Influence of Periodontal Disease on cardiovascular markers in Diabetes Mellitus patients

Abstract

The objective of the present study was to establish if individuals with Diabetes Mellitus (DM2) and periodontal diseases (gingivitis or periodontitis) presented an increase in the concentration of modified LDL (moLDL) and what is the influence of periodontal treatment on the decrease of moLDL particles with consequent improvement in the parameters of DM2. Twenty-four diabetic patients with periodontitis (Group 1) and twenty-four diabetic patients with gingivitis (Group 2) were followed up for a period of 12 months. Group 1 was treated with periodontal debridement, and Group 2 received supra-gingival scaling and prophylaxis. In both groups, periodontal clinical parameters: probing depth (PD), clinical attachment level (CAL), gingival resection (GR), bleeding on probing index (BOP) and plaque index; inflammatory serum markers (glycemia, A1c, total cholesterol, HDL-cholesterol (HDL-c), LDL-cholesterol (LDL-c), triglycerides and hs-CRP) and oxidized LDL (oxLDL) were measured at baseline, t = 6 and t = 12 months after treatment. Solutions of LDL were analyzed using the nonlinear optical Z-Scan and optical absorption techniques. The periodontal clinical parameters showed significant improvement (p < 0.05) in both Group after 12 months. For both groups, total cholesterol, HDL-c, LDL-c, triglycerides and A1c levels did not show significant reductions after periodontal therapy. hs-CRP levels in Group 1 presented a significant reduction after 12 months. The glycemic rate and the oxLDL concentrations did not show significant differences as a function of time. The optical measurements of LDL solutions revealed an improvement of the LDL-c quality in both groups. Periodontal debridement was able to improve periodontal parameters and the quality of LDL-c in diabetic patients but without changes in the oxLDL concentration in both groups. Considering the clinical relevance, the reduction of infectious and inflammatory sites present in the oral cavity through periodontal therapy may help with the control and prevention of hyperglycemia and precursors of cardiovascular diseases.

Salivary inflammatory biomarkers and glycated haemoglobin among patients with type 2 diabetic mellitus

“…Scientific reports have shown a strong association between periodontitis and diabetes, Actinomycosis actinomycetemcomitans (Aa), a facultative gram negative organism play a critical role in pathogenesis of periodontitis, high serum levels of immunoglobulin -A and Immunoglobulin G antibodies against Aa have been detected in the early stage of diabetes [29,30]. Indeed, periodontal treatment in diabetics led to a reduction in hsCRP after a follow up period [31]. Expectedly, the serum glycated haemoglobin levels were significantly higher in diabetics than healthy controls in our study.…”

Assessment of Common Dental Indices and Need for Periodontal Treatment in the Cardiology Outpatients Unit at the University Hospital Gabriel Tour&#233; (UH-GT) in Bamako

“…• The CPITN is known to be influenced by many conditions inclusive socio-economic [39] [40] [41], behavior like tobacco smoking [42] pregnancy [43] or diabetes [44]. In all cases dealing with cardiovascular patients requires more actions and above all act preventively.…”

Salivary Inflammatory Biomarkers and Glycated Haemoglobin among Patients with type 2 Diabetic Mellitus

“…Other conditions such as periodontal diseases, cardiac in ammation, obesity and renal dysfunction may also be associated with raised CRP levels this is a limitation for the use of these biomarkers for monitoring in diabetes mellitus 27 . Indeed, periodontal treatment in diabetics led to a reduction in hsCRP after a follow up period 28 . Expectedly, the serum glycated haemoglobin levels were signi cantly higher in diabetics than healthy controls in our study.…”