title: Cytokines and bone-related factors in systemically healthy patients with chronic periodontitis and patients with type 2 diabetes and chronic periodontitis.
abstract: BACKGROUND
  This study compares the levels of cytokines and bone-related factors in the gingival crevicular fluid (GCF) of systemically healthy patients with chronic periodontitis (CP); and better-controlled, and poorly controlled patients with type 2 diabetes and CP.
  
  
  METHODS
  Thirty-seven patients with type 2 diabetes and CP and 20 systemically healthy patients with CP were enrolled in this study. The patients with diabetes mellitus were categorized as better-controlled (n = 17; HbA(1c) levels ≤8%) or poorly controlled (n = 20; glycated hemoglobin values >8%). Levels of tumor necrosis factor-α, interleukin (IL)-4, interferon (IFN)-γ, IL-23, IL-17, soluble receptor activator of nuclear factor-kappa B ligand (sRANKL), and osteoprotegerin (OPG) in GCF of diseased sites were analyzed by enzyme-linked immunosorbent assay.
  
  
  RESULTS
  Type 2 diabetes mellitus, as a whole, upregulates the levels of OPG, sRANKL, IFN-γ, IL-17, and IL-23 and downregulates the production of IL-4 in sites with CP (P <0.05). Better-controlled individuals exhibited the highest levels of IFN-γ, whereas poorly controlled patients presented the highest levels of IL-17 (P <0.05). There were no differences in the levels of tumor necrosis factor-α, OPG, and IL-23 among systemically healthy, better-controlled, and poorly controlled patients with diabetes (P >0.05).
  
  
  CONCLUSIONS
  Increased levels of proinflammatory cytokines and RANKL were observed in the GCF of patients with type 2 diabetes with CP, compared to patients without diabetes. In addition, poor or good glycemic status seems to modulate osteo-immunoinflammatory mediators in a different manner.
authors.affiliation: Department of Periodontology, Dental Research Division, Guarulhos University, São Paulo, Brazil.
authors.forename: Fernanda Vieira
authors.initials: FV
authors.lastname: Ribeiro
authors.forename: Adriana Cutrim
authors.initials: AC
authors.lastname: de Mendonça
authors.forename: Vanessa Renata
authors.initials: VR
authors.lastname: Santos
authors.forename: Marta Ferreira
authors.initials: MF
authors.lastname: Bastos
authors.forename: Luciene Cristina
authors.initials: LC
authors.lastname: Figueiredo
authors.forename: Poliana Mendes
authors.initials: PM
authors.lastname: Duarte
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001786:Blood Glucose / Q000378:metabolism; D016022:Case-Control Studies; D055113:Chronic Periodontitis / Q000150:complications / Q000276:immunology / Q000378:metabolism*; D015331:Cohort Studies; D016207:Cytokines / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000276:immunology / Q000378:metabolism*; D005260:Female; D005883:Gingival Crevicular Fluid / Q000276:immunology / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D053244:Osteoprotegerin / Q000378:metabolism; D053245:RANK Ligand / Q000378:metabolism; D053246:Receptor Activator of Nuclear Factor-kappa B / Q000378:metabolism; D012016:Reference Values; D018709:Statistics, Nonparametric
chemical_list: D001786:Blood Glucose; D016207:Cytokines; D053244:Osteoprotegerin; D053245:RANK Ligand; D053246:Receptor Activator of Nuclear Factor-kappa B; C505688:TNFSF11 protein, human