Low levels of serum Vitamin D in chronic periodontitis patients with type 2 diabetes mellitus: A hospital-based cross-sectional clinical study

Abstract

Aim:Vitamin D is associated with inflammatory diseases such as periodontal disease and diabetes mellitus (DM). The aim of our study was to find out the level of serum Vitamin D in chronic periodontitis patients (CHP) with and without type 2 DM.Materials and Methods:This study consists of 141 subjects, including 48 controls. Case groups consisted of 43 chronic periodontitis patients with type 2 DM (CHPDM) and 50 CHP. pocket depth (PD), clinical attachment loss (CAL), modified gingival index (MGI), plaque index (PI), and calculus index (CI) were taken. Serum 25-hydroxyvitamin D (25[OH] D) level in ηg/ml was estimated by electrochemiluminescence immunoassay with Elecsys and cobase e immunoassay analysers(cobase e 411). Other laboratory investigations including fasting blood sugar (FBS) and serum calcium were measured in all subjects.Results:The mean serum 25(OH) D level was 22.32 ± 5.76 ηg/ml, 14.06 ± 4.57 ηg/ml and 16.94 ± 5.58 ηg/ml for control, CHPDM and CHP groups respectively. The difference was statistically significant (P < 0.05). The mean value of FBS was significantly high in CHPDM group as compared to CHP group. Periodontal parameters like MGI, PI, PD, and CI showed significant difference between groups (P < 0.05) and higher score was found in CHP group, while CAL and PI showed no statistically significant difference between CHP and CHPDM group (P > 0.05).Conclusions:This study observed a low level of serum Vitamin D level in patients with CHP and CHPDM. Low Vitamin D level was observed in case groups may be due to the diseases process rather than low Vitamin D acting as a cause for the disease.

Vitamin D deficiency in patients with aggressive periodontitis

“…Further support for the role of vitamin D in periodontal diseases comes from clinical trials showing that vitamin D supplementation can reduce tooth loss and attenuate the severity of the periodontal disease or gingival inflammation (Garcia et al, ). This association seems consistent across racial or ethnic groups (Abreu et al, ; Joseph et al, ; Zyablitskaya et al, ).…”

Vitamin D and Periodontitis: A Systematic Review and Meta-Analysis

“…Two articles [ 28 , 56 ] reported 91 aggressive periodontitis cases—one assessed the circulating 25(OH)D levels [ 28 ], and the other assessed salivary levels [ 56 ]. Quantitative analysis included a total of 10,506 subjects (subcategorised as 9718 periodontal healthy patients and 788 patients with chronic periodontitis) from 13 studies, of which three [ 33 , 57 , 58 ] assessed 25(OH)D levels through salivary samples, nine through serum levels [ 28 , 29 , 30 , 31 , 32 , 36 , 59 , 60 , 61 ], and one assessed both methods [ 62 ].…”

Relationship between serum 25‐hydroxyvitamin D3levels and severity of chronic periodontitis in type 2 diabetic patients: A cross‐sectional study

“…The 25(OH)D 3 level showed an obvious inverse correlation with FBG levels but not with HbA1c percentage in T2DCP patients. The reason may be that VD 3 could improve insulin resistance (IR) in T2DCP by decreasing blood glucose rather than the HbA1c level . Strong bacterial toxicity due to periodontitis may aggravate systemic inflammation via enhanced cytokine secretion, which would promote IR and ultimately maintain a state of hyperglycemia .…”

“…The reason may be that VD 3 could improve insulin resistance (IR) in T2DCP by decreasing blood glucose rather than the HbA1c level. 26,27 Strong bacterial toxicity due to periodontitis may aggravate systemic inflammation via enhanced cytokine secretion, which would promote IR and ultimately maintain a state of hyperglycemia. 2,3 Our findings suggest that hyperglycemia might promote the inflammatory status induced by VD 3 deficiency, 28 which may be a predisposing factor for the severity of periodontitis in T2DCP.…”