Levels of serum retinol‐binding protein 4 before and after non‐surgical periodontal treatment in lean and obese subjects: An interventional study

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Aim:To evaluate the relationship between oxidative stress parameters in polymorphonuclear leucocytes (PMNs) and PMN-endothelial cell interactions in patients with chronic periodontitis (CP) according to different degrees of severity of the disease. Materials and methods:For this cross-sectional study, 182 subjects were divided into four groups according to degree of CP: without CP (n = 37), mild CP (n = 59), moderate CP (n = 51), and severe CP (n = 35). We determined anthropometric and biochemical variables, periodontal parameters, inflammatory markers, oxidative stress parameters (superoxide and mitochondrial membrane potential), and PMNendothelium cell interactions (rolling flux, velocity, and adhesion).Results: Systemic inflammatory markers-C-reactive protein, leucocyte count, TNFα, and retinol-binding protein 4-were altered in the group with CP. Total superoxide was augmented in patients with moderate and severe periodontitis, whereas mitochondrial membrane potential did not change. Furthermore, PMNs adhesion and rolling flux were increased in subjects with CP. Conclusion:In a systemic proinflammatory environment, PMNs from patients with CP exhibit hyperactivity and produce higher amounts of superoxide. In parallel with this, an increase in PMNs rolling flux and cell adhesion to the endothelium suggests the presence of alterations of PMN-endothelium interactions in patients with CP that can lead to atherosclerosis and cardiovascular complications. K E Y W O R D Sendothelial dysfunction, humans, oxidative stress, periodontitis, reactive oxygen species

Section: Discussionmentioning

confidence: 97%

Chronic periodontitis impairs polymorphonuclear leucocyte–endothelium cell interactions and oxidative stress in humans

Martínez-Herrera

López‐Domènech

Silvestre

et al. 2018

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“…Previous research has suggested that obesity plays a negative role in the response to non‐surgical periodontal therapy (Suvan et al., ; Bouaziz et al., ; Gonçalves, Feres, et al., ; Gonçalves, Zimmermann, et al., ; Martinez‐Herrera et al., ). However, to date, few studies have evaluated the beneficial effect of weight loss on chronic periodontitis.…”

Section: Discussionmentioning

confidence: 99%

“…In reference to sample size determination, the present study was designed to have a power of 80% in order to be able to detect differences of ≥0.15 between the groups in relation to the primary efficacy criterion (absolute PD variation), assuming a common standard deviation of 0.21. This was based on data obtained in a previous study by our group (Martinez‐Herrera et al., ) and a dropout rate of 33% among obese patients submitted to dietary therapy. Under these premises, at least 46 subjects per group were considered.…”

Section: Methodsmentioning

confidence: 99%

“…While some studies (Zuza et al., ; Al‐Zahrani & Alghamdi, ; Altay, Gürgan, & Ağbaht, ) have not found differences in the response to periodontal treatment between obese patients and non‐obese individuals, others have observed an impaired response to periodontal treatment in obese subjects (Suvan et al., ; Bouaziz, Davideau, Tenenbaum, & Huck, ; Gonçalves, Feres, et al., ; Gonçalves, Zimmermann, et al., ). Our group has recently shown that obese patients present worse clinical outcomes than non‐obese subjects 3 months after non‐surgical periodontal treatment (Martinez‐Herrera et al., ), suggesting that obesity has a negative effect on the response to periodontal treatment. In this regard, weight loss could provide an additional beneficial effect to therapy for periodontitis in obese patients, since systemic proinflammatory cytokines tend to decrease after weight loss (Ouchi, Parker, Lugus, & Walsh, ).…”

Section: Introductionmentioning

confidence: 97%

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Dietary therapy and non‐surgical periodontal treatment in obese patients with chronic periodontitis

Martínez-Herrera

López‐Domènech

Silvestre

et al. 2018

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Aim:The effect of dietary weight loss intervention on periodontal therapy is unknown. Therefore, we aimed to evaluate whether weight loss improves the response of obese subjects to non-surgical periodontal treatment. Materials and methods: This interventional study in obese patients was conducted atthe University Hospital Dr. Peset (Valencia, Spain). Patients were divided into two groups with and without dietary therapy. All participants received non-surgical periodontal treatment. Periodontal, anthropometric and biochemical parameters were assessed at baseline and 12 weeks.Results: A total of 78 patients were re-evaluated after intervention. All periodontal parameters improved in both groups after periodontal treatment, but the reductions in mean probing depth (PD) (0.23 mm vs. 0.12 mm) and in percentage of sites with PD 4-5 mm (10.4% vs. 5.89%) were significantly higher in the dietary group. Additionally, complement component 3 (C3) and tumour necrosis factor alpha (TNFα) decreased in the dietary group after intervention. Percentage of change in mean PD correlated with change in C3 (r = 0.233, p = 0.043), and percentage of change in sites with PD 4-5 mm correlated with change in TNFα (r = 0.414, p = 0.012). Conclusions:This study suggests that dietary weight loss intervention causes a greater reduction in systemic inflammation, which may enhance the response to periodontal treatment. K E Y W O R D S diet therapy, non-surgical periodontal treatment, obesity, periodontitis, weight loss | 1449 MARTINEZ-HERRERA ET Al. S U PP O RTI N G I N FO R M ATI O N Additional supporting information may be found online in the Supporting Information section at the end of the article. How to cite this article: Martinez-Herrera M, López-Domènech S, Silvestre FJ, et al. Dietary therapy and nonsurgical periodontal treatment in obese patients with chronic periodontitis.

“…Plasma concentrations of RBP4 did not differ between groups, and no statistically noticeable changes after periodontal therapy could be observed. However, a recent interventional case–control study reported decreasing serum concentrations of RBP4 at 12 weeks after non‐surgical periodontal treatment in lean and obese patients (Martinez‐Herrera et al, 2018). However, we could not confirm these results for our 27.5‐months observation and treatment period.…”

Section: Discussionmentioning

confidence: 99%

Effect of periodontal therapy on adipokine biomarkers in overweight

Matern

Koch

Petersmann

et al. 2020

Aim The aim of this study was to evaluate the effect of non‐surgical periodontal therapy on circulating levels of the systemic inflammation‐associated biomarkers orosomucoid (ORM), high‐sensitivity C‐reactive protein (hsCRP), chemerin, and retinol‐binding protein 4 (RBP4) in overweight or normal‐weight patients with periodontitis at 27.5 months after therapy. Materials and methods This exploratory subanalysis includes patients from the ABPARO‐trial (ClinicalTrials.gov NCT00707369). The per‐protocol collective provided untreated periodontitis patients with high (≥28 kg/m2) or moderate (21–24 kg/m2) BMI. Out of the per‐protocol collective, 80 patients were randomly selected and stratified for BMI group, sex, and treatment group (antibiotics/placebo), resulting in 40 overweight and normal‐weight patients. Patients received non‐surgical periodontal therapy and maintenance at 3‐month intervals. Plasma samples from baseline and 27.5 months following initial treatment were used to measure the concentrations of ORM, hsCRP, chemerin, and RBP4. Results At the 27.5‐month examination, ORM and hsCRP decreased noticeably in the overweight group (ORM: p = .001, hsCRP: p = .004) and normal‐weight patients (ORM: p = .007, hsCRP: p < .001). Chemerin decreased in the overweight group (p = .048), and RBP4 concentrations remained stable. Conclusion Non‐surgical periodontal therapy reduced systemically elevated inflammation‐associated biomarkers in periodontitis patients. These improvements were more pronounced in overweight patients than in normal‐weight patients.