Asprosin, Adropin, Irisin Levels in Periodontitis
Condition: Periodontal Diseases; Gingivitis; Obesity
MeSH terms: Gingivitis; Marfan Syndrome; Periodontal Diseases
Study type: Observational [Patient Registry]

Summary: 
      The recently discovered association of the hormones 'asprosin, adropin and irisin' with
      obesity and metabolic status, as well as the fact that periodontal diseases are affected by
      obesity and nutrition bilaterally, have led us to investigate the relationship between
      selected target markers and periodontal disease. The primary aim and main objective of this
      study is to increase the knowledge and to direct future researches as a result of the lack of
      adequate research in the past and the very limited investigations with these hormones in
      dentistry and periodontology.

      Our study was conducted on 122 patients who applied to Adıyaman University Faculty of
      Dentistry and were referred to the Department of Periodontology for routine periodontal
      controls. Participants' gender, age, height, weight, BMI, education level, tooth brushing and
      flossing habits as well as clinical parameters PI, GI, SCD, CAS and SDI were noted.
      Participants were divided into 4 groups as healthy, gingivitis, initial periodontitis and
      advanced periodontitis and grouped according to the current periodontal classification of
      2017. DOS was collected from the groups for examination and 'asprosin, adropin and irisin'
      values in the samples were evaluated by ELISA test.
    

Detailed description: 
      A total of 122 patients participated in the study. All patients participating in the trial
      received written and verbal information about the purpose and method of the study and signed
      consent. Patients with cardiovascular disease, liver and kidney disease, metabolic disorders,
      diabetes, asthma, thyroid dysfunction, who used antibiotics or anti-inflammatory drugs within
      the last three months, who received periodontal treatment within the last six months, obese
      patients with body mass index (BMI) ≥ 30 kg/m2 according to the reference range determined by
      the World Health Organization, and patients who refused to participate were excluded from the
      study. In order to calculate the BMI of the individuals included in the study, height-weight
      information, tooth brushing frequency in order to determine oral hygiene habits, and
      educational status were also recorded to determine economic levels. Age and gender were also
      noted. Individuals aged 25-60 years were divided into four groups according to their
      periodontal status.

      The periodontal assessment was performed by a single trained examiner (S.D.). A graded
      periodontal probe (Williams, Hu-Friedy, Chicago, IL, USA) was used to measure probing depth
      (PD), which was determined as the depth from the gingival margin to the bottom of the
      gingival sulcus/periodontal pocket; clinical attachment loss (CAL) which was calculated as
      the distance from the cemento-enamel junction to the bottom of the periodontal pocket and
      dual recording (+/-) of bleeding on probing (BOP), gingival index (GI) and plaque index (PI)
      in total except third molars. To assess the intra-examiner calibration, Cronbach's alpha was
      used and its value was 0.90 for PD and CAL measures. Alveolar bone loss (ABL) was determined
      in each participant by orthopantomography. The distance between the cemento-enamel junction
      and the bone crest was measured in both mesial and distal regions and its ratio to the root
      length was calculated to assess bone loss. The periodontal status of the patients was
      evaluated based on the Classification of Periodontal and Peri-Implant Diseases and Conditions
      from the 2017 World Workshop. Participants were classified into four distinct groups based on
      their periodontal conditions:

        1. Group 1: 30 periodontally healthy individuals;

        2. Group 2: 30 patients with gingivitis;

        3. Group 3: 32 patients with generalized stage I and stage II periodontitis;

        4. Group 4: 30 patients with generalized stage III and stage IV periodontitis. An
           individual to be considered to have periodontal health according to this definition, the
           percentage of sites with bleeding on probing should be no more than 10%, and the probing
           depth should be 3 mm or less. Patients with gingivitis had PD ≤3 mm, BOP in ≥30% of the
           probing sites, and no interproximal AL or radiographic bone loss. Stage I periodontitis
           was diagnosed with interdental attachment loss (AL) ranging between 1 and 2 mm at the
           site of greatest loss. Radiographic bone loss (BL) is limited to less than 15% and no
           tooth loss. Additionally, the maximum probing depth (PD) is equal to or less than 4 mm,
           which primarily involves horizontal bone loss. Stage II periodontitis was diagnosed with
           interdental attachment loss (AL) ranging between 3 and 4 mm at the site of greatest
           loss. Radiographic bone loss (BL) extends to a range of 15% to 33%; there is no tooth
           loss. The maximum probing depth (PD) is equal to or less than 5 mm, or primarily
           involves horizontal bone loss. Stage III periodontitis is diagnosed when interdental
           attachment loss (AL) is ≥ 5, radiographic bone loss (BL) extends to the mid-third of the
           root and beyond, and tooth loss may become evident ≤4 teeth. Either PD ≥ 6 mm or
           vertical BL ≥ 3 mm, or Class II/III furcation involvement, or moderate ridge defect.
           Stage IV periodontitis is diagnosed with interdental attachment loss (AL) of ≥ 5 mm at
           the site of greatest loss, with radiographic BL extending to the mid-third of the root
           and beyond. ≥5 tooth losses due to periodontitis are evident. In addition to Stage III,
           either masticatory dysfunction, secondary occlusal trauma (tooth mobility degree ≥ 2),
           severe ridge defect, bite collapse, or teeth drifting and flaring
    

Intervention name(s): Clinical periodontal measuremenets; ELISA test from gingival crevicular fluid (GCF)
Intervention type(s): Diagnostic Test; Diagnostic Test
Intervention description(s): The periodontal assessment was performed by a single trained examiner (S.D.). A graded periodontal probe (Williams, Hu-Friedy, Chicago, IL, USA) was used to measure probing depth (PD) which was determined as the depth from the gingival margin to the bottom of the gingival sulcus/periodontal pocket, clinical attachment loss (CAL) which was calculated as the distance from the cemento-enamel junction to the bottom of the periodontal pocket and dual recording (+/-) of bleeding on probing (BOP), gingival index (GI) and plaque index (PI) in total except third molars G; GCF sampled from the buccal aspects of non-contiguous proximal regions in maxillary single-rooted teeth. In the periodontitis groups, fluid samples were taken from the two deepest pockets. In the gingivitis and periodontal healthy groups, fluid samples were obtained from areas with and without visible inflammation, respectively
Observational model: Case-Control
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        All patients admitted to the periodontology clinic between the study dates
      
Keywords: adropin; asprosin; irisin; periodontal disease; gingival crevicular fluid