Gingival Crevicular Fluid Vaspin and Omentin Levels in Type 2 Diabetic Patients With Chronic Periodontitis
Condition: Chronic Periodontitis; Diabetes Mellitus
MeSH terms: Periodontitis; Chronic Periodontitis; Diabetes Mellitus
Study type: Interventional

Summary: 
      The aim of the present study were 1) to determine the role of these adipokines in the
      pathogenesis of periodontal disease, inflammation and tissue destruction comparing with
      gingival crevicular fluid (GCF) levels of TNF-α, which has a known pro-inflammatory effect in
      periodontal disease, 2) to investigate the effect of non-surgical periodontal treatment on
      GCF vaspin and omentin levels in type 2 diabetic (T2DM) patients with Chronic Periodontitis
      (CP).
    

Detailed description: 
      Adipose tissue produces and releases a variety of inflammatory factors, including
      adipocytokines , such as adiponectin, leptin, tumor-necrosis factor alpha (TNF-α),
      interleukin-6 (IL-6), visfatin, vaspin and omentin.These adipokines have widespread effects
      on carbohydrate and lipid metabolism and appear to play an important role in the pathogenesis
      of insulin resistance, diabetes, inflammation, wound healing, and immune responses.Recently,
      studies evaluated the serum vaspin and omentin levels as inflammatory markers in T2DM
      patients. Based on the above mentioned studies, the present investigation has been devoted to
      elucidate the role of adipokines in the pathogenesis that might link DM and periodontal
      disease. We hypothesize that vaspin and omentin are inflammatory adipokines involved in
      chronic inflammation and are associated with T2DM and CP. Additionally, the evaluation of GCF
      vaspin and omentin levels can provide advance the biologic link between DM and periodontitis.
      Until now, levels of GCF vaspin and omentin in CP patients with T2DM before and after
      non-surgical periodontal treatment has not been explored. Hence, the aim of the present study
      were 1) to determine the role of these adipokines in the pathogenesis of periodontal disease,
      inflammation and tissue destruction comparing with GCF levels of TNF-α, which has a known
      pro-inflammatory effect in periodontal disease 2) to investigate the effect of non-surgical
      periodontal treatment on GCF vaspin and omentin levels in T2DM patients with CP.

      A total of 15 T2DM patients with CP ( DM-CP group), 15 CP patients (CP group), 15 T2DM
      patients (DM-CTRL group) and 15 subjects with systemically and periodontally healthy control
      subjects (CTRL group) were included in the study. Diabetic subjects should have T2DM and had
      no any known systemic diseases other than T2DM. The glycemic status of patients previously
      diagnosed with T2DM was confirmed by their glycated haemoglobin (HbA1c) levels. Periodontal
      disease status was determined according to clinical and radiographic criteria by the 1999
      classification of periodontal disease.

      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): gingival crevicular fluid; non-surgical periodontal treatment
Intervention type(s): Other; Other
Intervention description(s): gingival crevicular fluid was collected; scaling and root planing were performed
Allocation: Non-Randomized
Intervention model: Single Group Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: vaspin; omentin; diabetes mellitus; chronic periodontitis; tumor-necrosis factor alfa; gingival crevicular fluid