title: Periodontal treatment with topical antibiotics improves glycemic control in association with elevated serum adiponectin in patients with type 2 diabetes mellitus.
abstract: OBJECTIVE
  Chronic inflammation of periodontitis aggravates glycemic control in type 2 diabetic patients through aggravation of insulin resistance. Increased or decreased release of various inflammatory mediators, such as high sensitivity C-reactive protein (hs-CRP), tumor necrosis factor (TNF)-α, interleukin (IL)-6 and adipokines, such as adiponectin, leptin, and resistin, are presumed to be responsible for developing and progressing insulin resistance. The purpose of this study was to examine the effects of periodontal treatment on glycemic control, serum inflammatory mediators and adipokines in type 2 diabetes patients with periodontitis.
  
  
  METHODS
  Twenty-one type 2 diabetic patients with periodontitis received periodontal treatment with topical antibiotics (intervention group) and 8 patients did not receive periodontal treatment (control group). Periodontal examination, including probing pocket depth (PPD) and bleeding on probing (BOP), and blood sampling were performed at baseline, 2 and 6 months after periodontal treatments. Glycated hemoglobin (HbA1c), hs-CRP, TNF-α, IL-6, adiponectin, leptin, and resistin were analyzed.
  
  
  RESULTS
  In the intervention group, improvements of PPD and BOP, decrease in HbA1c and elevation of serum adiponectin were observed, while in the control group, all parameters were not changed. Generalized linear model revealed that changes of serum adiponectin and TNF-α and change of BOP correlated significantly with the reduction of HbA1c at 6 months after periodontal treatments.
  
  
  CONCLUSIONS
  The results demonstrated that periodontal treatment improves periodontal status and glycemic control with elevation of serum adiponectin in type 2 diabetic patients. The results suggest that HbA1c is reduced by amelioration of insulin resistance due to elevated serum adiponectin after periodontal treatments.
authors: Global Center of Excellence Program, International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo Medical and Dental University Graduate School, Tokyo, Japan.
authors: Pariksha
authors: P
authors: Bharti
authors: Section of Periodontology, Department of Hard Tissue Engineering, Tokyo Medical and Dental University Graduate School, Tokyo, Japan. Electronic address:katagiri.peri@tmd.ac.jp.
authors: Sayaka
authors: S
authors: Katagiri
authors: Section of Behavioral Dentistry, Department of Comprehensive Oral Health Care, Tokyo Medical and Dental University Graduate School, Tokyo, Japan.
authors: Hiroshi
authors: H
authors: Nitta
authors: Section of Periodontology and Endodontology, Health Sciences University of Hokkaido, Sapporo, Japan.
authors: Toshiyuki
authors: T
authors: Nagasawa
authors: Section of Periodontology, Department of Hard Tissue Engineering, Tokyo Medical and Dental University Graduate School, Tokyo, Japan.
authors: Hiroaki
authors: H
authors: Kobayashi
authors: Section of Periodontology, Department of Hard Tissue Engineering, Tokyo Medical and Dental University Graduate School, Tokyo, Japan.
authors: Yasuo
authors: Y
authors: Takeuchi
authors: Tokyo Medical and Dental University Medical Hospital, Tokyo, Japan.
authors: Hajime
authors: H
authors: Izumiyama
authors: Department of Clinical and Molecular Endocrinology, Tokyo Medical and Dental University Graduate School, Tokyo, Japan.
authors: Isao
authors: I
authors: Uchimura
authors: Department of Clinical Nutrition, Faculty of Health Care, Kiryu University, Gunma, Japan.
authors: Shuji
authors: S
authors: Inoue
authors: Global Center of Excellence Program, International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo Medical and Dental University Graduate School, Tokyo, Japan.
authors: Yuichi
authors: Y
authors: Izumi
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000287:Administration, Topical; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001786:Blood Glucose / Q000378:metabolism*; D055113:Chronic Periodontitis / Q000097:blood / Q000150:complications / Q000188:drug therapy; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000188:drug therapy; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000188:drug therapy
chemical_list: D052242:Adiponectin; D000900:Anti-Bacterial Agents; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D018836:Inflammation Mediators