Background An increased osteoprotegerin (OPG) level has been reported in both type-2 diabetes mellitus (T2DM) and cardiovascular diease (CVD) that are linked to sympathovagal imbalance (SVI). We explored the link of osteoprotegerin with cardiovagal modulation in T2DM. Methods We assessed fasting serum OPG, high-sensitive C-reactive protein (hsCRP), glucose, insulin and lipid profile in patients having T2DM receiving oral antidiabetic drugs (OAD) (n = 42) compared with age, gender and body composition-matched healthy participants without diabetes (n = 42). Rate pressure product (RPP), spectral indices of heart rate variability (HRV) and body composition were recorded in both the groups. Association of HOMA-IR and OPG with various parameters were assessed. Results Osteoprotegerin, HOMA-IR, hsCRP, coronary lipid risk factor were significantly increased, markers of cardiovagal modulation (TP, SDNN, RMSSD) were considerably decreased, ratio of low-frequency to high-frequency (LH-HF ratio), the indicator of SVI, and RPP, the marker of myocardial work stress were significantly higher in patients with diabetes, suggesting an overall elevated CVD risks in them. HOMA-IR was correlated with RMSSD, lipid risk factors and OPG. Rise in OPG was correlated with decreased cardiovagal modulation in patients with diabetes. There was significant contribution of OPG in decreasing TP, suggesting impaired cardiovagal modulation. Conclusion T2DM patients receiving OAD had higher cardiometabolic risks compared to age, gender and body composition-matched healthy individuals. Increased level of OPG is linked to decreased cardiovagal modulation in T2DM patients.

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Chronic inflammatory conditions, such as periodontitis, have shown adverse lipid profiles. The periodontal bacterial burden can induce systemic levels of inflammatory mediators precipitating dyslipidemia. Several studies have provided convincing data linking periodontitis, metabolic syndrome and obesity. Based on these findings, this study gauged the impact of comprehensive periodontal care with surgical therapy on standard periodontal clinical indices, and parameters such as the Body-Mass Index (BMI), Waist-Hip circumference ratio (WHR), and serum lipid levels. Thirty patients with high lipid levels and chronic periodontitis were allocated randomly to group A, receiving complete periodontal therapy, and group B, with scaling only. Apart from BMI and WHR, plaque, and gingival indices, probing depth, total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) were recorded before and after three months of intervention. Data analysis utilized the paired t-test and Pearson’s correlation coefficient. Patients receiving complete periodontal treatment showed significantly reduced post-therapy lipid levels (TC, LDL), standard clinical indices (plaque and gingival indices) and probing depth, Body mass index, and waisthip ratio (p< 0.05) compared to their respective baseline levels. Plaque index, Gingival index and probing depth were observed to correlate with total cholesterol levels. Therefore, alleviating conditions with persistent inflammation is essential to manage borderline hyperlipidemia.

ARTICLE INFO ABSTRACTEndo-perio lesions are common but difficult to diagnose problems. Although most cases resolve following endodontic management, extensive tissue loss calls for the surgical intervention. Currently more and more research is focused on regeneration of dental tissues. Recent advances in regenerative procedures like platelet rich fibrin have made the results of the procedure more predictable. In our case, a 45 year old male patient with endo-perio lesion in right maxillary first molar was treated with platelet rich fibrin and demineralized freeze dried bone graft after conventional endodontic therapy. At the end of 6 months, there was significant radiographic and clinical healing. The novel technique described in the case report will help the clinicians in managing an endo-perio case through regenerative procedures in an efficient way.