Association between Periodontitis and HbA1c Levels in Non-Diabetic Patients: A Systematic Review and Meta-Analysis

BACKGROUND

A high detection rate of diabetes among dental visitors has been reported recently. This systematic review aimed to evaluate the association between periodontitis and glycated hemoglobin (HbA1c) levels among non-diabetic individuals.

METHODS

The EMBASE, MEDLINE, Web of Science, Cochrane Library, PubMed, and Open GREY databases were searched, and observational studies published until 1st June 2023 were identified. A methodological quality assessment was conducted based on the original and modified versions of the Newcastle-Ottawa scale. Cohort, case-control, and cross-sectional studies that performed clinical periodontal examinations and measured HbA1c levels in non-diabetic adults were included. A meta-analysis was conducted to estimate the weighted mean difference (WMD) between individuals with and without periodontitis.

RESULTS

In total, 29 case-control and 5 cross-sectional studies were selected from 2583 potentially eligible articles. Among them, sixteen case-control and three cross-sectional studies with moderate to high quality were selected for the meta-analyses. The HbA1c levels in periodontitis patients were significantly higher than those in individuals with healthy periodontal conditions (WMD = 0.16; p < 0.001) among the non-diabetic populations.

CONCLUSIONS

This study reveals a significant association between periodontitis and HbA1c levels in non-diabetic populations. Thus, HbA1c screening may be recommended to detect potential hyperglycemia in non-diabetic periodontitis patients.

Omentin-1 ameliorates experimental inflammatory bowel disease via Nrf2 activation and redox regulation

AIMS

Omentin-1 production is decreased in patients with IBD. However, the specific role of Omentin-1 in IBD has not been fully elucidated. This study aimed to investigate the expression and role of Omentin-1 in IBD and the potential mechanisms.

MAIN METHODS

We collected human serum and colon biopsy samples at the Wuhan Union Hospital. Omentin-1 recombinant protein was injected intraperitoneally in a DSS-induced experimental IBD mouse model. Omentin-1 levels were measured in IBD patients, colitis mice, and LPS-induced HT-29 cells. Omentin-1 and/or a Nrf2 specific inhibitor (ML385) were administered to DSS mice and LPS-induced HT-29 cells. The effects of Omentin-1 on inflammation, intestinal barrier function, Nrf2 pathway, oxidative stress, and NF-κB signaling were detected in vivo and in vitro.

KEY FINDINGS

Serum Omentin-1 levels were significantly reduced in UC and CD patients compared with controls (173.7 (IQR, 120.1-221.2) ng/ml, 80.8 (43.8-151.8) ng/ml, and 270.7 (220.7-306.5) ng/ml, respectively). The levels of Omentin-1 were also significantly lower in colitis mice and LPS-induced HT-29 cells. Omentin-1 treatment effectively ameliorated inflammation and impaired intestinal barrier, decreased ROS and MDA levels, and increased GSH and SOD production in the DSS-induced colitis mice and LPS-induced HT-29 cells. Mechanically, Omentin-1 repaired the intestinal barrier by activating Nrf2, then improving oxidative stress and inhibiting NF-κB signaling. Furthermore, the interaction between Omentin-1 and Nrf2 was identified.

SIGNIFICANCE

Omentin-1 activates the Nrf2 pathway to regulate redox balance, ultimately protecting intestinal barrier function and reducing intestinal inflammation. In general, Omentin-1 can be used as a promising therapeutic target for IBD.

Determination of serum and gingival crevicular fluid levels of omentin in healthy and rheumatoid arthritis subjects with and without periodontitis

OBJECTIVE

The aim of this study was to assess and correlate the serum and GCF levels of omentin with the periodontal status of rheumatoid arthritis (RA) patients with and without periodontitis.

METHODS

Forty-four patients were divided into four groups: group H: 11 systemically and periodontally healthy subjects; group P: 11 systemically healthy subjects with periodontitis; group RA: 11 periodontally healthy subjects with rheumatoid arthritis and group RA + P: 11 rheumatoid arthritis subjects with periodontitis. Periodontal parameters (plaque index, modified gingival index, probing depth, and clinical attachment level) were recorded and serum and GCF samples were collected for the estimation of omentin using ELISA.

RESULTS

The mean value of plaque index, modified gingival index, probing depth, and clinical attachment level were significantly higher whereas serum and GCF omentin levels were found to be decreased in group IV when compared to the other groups. The significant correlation was found between the serum and GCF omentin levels with all the periodontal parameters.

CONCLUSION

The omentin level in serum and GCF was found to be lower in RA patients with periodontitis. It is also inversely correlated with the periodontal parameters. Thus, omentin can serve as a significant diagnostic and therapeutic tool in both periodontal and rheumatoid disease.

New insights into different adipokines in linking the pathophysiology of obesity and psoriasis

Psoriasis is a chronic, systemic, hyper-proliferative immune-mediated inflammatory skin disease. The results of epidemiological investigations have shown that psoriasis affects around 2% of the general population worldwide, and the total number of psoriasis patients is more than 6 million in China. Apart from the skin manifestations, psoriasis has been verified to associate with several metabolic comorbidities, such as insulin resistance, diabetes and obesity. However, the underlying mechanism is still not elucidated. Adipocytes, considered as the active endocrine cells, are dysfunctional in obesity which displays increased synthesis and secretion of adipokines with other modified metabolic properties. Currently, growing evidence has pointed to the central role of adipokines in adipose tissue and the immune system, providing new insights into the effect of adipokines in linking the pathophysiology of obesity and psoriasis. In this review, we summarize the current understanding of the pathological role of adipokines and the potential mechanisms whereby different adipokines link obesity and psoriasis. Furthermore, we also provide evidence which identifies a potential therapeutic target aiming at adipokines for the management of these two diseases.

The association between omentin and diabetes: a systematic review and meta-analysis of observational studies

AIMS

A number of studies have examined the association between the serum levels of omentin and diabetes, but the findings have been inconclusive. Herein, we systematically reviewed available observational studies to elucidate the overall relationship between omentin and diabetes, including type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), and impaired glucose tolerance (IGT) among adolescent and adult population.

METHODS

PubMed, Cochrane's Library, Science Direct, Scopus, Google Scholar, and ISI Web of Science databases were searched for all available literature until January 2019 for studies assessing the association between omentin and diabetes. The Newcastle-Ottawa Quality Assessment Scale was used to assess the quality of each study.

RESULTS

A total of 28 articles met the inclusion criteria and were included in our systematic review and meta-analysis. There was a significant association between serum omentin and diabetes (WMD-1.68; 95% CI, -2.17 to -1.19; P<0.001). The result of our sub-group analysis based on participants' health status revealed that omentin was significantly lower in T2DM and IGT subjects but not in T1DM ones compared to healthy controls.

CONCLUSION

We found that serum omentin level is significantly lower in T2DM and IGT patients but not in T1DM ones. These data could be used by clinicians for early diagnosis and management of diabetes. Furthermore, we need more clinical trials to investigate new agents which could influence omentin levels.

Study of salivary and serum vaspin and total antioxidants in anorexia nervosa

OBJECTIVES

Patients with anorexia nervosa (AN) are primarily at high risk of multiple somatic complications, including oral diseases. In recent years, a number of new molecules that may play a potentially important role in AN progress and prognosis have been identified in saliva, but their exact roles are still poorly understood. Two such group of substances are antioxidants and vaspin. The purpose of this observational, cross-sectional study was to measure both the salivary and serum total antioxidant status (TAS), and vaspin (VASP) concentrations of patients with AN in comparison to an average population.

MATERIAL AND METHODS

Ninety subjects participated (30 patients with AN, 60 matched healthy control subjects). A clinical examination was made, and blood and salivary samples were taken during the acute stage of AN (BMI < 15 kg/m²) in the first week of hospitalization. Enzyme immunoassay (ELISA) suitable for measuring VASP and colorimetric assay for TAS were used.

RESULTS

Anorexic patients had significant reductions in salivary flow, TAS, and an elevation in VASP levels in their saliva and serum. Significant correlations between TAS, VASP, salivary flow, and nutritional status were detected.

CONCLUSION

Determination of TAS and VASP in combined biological material confirmed that saliva might be a reliable non-invasive source of information for potent nutritional biomarkers.

CLINICAL RELEVANCE

Our findings suggest that VASP cannot be excluded, as its increased concentration in saliva is an adaptive mechanism in reduced TAS, one resulting from diminished salivary secretion. It is therefore worth conducting further research aimed at recognizing the role of TAS and VASP in the saliva of underweight patients.

Omentin-A Novel Adipokine in Respiratory Diseases

Adipokines, secreted by the adipose tissue, are extensively involved in the regulation and maintenance of various physiological and pathological processes, including insulin sensitivity, energy expenditure, glucose and lipid metabolism, inflammatory activity, neuroendocrine activity, immunity, cancer, homeostasis, angiogenesis, cardiovascular function, breeding and bone metabolism, and all functions of the endocrine-reproductive system axis. Omentin is a recently identified adipokine, which has become a research hotspot due to its pleiotropic effects on various diseases. However, the specific receptor for omentin has not been identified so far. In this study, we report that omentin levels fluctuate in various diseases. In addition, we have focused on the pleiotropic roles of omentin in pulmonary diseases, as it may act as a biomarker for malignant pleural mesothelioma (MPM) and is related to disease severity. Omentin may play significant roles in other pulmonary diseases, such as asthma, obstructive sleep apnea syndrome (OSAS), pulmonary arterial hypertension (PAH), acute respiratory distress syndrome (ARDS), and chronic obstructive pulmonary disease (COPD). This review summarizes the advances in current knowledge and future trends, which may provide a concise and general view on omentin and its effects on pulmonary biology.

Adipose Tissue-Derived Omentin-1 Function and Regulation

Omentin-1, also known as intelectin-1, is a recently identified novel adipocytokine of 313 amino acids, which is expressed in visceral (omental and epicardial) fat as well as mesothelial cells, vascular cells, airway goblet cells, small intestine, colon, ovary, and plasma. The level of omentin-1 expression in (pre)adipocytes is decreased by glucose/insulin and stimulated by fibroblast growth factor-21 and dexamethasone. Several lines of experimental evidence have shown that omentin-1 plays crucial roles in the maintenance of body metabolism and insulin sensitivity, and has anti-inflammatory, anti-atherosclerotic, and cardiovascular protective effects via AMP-activated protein kinase/Akt/nuclear factor-κB/mitogen-activated protein kinase (ERK, JNK, and p38) signaling. Clinical studies have indicated the usage of circulating omentin-1 as a biomarker of obesity, metabolic disorders including insulin resistance, diabetes, and metabolic syndrome, and atherosclerotic cardiovascular diseases. It is also possible to use circulating omentin-1 as a biomarker of bone metabolism, inflammatory diseases, cancers, sleep apnea syndrome, preeclampsia, and polycystic ovary syndrome. Decreased omentin-1 levels are generally associated with these diseases. However, omentin-1 increases to counteract the acute phase after onset of these diseases. These findings indicate that omentin-1 may be a negative risk factor for these diseases, and also act as an acute-phase reactant by its anti-inflammatory and atheroprotective effects. Therapeutic strategies to restore omentin-1 levels may be valuable for the prevention or treatment of these diseases. Weight loss, olive oil-rich diet, aerobic training, and treatment with atorvastatin and antidiabetic drugs (metformin, pioglitazone, and exenatide) are effective means of increasing circulating omentin-1 levels. This review provides insights into the potential use of omentin-1 as a biomarker and therapeutic target for these diseases. © 2017 American Physiological Society. Compr Physiol 7:765-781, 2017.