Systemic Inflammatory Biomarkers and Their Association With Periodontal and Diabetes-Related Factors in the Diabetes and Periodontal Therapy Trial, A Randomized Controlled Trial.
The present study evaluates effects of non-surgical periodontal treatment on serum biomarkers in patients with type 2 diabetes mellitus (t2DM) and chronic periodontitis who participated in the Diabetes and Periodontal Therapy Trial (DPTT); and associations among diabetes markers, serum biomarkers, and periodontal measures in these patients.



DPTT participants randomized to receive immediate or delayed non-surgical periodontal therapy were evaluated at baseline and 6 months. Serum samples from 475 participants with 6-month data were analyzed for the following biomarkers: 1) high sensitivity C-reactive protein; 2) E-selectin; 3) tumor necrosis factor (TNF)-α; 4) vascular cell adhesion molecule (VCAM); 5) interleukin (IL)-6; 6) IL-8; 7) intercellular adhesion molecule; and 8) IL-10. Changes in biomarker levels from baseline and correlations among biomarker levels and clinical findings were analyzed.



No differences between treatment and control groups were observed for any biomarkers at baseline or 6 months (P >0.05 for all variables). VCAM levels increased by an average (standard deviation) of 17.9 (99.5); ng/mL (P = 0.006) and E-selectin decreased by 2.33 (16.08) ng/mL (P = 0.03) in the treatment group after 6 months. E-selectin levels were significantly correlated with DM-related variables (hemoglobin A1c [HbA1c] and fasting glucose) at baseline and with 6-month change in both groups; no significant correlations were found among periodontal clinical parameters and serum biomarkers or DM-related variables. Neither HbA1c or body mass index varied during the study period in either study group.



Non-surgical periodontal therapy and periodontal disease severity were not associated with significant changes in serum biomarkers in DPTT participants during the 6-month follow-up. Correlations among changes in E-selectin, IL-6, and DM-related variables suggest that t2DM may be the primary driver of systemic inflammation in these patients.
Department of Periodontology, University of Alabama at Birmingham, Birmingham, AL.
Maria L
ML
Geisinger
Department of Developmental and Surgical Sciences, University of Minnesota, Minneapolis, MN.
Bryan S
BS
Michalowicz
Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, NY.
Wei
W
Hou
Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, NY.
Elinor
E
Schoenfeld
Department of Endocrinology, Stony Brook University.
Marie
M
Gelato
Department of Periodontology and Implant Dentistry, New York University, New York, NY.
Steven P
SP
Engebretson
Department of Periodontics, University of Alabama at Birmingham.
Michael S
MS
Reddy
Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, NY.
Leslie
L
Hyman
D015415:Biomarkers; D012534:Dental Scaling; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D010518:Periodontitis / Q000150:complications*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D015415:Biomarkers; D006442:Glycated Hemoglobin; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha
Biomarkers; cytokines; diabetes mellitus, periodontal diseases; periodontitis