Comparison of the inflammatory states of serum and gingival crevicular fluid in periodontitis patients with or without type 2 diabetes mellitus.

Background/purpose:There is a two-way relationship between periodontitis and type 2 diabetes mellitus. This study aimed to compare the inflammatory states in serum and gingival crevicular fluid (GCF) in periodontitis patients with or without type 2 diabetes mellitus (T2DM) and healthy subjects. Materials and methods: 20 subjects were systematic and periodontal healthy (H group), 40 subjects were with periodontitis (CP group), and other 40 were with periodontitis and type 2 diabetes mellitus (DC group). Fasting blood glucose (FBG) and HbA1c was tested. GCF and serum level of interleukin (IL) -17, visfatin, receptor activator of nuclear factor-kappa B (NF-κB) ligand (RANKL)/osteoprotegerin (OPG) ratio were measured. Results: The GCF volume, total amount of IL-17, vastatin, RANKL/OPG ratio in GCF and their concentrations in serum were higher (P < 0.05) in CP and DC groups than in H group, which were also higher (P < 0.05) in DC group than in CP group except for visfatin in GCF and IL-17 in serum. At sample sites of PD ≤ 3 mm, GCF volume, IL-17, visfatin and RANKL/OPG ratio in DC and CP groups were higher (P < 0.05) than that in H group, which were also higher in DC group than in CP group either with PD ≤ 3 mm or PD > 3 mm. Inflammatory state in GCF was positively correlated to systemic inflammation, and both of them were positively correlated to FBG. Conclusion: Moderate and severe periodontitis aggravated systemic inflammation. T2DM together with periodontitis resulted in more severe systemic inflammation. The positive correlation between the periodontal and systemic inflammation and their association with FBG indicated an inflammatory link between periodontitis and T2DM.

The Effects of Initial Periodontal Therapy on the Serum Receptor Activator of Nuclear Factor-κß Ligand/Osteoprotegerin System in Patients With Type 2 Diabetes Mellitus and Periodontitis.

BACKGROUND: The aim of the present study is to evaluate the serum receptor activator of nuclear factor-κß ligand (RANKL)/osteoprotegerin (OPG) system in patients with chronic periodontitis (CP) and type 2 diabetes mellitus (T2DM) and its changes after periodontal intervention. METHODS: Thirty-five patients with CP + T2DM, 35 systemically healthy patients with CP, and 35 healthy controls were enrolled, and serum levels of RANKL and OPG were measured at baseline. Then the CP + T2DM group was divided into a well-controlled subgroup and a poorly controlled subgroup according to their hemoglobin A1c (HbA1c), and initial periodontal therapy was performed. After 3 months, patients in both subgroups were recalled, and serum RANKL and OPG levels were tested again and compared with the baseline. RESULTS: At baseline, serum levels of OPG in the T2DM + CP group were much lower than in the CP group and healthy controls (197.41 ± 57.05 pg/mL versus 232.60 ± 70.85 pg/mL [CP group] or 244.96 ± 85.13 pg/mL [healthy controls], P <0.05), whereas their RANKL levels were much higher than in the other two groups (324.35 ± 87.62 pg/mL versus 284.52 ± 90.35 pg/mL [CP group] or 163.01 ± 45.24 pg/mL [healthy control], P <0.05), as was the RANKL/OPG (R/O) ratio (1.68 ± 0.33 versus 1.26 ± 0.35 [CP group] or 0.72 ± 0.25 [healthy control], P <0.001). Serum levels of OPG in both disease groups had significant negative correlations with HbA1C, and serum levels of RANKL in all participants had significant positive correlations with periodontal parameters. After periodontal intervention, both the well-controlled and poorly controlled subgroups exhibited significant increases in OPG and decreases in RANKL in serum, and the R/O ratio was also notably reduced. Additionally, the poorly controlled subgroup exhibited a greater reduction in HbA1c and a greater increase in OPG than the well-controlled subgroup. CONCLUSIONS: The changing trend in the serum RANKL/OPG system in patients with T2DM + CP was similar to that seen in CP patients and may be even more pronounced. Periodontal intervention effectively improved glucose metabolism and changed the serum RANKL/OPG system regardless of whether patients' HbA1c was well-controlled or poorly controlled over the 3-month observation period.

[Effects of dental health awareness and behaviours on the glycemic metabolic characteristics and periodontal disease of patients with type 2 diabetic].

OBJECTIVE: To analyze the effects of dental health awareness and behaviours on the relationship between glycemic metabolic characteristics and periodontal disease of type 2 diabetic patients. METHODS: In the study, 83 subjects with type 2 diabetes mellitus were recruited. The clinical periodontal indexes, such as pocket probing depth (PPD), attachment loss (AL), modified bleeding index (mBI), plaque index (PLI) were obtained with a Williams type periodontal probe; Laboratory examinations including glycosylated haemoglobin A1(HbA1C) were made, glucose assay tested, and the structured questionnaire interview conducted evaluationg the knowledge, attitude and practice (KAP) about periodontal health. RESULTS: The prevalence of moderate and severe periodontitis was 67.5%, compared with mild periodontitis, whose severities were affected by the higher level of HbA1C (≥8.0%) (OR 54.1-143.1), followed by using glycemic drug (OR=12.9-44.6), stress (OR=16.9-29.6), and the dissatisfaction with diabetic therapy (OR=16.9-18.0) et al. Meanwhile the attachment loss conditions were also correlated with the poor periodontal knowledge level(OR=3.4),older age(OR=1.1),and misjudgement of gingival inflammation (OR=13.3) et al. On the other hand, individuals with moderate and severe periodontitis, having bad teeth brushing effects and knowing about dental plaque inadequately, had a significantly higher risk for the poorly controlled glycemic results (HbA1C≥8.0%), and the OR was 8.61, 8.07, and 7.49 respectively. CONCLUSION: In patients with type 2 diabetes the severity of periodontal disease and the glycemic metabolic level (HbA1C) have a definite bidirectional adverse interrelationship, which is affected by the dental health awareness and behaviours.

[Effect of periodontal therapy on metabolic control and serum biochemical markers in subjects with type 2 diabetes and chronic periodontitis].

OBJECTIVE: To investigate the effect of periodontal therapy on periodontal clinical index, metabolic control and serum biochemical markers in subjects with type 2 diabetes and chronic periodontitis comprehensively. METHODS: Forty patients with type 2 diabetes and chronic periodontitis were enrolled, and periodontal clinical parameters, HbA1c, fasting blood glucose (FBG) and serum biochemical markers were tested at baseline and 3 months after initial periodontal therapy. RESULTS: The periodontal clinical parameters (PLI, BI,PD,CAL and BOP) improved significantly 3 months after initial periodontal therapy (P<0.001). The HbA1c also decreased statistically (P=0.014), while there was no change in venous fasting blood glucose. Other serum biochemical markers changed significantly including serum phosphor increased, calcium-phosphorus ratio decreased, triglyceride decreased, Apo A1 increased, lipoprotein a decreased, and serum total bilirubin increased. CONCLUSION: The initial periodontal therapy can significantly improve periodontal clinical parameters and HbA1c control, but the effect on venous fasting blood glucose was not revealed yet. In addition, initial periodontal therapy can also intervene serum phosphorus,calcium-phosphorus ratio, and the metabolism of lipid.

[Pregnancy by a man with severe oligospermia after vasectomy: a case report].

OBJECTIVE: To analyze the risk of pregnancy in the woman whose husband has severe oligospermia after vasectomy. METHODS: A woman was found pregnant, whose husband, a 35-year-old man, had received vasectomy two years before. Two seminal examinations at the interval of 7 days showed the total number of motile sperm to be 0.047 x 10(6) and 0.044 x 10(6), respectively. DNA analysis after miscarriage exhibited a 99.9996% relative chance paternity (RCP). RESULTS: DNA analysis proved the biological paternity of the man with severe oligospermia after vasectomy. CONCLUSION: A man with severe oligospermia after vasectomy could make his wife pregnant.