Chemerin and IL-6 Levels in Diabetes and Periodontitis
Condition: Chronic Periodontitis; Diabetes Mellitus
MeSH terms: Periodontitis; Chronic Periodontitis; Diabetes Mellitus
Study type: Interventional

Summary: 
      The aims of the present study were to determine the gingival crevicular fluid (GCF) chemerin
      and interleukin-6 (IL-6) levels and to analyse the relationship between chemerin and IL-6 in
      periodontal health and in chronic periodontitis (CP) with and without type 2 diabetes
      mellitus (T2DM) as well as to evaluate the effect of non-surgical periodontal therapy on the
      GCF chemerin levels.
    

Detailed description: 
      Adipose tissue is an active endocrine organ that secretes several inflammatory cytokines,
      namely, adipokines, which interfere with insulin sensitivity, with glucose and lipid
      metabolism, and with the inflammatory process.Chemerin, a more recently identified adipose
      tissue specific adipokine, has a crucial role in adipocyte differentiation and development,
      as well as in glucose, lipid metabolism and inflammation. Experimental data supports both
      pro- and anti-inflammatory roles for chemerin in immune cells. Therefore, it is not clear
      whether chemerin contributes more to the progression of inflammation or the resolution.The
      present investigation has been devoted to elucidate the role of chemerin in the pathogenesis
      that might link between DM and periodontal disease. We hypothesize that chemerin may hold
      value as an inflammatory mediator in CP patients with and without T2DM and non-surgical
      periodontal treatment could have a beneficial influence on the levels of chemerin.

      The aim of this study were:

        1. to determine the role of chemerin in the pathogenesis of periodontal disease and DM via
           comparing with GCF levels of IL-6, which has a known proinflammatory effect in
           periodontal disease and DM

        2. to evaluate the effect of non-surgical periodontal treatment on GCF chemerin levels in
           periodontitis patients with and without T2DM.

      The study included eighty subjects: 20 subjects with systemically and periodontally healthy
      (CTRL group), 20 patients with T2DM and periodontally healthy (DM-CTRL group), 20 patients
      with systemically healthy and CP (CP group), 20 patients with CP and T2DM (DM-CP group).
      Periodontitis patients received nonsurgical periodontal therapy. GCF sampling and clinical
      periodontal parameters were assessed at baseline and 6 weeks after periodontal therapy.
      Chemerin and interleukin-6 (IL-6) levels were measured by enzyme-linked immunosorbent assay,
      and their relative ratios were calculated.

      Subjects were clinically evaluated using the following parameters; plaque index (PI),
      gingival index (GI) , PD, clinical attachment level (CAL) and BOP (deemed positive if it
      occurred within 15 seconds after probing). Clinical measurements were recorded by one
      calibrated examiner at six sites per tooth from the full-mouth teeth excluding third molars
      using with a Williams periodontal probe (Nordent Manufacturing Inc., ElkGrove Village, IL,
      USA) calibrated in millimeters. Anthropometric measurements included weight (kg) and height
      (m) of the subjects to calculate the BMI ( weight divided by the square of height, kg/m2 ).

      All clinical and radiological examinations, sampling site selections were performed by one
      examiner and the samples were collected on the day after clinical examination of patients.
      This was to prevent contamination of GCF with blood associated with the probing of inflamed
      sites. The deepest two pocket sites of single-rooted teeth were selected for the collection
      of GCF in both periodontitis groups, and also two pocket sites with an absence of
      inflammation were sampled to ensure the collection of an adequate amount of GCF in control
      groups. In patients from CP and DM-CP groups, sites showing greatest PD when measured with a
      periodontal probes and signs of inflammation, along with radiographic conformation of bone
      loss were sampled. GCF samples were collected at baseline and after 8 weeks from baseline
      sampling in both periodontitis groups, and only at baseline in control groups. To avoid
      salivary contamination, the sites to be sampled were rinsed with water, isolated by cotton
      rolls and gently air dried. Paper strips (Periopaper; Oraflow Inc.,Smithtown, NY, USA) were
      gently inserted 1-2 mm into the sulcus/pocket for 30 seconds. Care was taken to avoid
      mechanical injury of the gingival tissues. All samples containing blood and saliva were
      discarded. The two strips from two sites of each individual were placed into coded sealed
      plastic eppendorf tubes and pooled before freezing at -80 degree
    

Intervention name(s): non-surgical periodontal treatment
Intervention type(s): Other
Intervention description(s): scaling and root planing were performed
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: periodontitis; diabetes mellitus; chemerin; interleukin-6