IMPACT OF NON-SURGICAL PERIODONTAL TREATMENT ON SERUM TNF-α LEVELS IN INDIVIDUALS WITH TYPE 2 DIABETES: A SYSTEMATIC REVIEW AND META-ANALYSIS

Lima, Rafael Paschoal Esteves; Atanazio, Andressa Rafaela Silva; Costa, Fernando Oliveira; Cunha, Fabiano Araújo; Abreu, Lucas Guimarães

doi:10.1016/j.jebdp.2021.101546

Cited by 13 publications

(5 citation statements)

References 49 publications

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“…TNF-α, as a pro-inflammatory mediator, has been shown to have high serum levels in individuals with periodontitis, indicating its involvement in the pathologic process of periodontitis. Moreover, TNF-α has been reported to be associated with several diseases, including diabetes, cardiovascular disease, cancer, and metabolic disorders [ 67 ]. Notably, TNF-α levels are correlated with the degree of adiposity and the associated insulin resistance [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of non-surgical periodontal treatment on cytokines/adipocytokines levels among periodontitis patients with or without obesity: a systematic review and meta-analysis

Zhang,

Jia,

Zhang

et al. 2023

BMC Oral Health

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Background The objective of this systematic review and meta-analysis was to evaluate the effects of non-surgical periodontal therapy (NSPT) on inflammatory-related cytokines/adipocytokines in periodontitis patients with or without obesity. Methods We followed the preferred reporting items for systematic reviews and meta-analyses statement and registered the study (CRD42022375331) in the Prospective International Register of Systematic Reviews. We screened randomized-controlled trials and controlled clinical trials from six databases up to December 2022. Quality assessment was performed with RoB-2 and ROBINS-I tools for randomized trials and non-randomized trials, respectively. Meta-analysis was carried out using a random-effect model. Results We included seventeen references in the systematic analysis, and sixteen in the meta-analysis. Baseline results of pro-inflammatory biomarkers, including serum interleukin (IL)-6, serum and gingival crevicular fluid (GCF), tumor necrosis factor (TNF)-a, serum C-reactive protein (CRP)/hs-CRP, and serum and GCF resistin, were higher in obesity subjects than in normal weight subjects. The effect of NSPT with respect to levels of cytokines/adipocytokines, including IL-6, TNF-a, CRP/hs-CRP, resistin, adiponectin, leptin and retinol binding protein 4 (RBP4), were then analyzed in the systematic and meta-analysis. After three months of NSPT, serum (MD = -0.54, CI = -0.62 – -0.46), and GCF (MD = -2.70, CI = -4.77 – -0.63) levels of IL-6, along with the serum RBP4 (MD = -0.39, CI = -0.68–0.10) decreased in periodontitis individuals with obesity. NSPT also improved GCF adiponectin levels after three months (MD = 2.37, CI = 0.29 – 4.45) in periodontitis individuals without obesity. Conclusions Obese status altered the baseline levels of cytokines/adipocytokines (serum IL-6, serum and GCF TNF-a, serum CRP/hs-CRP, and serum and GCF resistin). Then NSPT can shift the levels of specific pro-inflammatory mediators and anti-inflammatory mediators in biological fluids, both in obesity and non-obesity individuals. NSPT can reduce serum and GCF IL-6 levels together with serum RBP4 level in individuals with obesity after 3 months, besides, there is no sufficient evidence to prove that obese patients have a statistically significant decrease in the levels of other cytokines compared to patients with normal weight. NSPT can also increase GCF adiponectin level in normal weight individuals after 3 months. Our findings imply the potential ideal follow-up intervals and sensitive biomarkers for clinical bioanalysis in personalized decision-making of effect of NSPT due to patients’ BMI value.

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Section: Discussionmentioning

confidence: 99%

Effect of non-surgical periodontal treatment on cytokines/adipocytokines levels among periodontitis patients with or without obesity: a systematic review and meta-analysis

Zhang,

Jia,

Zhang

et al. 2023

BMC Oral Health

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“…Similar results were obtained by Cao et al in a meta-analysis of 14 RCTs, in which a significant effect of PT on the reduction of HbA 1C was found [ 142 ]. Moreover, a meta-analysis of 18 clinical trials conducted by Lima et al showed that PT led to a significant reduction in the level of TNF-α ( p = 0.001) in patients with T2DM [ 143 ]. The beneficial effect of PT on the control of the lipid profile in T2DM patients was confirmed in a meta-analysis of seven clinical trials by Garde et al, showing a significant reduction in total cholesterol ( p = 0.001) and triglycerides ( p < 0.00001) [ 144 ].…”

Section: Periodontal Treatment and Atherosclerosis Cardiovascular Dis...mentioning

confidence: 99%

Unexpected Relationships: Periodontal Diseases: Atherosclerosis–Plaque Destabilization? From the Teeth to a Coronary Event

Czerniuk

Surma

Romańczyk

et al. 2022

Biology

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Atherosclerotic cardiovascular disease (ASCVD) and periodontal disease (PD) are global health problems. High frequency of ASCVD is associated with the spread of many risk factors, including poor diet, sedentary lifestyle, diabetes, hyperlipidemia, obesity, smoking, hypertension, chronic kidney disease, hypertension, hyperhomocysteinemia, hyperuricemia, excessive stress, virus infection, genetic predisposition, etc. The pathogenesis of ASCVD is complex, while inflammation plays an important role. PD is a chronic, multifactorial inflammatory disease caused by dysbiosis of the oral microbiota, causing the progressive destruction of the bone and periodontal tissues surrounding the teeth. The main etiological factor of PD is the bacteria, which are capable of activating the immune response of the host inducing an inflammatory response. PD is associated with a mixed microbiota, with the evident predominance of anaerobic bacteria and microaerophilic. The “red complex” is an aggregate of three oral bacteria: Tannerella forsythia Treponema denticola and Porphyromonas gingivalis responsible for severe clinical manifestation of PD. ASCVD and PD share a number of risk factors, and it is difficult to establish a causal relationship between these diseases. The influence of PD on ASCVD should be treated as a factor increasing the risk of atherosclerotic plaque destabilization and cardiovascular events. The results of observational studies indicate that PD significantly increases the risk of ASCVD. In interventional studies, PD treatment was found to have a beneficial effect in the prevention and control of ASCVD. This comprehensive review summarizes the current knowledge of the relationship between PD and ASCVD.

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“…Over recent years, many systematic reviews have reported that NSPT can play a positive role in diabetes, including reductions in HbA1c, blood glucose, and systemic inflammatory factors. [17][18][19] To our knowledge, only one systematic review has investigated the impact of DM on clinical periodontal outcomes; this report concluded that DM had no significant effects on clinical periodontal outcomes. 20 For further analysis, we dichotomized type 2 diabetes status into 'no diabetes', 'well-controlled type 2 diabetes', and 'poorly controlled type 2 diabetes' and then performed network meta-analysis for statistical evaluation.…”

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 98%

The impact of different states of type 2 diabetes when stratified by baselineHbA1con the periodontal outcomes of non‐surgical periodontal treatment: A systematic review and network meta‐analysis

Kang,

Liu,

Yuan

et al. 2024

Int J Dental Hygiene

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BackgroundType 2 diabetes mellitus (T2DM) has been considered by many studies to have a bidirectional relationship with periodontitis. This systematic review and network meta‐analysis aimed to investigate the impact of different states of T2DM when stratified by baseline HbA1c on the clinical outcomes of non‐surgical periodontal treatment (NSPT).MethodsThis study followed the Preferred Reporting Items for Meta‐Analyses (PRISMA) guidelines and involved an electronic literature search (from inception to the 2nd of January 2023). The study included at least two groups of patients: chronic periodontitis only (No‐DM) or periodontitis and well‐controlled/poorly controlled type 2 diabetes mellitus (WC/PC‐T2DM). Clinical outcomes included probing depth (PD) reduction, bleeding on probing reduction, and clinical attachment level (CAL) gain. Direct and indirect comparisons between groups were assessed by network meta‐analysis, thus allowing us to establish a treatment ranking.ResultsTen prospective cohort studies (11 data sets) were included for qualitative analysis and network meta‐analysis. The data included in this study had high consistency; in addition, a funnel plot and Egger's test showed that the articles had low publication bias. Network meta‐analysis showed that the effect of NSPT in the No‐DM group was significantly better than the WC‐T2DM group [weighted mean difference (WMD) = 0.09, 95% confidence interval (CI) (0.01, 0.18)] and the PC‐T2DM group [WMD = 0.09, 95% CI (0.01, 0.18)] in terms of CAL gain and better than the PC‐T2DM group [WMD = 0.15, 95% CI (0.02, 0.28)] in terms of PD reduction. According to the surface under the cumulative ranking value, the No‐DM group had the highest probability of achieving the best outcome following NSPT.ConclusionsCollectively, our analyses show that T2DM exerts significant effects on the outcomes of NSPT.

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IMPACT OF NON-SURGICAL PERIODONTAL TREATMENT ON SERUM TNF-α LEVELS IN INDIVIDUALS WITH TYPE 2 DIABETES: A SYSTEMATIC REVIEW AND META-ANALYSIS

Cited by 13 publications

References 49 publications

Effect of non-surgical periodontal treatment on cytokines/adipocytokines levels among periodontitis patients with or without obesity: a systematic review and meta-analysis

Effect of non-surgical periodontal treatment on cytokines/adipocytokines levels among periodontitis patients with or without obesity: a systematic review and meta-analysis

Unexpected Relationships: Periodontal Diseases: Atherosclerosis–Plaque Destabilization? From the Teeth to a Coronary Event

The impact of different states of type 2 diabetes when stratified by baselineHbA1con the periodontal outcomes of non‐surgical periodontal treatment: A systematic review and network meta‐analysis

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