Periodontal Disease, Local and Systemic Inflammation in Puerto Ricans with Type 2 Diabetes Mellitus

Cross-sectional association among dietary habits, periodontitis, and uncontrolled diabetes in Hispanics: the LLIPDS study

Objectives

Type 2 Diabetes (T2D) is recognized as a risk factor for periodontal disease (PD), with evidence supporting a bidirectional relationship. Food choices are thought to influence both conditions, but research on their impact specifically on PD remains limited. This study aimed to explore whether food choices were linked to higher prevalence of adverse periodontal parameters and poorly controlled glucose levels among Hispanic adults with T2D.

Methods

A cross-sectional study was conducted with 260 Puerto Rican adults aged 40-65 years, all diagnosed with T2D. Dietary habits were assessed by weekly frequencies of food choices deemed healthy or unhealthy over the past year. Periodontal health was evaluated by the percentage of sites with probing pocket depth (PPD) ≥4 mm and bleeding on probing (BOP) at corresponding teeth. Glucose control was measured by glycated hemoglobin (HbA1c) levels, with uncontrolled glucose defined as HbA1c ≥ 7%. Linear regression models adjusted for demographic and clinical variables estimated associations with PD. Logistic regression assessed associations with glucose control.

Results

The median Healthy Eating Score was 0.5 (Q1, Q3: -3.9, 4.5). A higher Healthy Eating Score was significantly associated with fewer sites exhibiting PPD ≥ 4 mm and BOP (adjusted β: -0.02; SE: 0.01; p = 0.035), and reduced odds of uncontrolled glucose (adjusted odds ratio: 0.94; 95% CI: 0.89-0.98; p = 0.007).

Conclusions

Adherence to a healthier dietary pattern appears to correlate with lower periodontal inflammation and greater glucose control among Hispanics with T2D. Prospective studies are needed to confirm causality and long-term effects.

Parvimonas micra-polarized M2-like tumor-associated macrophages accelerate colorectal cancer development via IL-8 secretion

Parvimonas micra (Pm), a periodontal pathogen, has been implicated in the impairment of anti-tumor responses in colorectal cancer (CRC). The tumor microenvironment in CRC involves tumor-associated macrophages (TAMs), which are pivotal in modulating tumor-associated immune responses. The polarization of TAMs towards an M2-like phenotype promotes CRC progression by suppressing the immune system. However, the mechanisms by which Pm affects the progression of CRC remain inadequately elucidated. In this study, we explored the impact of Pm infection on CRC cell characteristics, including proliferation, chemoresistance, migration, and macrophage polarization. We found that Pm-infected THP-1-derived macrophages exhibited elevated interleukin-10 levels, a well-established M2 marker. Conditioned media from Pm-treated THP-1 cells significantly enhanced CRC cell proliferation, cisplatin resistance, and migration, and interleukin-8 was identified as a key factor. Consistent with the in vitro results, an azoxymethane/dextran sodium sulfate mouse model treated with oral Pm showed accelerated CRC tumor growth. These results offer mechanistic insights into the influence of Pm infection on tumor microenvironment in CRC through M2-like macrophage polarization. The identified pathways may serve as potential targets for therapeutic interventions for CRC.

Association Between Gastroesophageal Reflux Disease and Periodontitis: A Longitudinal Follow-Up Study from the Korean National Health Screening Cohort

BACKGROUND

Gastroesophageal reflux disease (GERD) and periodontitis are common conditions in older adults that can lead to serious complications, gaining public health attention. Although GERD and periodontitis share common risk factors, such as age, lifestyle habits, and socioeconomic status, large-scale studies examining their specific relationship are limited.

METHODS

This study aimed to assess the association between GERD and the likelihood of developing periodontitis using a national validated cohort data from Korea. Data were drawn from the Korean National Health Insurance Service Health Screening Cohort (2004-2019) using the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) diagnostic codes. The study included 16,744 GERD patients and 66,976 matched controls (matched 1:4 by age, sex, income, and residence). Cox proportional hazard models estimated hazard ratios (HRs) for periodontitis, adjusting for various factors, with subgroup analyses based on age, income, and other covariates.

RESULTS

The overall incidence of periodontitis was similar between the GERD and control groups, with no significant difference in the adjusted hazard ratios (aHR = 1.00, 95% CI 0.99-1.02, p = 0.625). However, subgroup analyses in the GERD group showed a slightly increased likelihood of periodontitis in individuals over 60 years old (aHR = 1.03, 95% CI 1.00-1.06, p = 0.050) and those in lower-income brackets (aHR = 1.03, 95% CI 1.01-1.06, p = 0.023).

CONCLUSIONS

In summary, while GERD was not associated with an increased overall probability of periodontitis, age and socioeconomic factors may influence the likelihood of periodontitis development in certain GERD patients. These findings may highlight the need for targeted preventive strategies and closer oral health monitoring in older and lower-income populations with GERD.

Effect of Compound Xuejie Powder combined with negative pressure wound therapy on diabetic foot ulcers and blood flow in the dorsal foot artery

OBJECTIVE

To observe the therapeutic effect of Compound Xuejie Powder combined with negative pressure wound therapy (NPWT) on diabetic foot ulcers and its influence on the blood flow of the dorsal artery in the foot.

METHODS

A total of 103 patients with diabetic foot ulcers, admitted to our hospital between February 2021 and March 2023, were included in this study. The control group was given NPWT on the basis of conventional treatment such as controlling blood sugar and blood pressure, anti-infection therapy and improving blood circulation, while the observation group was given Compound Xuejie Powder combined with NPWT on the basis of conventional treatment. The two groups were compared in terms of granulation tissue coverage and thickness, wound healing time, levels of inflammatory factors related to Notch signaling pathway in wound exudation, serum angiogenesis factors, and dorsal foot artery blood flow.

RESULTS

Before treatment, there were no significant differences between the two groups in the levels of inflammatory factors related to the Notch signaling pathway in wound exudates or serum angiogenesis factors (all P>0.05). After treatment, vascular endothelial growth factor (VEGF) level increased, while the levels of TNF-α, IL-1β, IL-6, IL-17 and chemoattractant factor (pigment epithelium-derived factor, PEDF) decreased in both groups, an these alterations in the observation group were more pronounced compared to the control group (all P<0.05). There was no significant difference in dorsal foot artery blood flow before treatment (all P>0.05); however, Vm, PI, RI and vascular diameter were notably increased in both groups after the treatment, with more pronounced improvements noticed in the observation group (all P<0.05). The total effective rate, granulation tissue coverage rate, and granulation tissue thickness were significantly higher while wound healing time was significantly shorter in the observation group compared to the control group (all P<0.05).

CONCLUSION

In the treatment of diabetic foot ulcers, Compound Xuejie Powder combined with NPWT can effectively inhibit local inflammation, improve the blood flow of the dorsal foot artery and promote ulcer healing.

Pathogenic Mechanisms That May Link Periodontal Disease and Type 2 Diabetes Mellitus-The Role of Oxidative Stress

Given the posited role of oxidative stress in the pathogenesis of both periodontitis and type 2 diabetes mellitus (T2DM), it may also serve as a link between these highly prevalent chronic inflammatory diseases. This view is supported by an ample body of evidence indicating that the severity and progression of periodontitis is in part driven by diabetes, while periodontal infection may hinder the attainment of adequate glycemic control in diabetic patients. Thus, this review focuses on the potential synergistic interactions along the oxidative stress-inflammation pathway characterizing both conditions. Because periodontitis and T2DM share the same risk factors and compromise patients' quality of life, to develop effective strategies for combatting both conditions, their mutual influence needs to be explored.

Investigating the Connection between Chronic Periodontitis and Parkinson's Disease: Findings from a Korean National Cohort Study

Recent research suggests a potential relevance between chronic periodontitis (CP) and Parkinson's disease (PD), raising concerns about comorbid PD among elderly CP patients. However, the epidemiologic basis for this association remains unclear. Employing a nested case-control design, this study explored the association between CP and subsequent PD occurrences in Korean adults, leveraging a validated national population-based dataset covering the period from 2002 to 2019. It included 8794 PD patients and 35,176 matched control individuals, established through propensity score matching for age, sex, residential area, and income. Baseline characteristics were compared using standardized differences, and logistic regression was employed to assess the impact of CP histories on PD likelihood while controlling for covariates. We performed a thorough examination of CP events within both 1-year and 2-year intervals preceding the index date, incorporating subgroup analyses. Our analysis revealed no statistically significant association between CP history and PD development overall. However, subgroup analysis revealed a slightly increased likelihood of PD development among CP individuals with a high disease burden (Charlson Comorbidity Index score ≥ 2). In conclusion, although our study did not find a significant overall association between CP history and PD development, the elevated likelihood of PD in subgroups with high disease burden may suggest that comorbidities influence PD probability among certain CP patients. Considering comorbid conditions in PD screening for some individuals with CP may be also important.

Exploring Interleukin-10 Levels in Diabetes Patients with and without Oral Diseases: A Systematic Review

Aim

Interleukin-10 (IL-10) is a cytokine that plays an important role in the progression of diabetes mellitus (DM). Oral diseases were more common in diabetics than in non-diabetics. The aim of this review is to identify IL-10 levels in diabetic patients with and without oral diseases.

Methods

A systematic review was conducted based on the PRISMA guidelines. Three databases (PubMed, Cochrane Library, and Science Direct) were used to search for articles up to November 2023 for studies on the measurement of IL-10 in diabetics with and without oral disease. The criteria were limited to human studies and full-text in English only. The outcome was the value of IL-10. The study was quality-graded using the Risk of Bias Assessment Tool for Non-randomized Studies (RoBANS).

Results

There were eleven articles that met the eligibility criteria for analysis. Four articles discovered higher IL-10 levels, while seven articles discovered lower IL-10 levels in diabetes patients with oral diseases compared with each control group.

Conclusion

Most studies showed lower IL-10 levels in diabetic patients with oral diseases compared with the control group.