (BL 26), and “Yishu” (EX-B 3) acupuncture points. Nerve conduction was detected. Serum interleukin (IL)-1β, IL-6, and IL-8 levels were determined through enzyme-linked immunosorbent assay. NF-κB and Nrf2 proteins were examined through immunoblot analysis. The mRNA of NF-κB and Nrf2 was evaluated through RT-PCR. We found that the conduction velocity and amplitude of the action potentials of sciatic nerve conduction were reduced in the DPN model group but were rescued by moxibustion treatment. Moxibustion also improved the effect of DPN on other parameters, including ultrastructural changes, NF-κB and Nrf2 expression in the sciatic nerve, and serum IL-1β, IL-6, and IL-8 levels. Our data suggested that moxibustion may alleviate neuroinflammation by inhibiting NF-κB and by activating Nrf2. Moxibustion may also provide therapeutic effects for patients with DPN by simultaneously targeting Nrf2 and NF-κB.
Collapse
Affiliation(s)
- Jia Li
- Hubei University of Chinese Medicine/Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture and Moxibustion, Wuhan, 430061, China
| | - Xia Hu
- College of Basic Medicine, Hubei University of Chinese Medicine, Wuhan, 430061, China
| | - Fengxia Liang
- Hubei University of Chinese Medicine/Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture and Moxibustion, Wuhan, 430061, China
| | - Jianmin Liu
- Hubei University of Chinese Medicine/Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture and Moxibustion, Wuhan, 430061, China
| | - Huanjiao Zhou
- Hubei University of Chinese Medicine/Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture and Moxibustion, Wuhan, 430061, China
| | - Jiaoping Liu
- Department of Oncology, Integrated Chinese and Western Medicines, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science & Technology (HUST), Wuhan, 430010, China
| | - Hua Wang
- Hubei University of Chinese Medicine/Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture and Moxibustion, Wuhan, 430061, China.
| | - Hongtu Tang
- Hubei University of Chinese Medicine/Hubei Provincial Collaborative Innovation Center of Preventive Treatment by Acupuncture and Moxibustion, Wuhan, 430061, China.
| |
Collapse
|
5
|
Galectin-3 Plays an Important Role in Preterm Birth Caused by Dental Infection of Porphyromonas gingivalis. Sci Rep 2018; 8:2867. [PMID: 29434245 PMCID: PMC5809409 DOI: 10.1038/s41598-018-21072-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 01/25/2018] [Indexed: 11/17/2022] Open
Abstract
Dental infection is risk for preterm birth (PTB) through unclear mechanisms. We established a dental infection-induced PTB mouse model, in which Porphyromonas gingivalis (P.g.) induced PTB by 2 days. We analysed pathogenic factors contributing to PTB and their effects on trophoblasts in vitro. TNF-α, IL-8, and COX-2 were upregulated in P.g.-infected placenta. Galectin-3 (Gal-3), an immune regulator, was significantly upregulated in placenta, amniotic fluid, and serum. In vitro, P.g.-lipopolysaccharide (P.g.-LPS) increased TNF-α and Gal-3 in trophoblasts via NF-κB/MAPK signalling. Gal-3 inhibition significantly downregulated P.g.-LPS-induced TNF-α production. TNF-α upregulated Gal-3. Gal-3 also increased cytokines and Gal-3 through NF-κB/MAPK signalling. Moreover, Gal-3 suppressed CD-66a expression at the maternal-foetal interface. Co-stimulation with Gal-3 and P.g.-LPS upregulated cytokine levels, while Gal-3 plus Aggregatibacter actinomycetemcomitans (A.a.)- or Escherichia coli (E. coli)-LPS treatment downregulated them, indicating the critical role of Gal-3 especially in P.g. dental infection-induced PTB. P.g.-dental infection induced PTB, which was associated with Gal-3-dependent cytokine production. New therapies and/or diagnostic systems targeting Gal-3 may reduce PTB.
Collapse
|
6
|
Graziani F, Gennai S, Solini A, Petrini M. A systematic review and meta-analysis of epidemiologic observational evidence on the effect of periodontitis on diabetes An update of the EFP-AAP review. J Clin Periodontol 2017; 45:167-187. [PMID: 29277926 DOI: 10.1111/jcpe.12837] [Citation(s) in RCA: 203] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2017] [Indexed: 12/23/2022]
Abstract
AIM To update the available evidence on the impact of periodontitis on diabetes control, incidence and complications. METHODS Observational studies on the effect of periodontitis on diabetes, published after 2012, were identified through electronic databases and hand-searched journals. Findings were summarized by evidence tables, using PRISMA statement. Quality of the included studies was evaluated through the Newcastle Ottawa scale. RESULTS Healthy individuals with periodontitis exhibit a poor glycaemic control and a higher risk of developing diabetes. Individuals affected by diabetes show a deterioration of glycaemic control if also affected by periodontitis and significantly higher prevalence of diabetes-related complications. Limited evidence is available on gestational diabetes and type 1 diabetes. CONCLUSIONS Periodontitis has a significant impact on diabetes control, incidence and complications. Nevertheless, the heterogeneity and quality of the included publications suggest that caution should be exercised when interpreting the data and that there remains an important need for additional evidence.
Collapse
Affiliation(s)
- Filippo Graziani
- Department of Surgical, Medical and Molecular Pathology, Critical Care Medicine, University of Pisa, Pisa, Italy.,Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
| | - Stefano Gennai
- Department of Surgical, Medical and Molecular Pathology, Critical Care Medicine, University of Pisa, Pisa, Italy.,Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
| | - Anna Solini
- Department of Surgical, Medical and Molecular Pathology, Critical Care Medicine, University of Pisa, Pisa, Italy.,Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy.,Unit of Internal Medicine, University Hospital of Pisa, Pisa, Italy
| | - Morena Petrini
- Department of Surgical, Medical and Molecular Pathology, Critical Care Medicine, University of Pisa, Pisa, Italy.,Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
| |
Collapse
|
7
|
Abstract
Diabetes and the oral cavity are closely associated as diabetes physiopathology affects the mouth and the oral manifestations are numerous and varied. These need to be searched systematically at every clinical examination as they are not only comorbidity factors but also have a two-way relationship with diabetes control. Periodontal diseases are the most frequent pathologies and the relationship with glycemic control has clearly been established: their frequency increases in case of uncontrolled glycemia, which makes them a good marker of glycated hemoglobin. Thorough oral health follow-up of diabetic patients that is coordinated by its various actors from the beginning of the treatment is thus of great interest. Most of the care given to diabetic patients can easily be performed at the dental clinic, provided adequate precautions are taken and improvement of the oral cavity is beneficial to glycemic control as well as to the patients' quality of life. When implemented by trained oral health professionals in dental clinics, therapeutic education proves highly efficient.
Collapse
Affiliation(s)
- Matthieu Ternois
- Centre Hospitalier de Roubaix, 59100 Roubaix, France; Faculté de chirurgie-dentaire, UF de chirurgie orale, Université de Lille 2, 59000 Lille, France; Laboratoire de virologie, CHRU de Lille, Université de Lille 2 (EA3610), pathogenèse virale du diabète de type 1, 59000 Lille, France.
| |
Collapse
|
8
|
Seraphim APCG, Chiba FY, Pereira RF, Mattera MSDLC, Moimaz SAS, Sumida DH. Relationship among Periodontal Disease, Insulin Resistance, Salivary Cortisol, and Stress Levels during Pregnancy. Braz Dent J 2017; 27:123-7. [PMID: 27058372 DOI: 10.1590/0103-6440201600596] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 03/11/2016] [Indexed: 11/22/2022] Open
Abstract
Pregnancy is a period involving important metabolic changes that enable the maintenance of the mother's health and development of the fetus. This study aimed to assess the relationship among periodontal disease, insulin resistance, salivary cortisol concentration and level of perceived stress in pregnant women. This was a cross-sectional study. The sample comprised 96 pregnant women between the fifth and seventh month of pregnancy registered at the Basic Health Units of the Unified Health System (SUS). The periodontal condition was assessed after obtainment free and informed consent from the participants. Participants were divided into three groups: control subjects with a healthy periodontal condition (CN; n=46), patients with gingivitis (GI; n=26), and patients with periodontitis (PI; n=24). Saliva and blood samples were collected for evaluation of salivary cortisol concentration, glycemia, insulinemia and Homeostasis Model Assessment-Insulin Resistance index. A validated survey for the assessment of perceived stress levels was also performed. PI group showed significantly higher (p<0.05) blood glucose levels (CN: 4.43±0.05; GI: 4.46±0.04; PI: 4.68±0.08), insulinemia (CN: 6.93±0.45; GI: 8.87±0.79; PI: 12.77±1.30), insulin resistance (CN: 1.40±0.10; GI: 1.81±0.18; PI: 2.66±0.29) compared with the CN and GI groups. The levels of perceived stress were higher (p<0.05) in PI and GI groups when compared to CN group (CN: 20.5±1.26; GI: 25.8±1.95; PI: 26.6±1.36). There was no significant difference in the concentration of salivary cortisol between the groups (CN: 11.13±0.58; GI: 11.96±0.74; PI: 11.47±0.74). It was concluded that there is a relationship between higher levels of perceived stress, insulin resistance and the occurrence of periodontal disease during pregnancy. This study emphasizes the importance of preventing periodontitis in order to avoid insulin resistance and stress during pregnancy since these can cause systemic complications for the mother and the fetus.
Collapse
Affiliation(s)
| | - Fernando Yamamoto Chiba
- Department of Child and Social Dentistry, Araçatuba Dental School, Universidade Estadual Paulista, Araçatuba, SP, Brazil
| | - Renato Felipe Pereira
- Department of Basic Sciences, Araçatuba Dental School, Universidade Estadual Paulista, Araçatuba, SP, Brazil
| | | | - Suzely Adas Saliba Moimaz
- Department of Child and Social Dentistry, Araçatuba Dental School, Universidade Estadual Paulista, Araçatuba, SP, Brazil
| | - Doris Hissako Sumida
- Department of Basic Sciences, Araçatuba Dental School, Universidade Estadual Paulista, Araçatuba, SP, Brazil
| |
Collapse
|
9
|
Esteves Lima RP, Cota LOM, Silva TA, Cortelli SC, Cortelli JR, Costa FO. Periodontitis and type 2 diabetes among women with previous gestational diabetes: epidemiological and immunological aspects in a follow-up of three years. J Appl Oral Sci 2017; 25:130-139. [PMID: 28403353 PMCID: PMC5393533 DOI: 10.1590/1678-77572016-0367] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 09/06/2016] [Accepted: 09/22/2016] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE The aim of this study was to verify the incidence on the development of type 2 diabetes in women with previous gestational diabetes with and without periodontitis after a three-year time interval. MATERIAL AND METHODS Initial sample of this follow-up study consisted of 90 women diagnosed with gestational diabetes who underwent periodontal examination. After three years, 49 women were subjected to new periodontal examination and biological, behavioral, and social data of interest were collected. Additionally, the quantification of the C-reactive protein in blood samples was performed. Fasting glucose and glycated hemoglobin levels were requested. Saliva samples were collected for quantification of interleukin 6 and 10, tumor necrosis factor α, matrix metalloproteinase 2 and 9. RESULTS The incidence of type 2 diabetes mellitus was 18.4% and of periodontitis was 10.2%. There was no significant difference in the incidence of type 2 diabetes mellitus among women with and without periodontitis. It was observed impact of C-reactive protein in the development of type 2 diabetes mellitus. However, it was not observed impact of periodontitis on the development of type 2 diabetes mellitus among women with previous gestational diabetes. CONCLUSIONS It was not observed impact of periodontitis on the development of type 2 diabetes among women with previous gestational diabetes. The impact of C-reactive protein in the development of type 2 diabetes mellitus highlights the importance of an inflammatory process in the diabetes pathogenesis.
Collapse
Affiliation(s)
- Rafael Paschoal Esteves Lima
- Universidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Periodontologia e Patologia, Belo Horizonte, MG, Brasil
| | - Luis Otávio Miranda Cota
- Universidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Periodontologia e Patologia, Belo Horizonte, MG, Brasil
| | - Tarcília Aparecida Silva
- Universidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Periodontologia e Patologia, Belo Horizonte, MG, Brasil
| | | | | | - Fernando Oliveira Costa
- Universidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Periodontologia e Patologia, Belo Horizonte, MG, Brasil
| |
Collapse
|
10
|
Clinical periodontal status and inflammatory cytokines in gestational diabetes mellitus. Arch Oral Biol 2016; 72:87-91. [DOI: 10.1016/j.archoralbio.2016.08.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 07/10/2016] [Accepted: 08/10/2016] [Indexed: 11/18/2022]
|
11
|
|
12
|
Esteves Lima RP, Cyrino RM, de Carvalho Dutra B, Oliveira da Silveira J, Martins CC, Miranda Cota LO, Costa FO. Association Between Periodontitis and Gestational Diabetes Mellitus: Systematic Review and Meta-Analysis. J Periodontol 2015; 87:48-57. [PMID: 26334246 DOI: 10.1902/jop.2015.150311] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND To the best of the authors' knowledge, there is no systematic review of the potential association between periodontitis and gestational diabetes mellitus (GDM) in the current literature. The aim of the present systematic review and meta-analysis is to search for scientific evidence regarding the association between periodontitis and GDM. METHODS The present study was conducted in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and registered (CRD2014010728) with PROSPERO (International prospective register for systematic reviews, University of York, York, UK). A search was conducted in three electronic databases without restrictions regarding language or date of publication. From 190 studies selected, 15 underwent full-text analysis. Eight studies were eligible (five cross-sectional and three case-control studies), and seven were entered in the meta-analysis. Meta-analysis was performed with tests for sensitivity and statistical heterogeneity. Summary effect measures were calculated by odds ratio (OR) and 95% confidence interval (CI). RESULTS There was a significant association between periodontitis and GDM in the meta-analyses of four cross-sectional studies (OR 1.67, 95% CI 1.20 to 2.32) and two case-control studies (OR 2.66, 95% CI 1.52 to 4.65). However, sensitivity tests for case-control studies showed a lack of consistency in data; when including one case-control study, the significance was null (meta-analysis of three case-control studies: OR 1.69, 95% CI 0.68 to 4.21). CONCLUSIONS There was substantial clinical, methodologic, and statistical heterogeneity among the studies. The scientific evidence cannot affirm a positive association between periodontitis and GDM. Future studies with different designs in distinct populations should be conducted to investigate this association.
Collapse
Affiliation(s)
| | - Renata Magalhães Cyrino
- Department of Periodontology, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Bernardo de Carvalho Dutra
- Department of Periodontology, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | - Carolina Castro Martins
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Federal University of Minas Gerais
| | - Luis Otávio Miranda Cota
- Department of Periodontology, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Fernando Oliveira Costa
- Department of Periodontology, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| |
Collapse
|
13
|
Kalsi DS, Chopra J, Sood A. Association of lipid profile test values, type-2 diabetes mellitus, and periodontitis. Indian J Dent 2015; 6:81-4. [PMID: 26097337 PMCID: PMC4455160 DOI: 10.4103/0975-962x.157270] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective: A two-way relationship between diabetes and periodontal disease has been suggested; whereas obesity and impaired lipid profile are risk factors for type-2 diabetes mellitus. This study examined the relationship between lipid profile, oral glucose tolerance test (OGTT) with periodontal health/disease dependent variables in healthy, diabetic and impaired glucose tolerance subjects. Materials and Methods: 120 patients were selected for the study and were determined to be periodontally healthy or diseased. All these patients underwent biochemical tests for OGTT and Lipid profile analysis and data was compared using Z-test. Results: The OGTT results deteriorated with deteriorating periodontal condition. A similar correlation was also observed between worsening lipid profile test values, OGTT score, and periodontal condition. Conclusion: This study indicates that hyperlipidemia may be one of the factors associated with periodontitis and that periodontitis may itself lead to abnormal serum lipid levels. Therefore, in addition to effects on diabetes, periodontitis may contribute to elevated serum lipid levels and therefore potentially to systemic disease arising from chronic hyperlipidemia.
Collapse
Affiliation(s)
- D S Kalsi
- Department of Periodontology, Baba Jaswant Singh Dental College, Ludhiana, Punjab, India
| | - Jyoti Chopra
- Department of Biochemistry, Baba Jaswant Singh Dental College, Ludhiana, Punjab, India
| | - Anchal Sood
- Department of Periodontology, Baba Jaswant Singh Dental College, Ludhiana, Punjab, India
| |
Collapse
|
14
|
Chen X, Wu G, Feng Z, Dong Y, Zhou W, Li B, Bai S, Zhao Y. Advanced biomaterials and their potential applications in the treatment of periodontal disease. Crit Rev Biotechnol 2015; 36:760-75. [PMID: 26004052 DOI: 10.3109/07388551.2015.1035693] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Periodontal disease is considered as a widespread infectious disease and the most common cause of tooth loss in adults. Attempts for developing periodontal disease treatment strategies, including drug delivery and regeneration approaches, provide a useful experimental model for the evaluation of future periodontal therapies. Recently, emerging advanced biomaterials including hydrogels, films, micro/nanofibers and particles, hold great potential to be utilized as cell/drug carriers for local drug delivery and biomimetic scaffolds for future regeneration therapies. In this review, first, we describe the pathogenesis of periodontal disease, including plaque formation, immune response and inflammatory reactions caused by bacteria. Second, periodontal therapy and an overview of current biomaterials in periodontal regenerative medicine have been discussed. Third, the roles of state-of-the-art biomaterials, including hydrogels, films, micro/nanofibers and micro/nanoparticles, developed for periodontal disease treatment and periodontal tissue regeneration, and their fabrication methods, have been presented. Finally, biological properties, including biocompatibility, biodegradability and immunogenicity of the biomaterials, together with their current applications strategies are given. Conclusive remarks and future perspectives for such advanced biomaterials are discussed.
Collapse
Affiliation(s)
- Xi Chen
- a State Key Laboratory of Military Stomatology, Department of Prosthetics , School of Stomatology, The Fourth Military Medical University , Xi'an , Shaanxi , P.R. China .,b Shaanxi Key Laboratory of Stomatology , Xi'an , Shaanxi , P.R. China , and
| | - Guofeng Wu
- a State Key Laboratory of Military Stomatology, Department of Prosthetics , School of Stomatology, The Fourth Military Medical University , Xi'an , Shaanxi , P.R. China .,b Shaanxi Key Laboratory of Stomatology , Xi'an , Shaanxi , P.R. China , and
| | - Zhihong Feng
- a State Key Laboratory of Military Stomatology, Department of Prosthetics , School of Stomatology, The Fourth Military Medical University , Xi'an , Shaanxi , P.R. China .,b Shaanxi Key Laboratory of Stomatology , Xi'an , Shaanxi , P.R. China , and
| | - Yan Dong
- a State Key Laboratory of Military Stomatology, Department of Prosthetics , School of Stomatology, The Fourth Military Medical University , Xi'an , Shaanxi , P.R. China .,b Shaanxi Key Laboratory of Stomatology , Xi'an , Shaanxi , P.R. China , and
| | - Wei Zhou
- a State Key Laboratory of Military Stomatology, Department of Prosthetics , School of Stomatology, The Fourth Military Medical University , Xi'an , Shaanxi , P.R. China .,b Shaanxi Key Laboratory of Stomatology , Xi'an , Shaanxi , P.R. China , and
| | - Bei Li
- b Shaanxi Key Laboratory of Stomatology , Xi'an , Shaanxi , P.R. China , and.,c State Key Laboratory of Military Stomatology, Center for Tissue Engineering , School of Stomatology, The Fourth Military Medical University , Xi'an , Shaanxi , P.R. China
| | - Shizhu Bai
- a State Key Laboratory of Military Stomatology, Department of Prosthetics , School of Stomatology, The Fourth Military Medical University , Xi'an , Shaanxi , P.R. China .,b Shaanxi Key Laboratory of Stomatology , Xi'an , Shaanxi , P.R. China , and
| | - Yimin Zhao
- a State Key Laboratory of Military Stomatology, Department of Prosthetics , School of Stomatology, The Fourth Military Medical University , Xi'an , Shaanxi , P.R. China .,b Shaanxi Key Laboratory of Stomatology , Xi'an , Shaanxi , P.R. China , and
| |
Collapse
|
15
|
Abstract
The oral health is influenced by systemic health, and one of the most common chronic diseases encountered in dental practice is diabetes mellitus. Diabetes can worsen oral infections and vice versa. In the literature, periodontitis and diabetes in the young to middle-aged adults have been the most widely researched area. Understanding the patho-physiology, clinical manifestations and management of different types of orofacial diseases in diabetic patients are important to the diabetologist and the dentist for the optimal care of patients with these diseases. This review explores the inter-link between diabetes and oral health.
Collapse
|
16
|
Hashimoto M, Yamazaki T, Hamaguchi M, Morimoto T, Yamori M, Asai K, Isobe Y, Furu M, Ito H, Fujii T, Terao C, Mori M, Matsuo T, Yoshitomi H, Yamamoto K, Yamamoto W, Bessho K, Mimori T. Periodontitis and Porphyromonas gingivalis in preclinical stage of arthritis patients. PLoS One 2015; 10:e0122121. [PMID: 25849461 PMCID: PMC4388350 DOI: 10.1371/journal.pone.0122121] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 02/17/2015] [Indexed: 12/12/2022] Open
Abstract
Purpose To determine whether the presence of periodontitis (PD) and Porphyromonas gingivalis (Pg) in the subgingival biofilm associates with the development of rheumatoid arthritis (RA) in treatment naïve preclinical stage of arthritis patients. Methods We conducted a prospective cohort study of 72 consecutive patients with arthralgia who had never been treated with any anti-rheumatic drugs or glucocorticoids. Periodontal status at baseline was assessed by dentists. PD was defined stringently by the maximal probing depth≧4 mm, or by the classification by the 5th European Workshop in Periodontology (EWP) in 2005 using attachment loss. Up to eight plaque samples were obtained from each patient and the presence of Pg was determined by Taqman PCR. The patients were followed up for 2 years and introduction rate of methotrexate (MTX) treatment on the diagnosis of RA was compared in patients with or without PD or Pg. Results Patients with PD (probing depth≧4mm) had higher arthritis activity (p = 0.02) and higher risk for future introduction of MTX treatment on the diagnosis of RA during the follow up than patients without PD (Hazard ratio 2.68, p = 0.03). Arthritis activity and risk for MTX introduction increased with the severity of PD assessed by EWP, although not statistically significant. On the other hand, presence of Pg was not associated with arthritis activity (p = 0.72) or the risk for MTX introduction (p = 0.45). Conclusion In treatment naïve arthralgia patients, PD, but not the presence of Pg, associates with arthritis activity and future requirement of MTX treatment on the diagnosis of RA.
Collapse
Affiliation(s)
- Motomu Hashimoto
- Department of the Control for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- * E-mail:
| | - Toru Yamazaki
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takeshi Morimoto
- Division of General Medicine, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan
| | - Masashi Yamori
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Keita Asai
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yu Isobe
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Moritoshi Furu
- Department of the Control for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiromu Ito
- Department of the Control for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Orthopedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takao Fujii
- Department of the Control for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Chikashi Terao
- Center for Genomic Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masato Mori
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takashi Matsuo
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroyuki Yoshitomi
- Center for Innovation in Immunoregulative Technology and Therapeutics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Keiichi Yamamoto
- Department of Clinical Epidemiology and Biostatistics, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Wataru Yamamoto
- Department of Health Information Management, Kurashiki Sweet Hospital, Kurashiki, Japan
| | - Kazuhisa Bessho
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tsuneyo Mimori
- Department of the Control for Rheumatic Diseases, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| |
Collapse
|
17
|
Wu Y, Wang W, Liu L. Effect of β-anhydroicaritin on the expression levels of tumor necrosis factor-α and matrix metalloproteinase-3 in periodontal tissue of diabetic rats. Mol Med Rep 2015; 12:1829-37. [PMID: 25847066 PMCID: PMC4464411 DOI: 10.3892/mmr.2015.3591] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Accepted: 02/26/2015] [Indexed: 11/20/2022] Open
Abstract
The present study aimed to investigate the effect of β-anhydroicaritin on the expression levels of tumor necrosis factor (TNF)-α and matrix metalloproteinase (MMP)-3, and the pathological changes in the periodontal tissue of diabetic rats. Male Wistar rats (n=40; three months old) were randomly divided into four groups: Normal control group, diabetes group, diabetes + β-anhydroicaritin group and diabetes + urate group, (n=10 in each group). Following an overnight fast, diabetes was induced by intraperitoneal injection of streptozocin. The rats were maintained for 12 weeks and the blood sugar, urine sugar and body weight were assessed in week 12. Histological changes of the periodontal tissues were observed by hematoxylin and eosin staining, and the expression levels of TNF-α and MMP-3 were observed by immunohistochemistry. Following 12 weeks, the TNF-α grey value in the diabetes group was significantly lower compared with that in the control group (P<0.05), while no significant difference was observed between TNF-α levels in the diabetes + β-anhydroicaritin group, diabetes + urate group and the control group (P>0.05). However, TNF-α levels in the diabetes + β-anhdroicaritin group and diabetes + urate group were significantly higher compared with those in the diabetes group (P<0.05), and those in the diabetes + β-anhydroicaritin group were lower compared with those in the diabetes + urate group (P<0.05). The MMP-3 grey value in the diabetes group was significantly lower compared with that in the control group (P<0.05), while no significant difference was observed between MMP-3 levels in the diabetes + β-anhydroicaritin group, diabetes + urate group and the control group (P>0.05). However, MMP-3 levels the diabetes + β-anhydroicaritin group and diabetes + urate group were significantly higher compared with those in the diabetes group (P<0.05), and those in the diabetes + β-anhydroicaritin group were lower compared with those in the diabetes + urate group (P<0.01). β-anhydroicaritin normalized the expression levels of TNF-α and MMP-3 in the periodontal tissue of diabetic rats and led to the recovery of the changes in the morphological structure of the periodontal tissue.
Collapse
Affiliation(s)
- Yingtao Wu
- Department of Periodontology and Oral Mucosa Diseases, Qingdao Stomatological Hospital, Qingdao, Shandong 266001, P.R. China
| | - Wanchun Wang
- Department of Periodontology and Oral Mucosa Diseases, Qingdao Stomatological Hospital, Qingdao, Shandong 266001, P.R. China
| | - Lian Liu
- Department of Acupuncture and Moxibustion, Qingdao Hiser Medical Group, Qingdao, Shandong 266001, P.R. China
| |
Collapse
|
18
|
Gümüş P, Özçaka Ö, Ceyhan-Öztürk B, Akcali A, Lappin DF, Buduneli N. Evaluation of biochemical parameters and local and systemic levels of osteoactive and B-cell stimulatory factors in gestational diabetes in the presence or absence of gingivitis. J Periodontol 2014; 86:387-97. [PMID: 25494659 DOI: 10.1902/jop.2014.140444] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is defined as varying glucose intolerance, with first onset or recognition in pregnancy. This study evaluates clinical and biochemical parameters in a possible association between GDM and gingivitis. METHODS A total of 167 pregnant females was included in the study. There were 101 females with GDM and 66 females without GDM. Subgroups were created according to the presence or absence of gingival inflammation. Plaque index, bleeding on probing, and probing depth were recorded at four sites per tooth. Serum, saliva, and gingival crevicular fluid (GCF) levels of interleukin (IL)-6, IL-8, soluble receptor activator of nuclear factor-kappa B ligand (sRANKL), osteoprotegerin (OPG), B-cell activating factor (BAFF), and a proliferation-inducing ligand (APRIL) were determined by enzyme-linked immunosorbent assay. Data were analyzed by Kruskal-Wallis and Mann-Whitney U tests and Spearman correlation analysis. RESULTS Age and anthropometric indices were higher in the GDM than non-GDM group (P <0.0001). Clinical periodontal recordings, serum BAFF, IL-8, and saliva sRANKL levels were higher in the GDM group (P <0.05). Saliva IL-6 level was higher in the GDM with gingivitis group than non-GDM with gingivitis group (P = 0.044). Serum and GCF BAFF (P <0.0001), serum, saliva, and GCF APRIL (P <0.0001; P <0.0001; P = 0.032, respectively), GCF OPG (P = 0.036), and serum and saliva sRANKL (P <0.0001) were higher in the GDM with gingivitis group than GDM without gingivitis group. CONCLUSIONS The inflammatory response seems to be more pronounced in females with GDM. The observed increase in both local and systemic levels of inflammatory cytokines may suggest an interaction between gingivitis and GDM.
Collapse
Affiliation(s)
- Pınar Gümüş
- Department of Periodontology, School of Dentistry, Ege University, İzmir, Turkey
| | | | | | | | | | | |
Collapse
|