the healthy periodontium. It contains different substances including: immunoglobulin, microorganisms, toxins, cells, and lysosomal enzymes and markers. GCF is regarded as a window for non-invasive analysis of periodontal [11-14] conditions, including markers of connective tissue and bone destruction. Evaluation of the molecular markers of tissue destruction in serum was sought to clarify the possible interactions between periodontitis and various systemic diseases and conditions such as gestational diabetes mellitus GDM and adverse pregnancy outcomes). Serum provides information about the inflammatory stimulus and the response generated in circulation towards the periodontal [15,16]. Pathogens that colonize the sub-gingival area. The present study was conducted to evaluate the levels of TNF-α in GCF and serum in chronic periodontitis patients with or without GDM before and after phase I (non-surgical) periodontal therapy and its correlation to periodontal clinical parameters.

When adipose tissue inflammation and dysfunction are established, adipokine secretion is significantly changed toward a diabetogenic, proinflammatory and atherogenic pattern. TNF-α is a pro-inflammatory cytokine that plays a central role in inflammatory reaction, alveolar bone resorption, and the loss of connective tissue attachment. It is positively correlated with Matrix metalloproteinases (MMPs), Prostaglandin E2 (PGE2) and nuclear factor kappa [8-10] ligand (RANKL) expression.