Key result
Chronic periodontitis with Type II diabetes was associated with decreased GCF periostin (16.77 vs 27.52 ng/mL) and increased TNF-α (147.67 vs 92.41 ng/L) compared to healthy controls (P<0.001).
Why the study?
The study aimed to estimate gingival crevicular fluid levels of periostin and TNF-α and assess their relationship in chronic periodontitis patients with and without Type II diabetes mellitus.
Do gingival crevicular fluid levels of periostin and TNF-α differ in patients with chronic periodontitis with and without Type II diabetes mellitus compared to healthy controls?
Case-Control (n=60)
Do gingival crevicular fluid levels of periostin and TNF-α differ in patients with chronic periodontitis with and without Type II diabetes mellitus compared to healthy controls?
p-value: p=<0.001
In chronic periodontitis, particularly when complicated by Type II diabetes, elevated TNF-α is associated with decreased periostin levels, suggesting a mechanism for compromised periodontal integrity.
Hypothesis-generating for GCF periostin and TNF-α in periodontitis-diabetes comorbidity; prospective studies needed before clinical consideration.
Background: Periostin, a matricellular protein, is downregulated in chronic inflammatory periodontal disease and is negatively modulated by tumor necrosis factor-α (TNF-α) in human periodontal fibroblast cell culture. The study aimed to estimate the gingival crevicular fluid (GCF) levels of periostin and TNF-α and to discern their relationship in chronic periodontitis (CP) individuals with and without Type II diabetes mellitus (DM). Materials and Methods: A total of 60 participants were divided into three groups, with 20 in each group. Group I – systemically and periodontally healthy, Group II – generalized CP, and Group III – generalized CP with Type II DM. Plaque index, gingival index, sulcular bleeding index, probing depth, and clinical attachment level were recorded. GCF periostin and TNF-α were quantified using the enzyme-linked immunosorbent assay. Results: Intergroup comparison was performed using the one-way ANOVA and Kruskal–Wallis. The relationship between the variables was analyzed using the Pearson's and Kendall's Tau correlation. The GCF periostin levels in Groups I, II, and III was 27.52 ± 2.39 ng/mL, 20.18 ± 1.42 ng/mL, and 16.77 ± 3.29 ng/mL, respectively. The GCF TNF-α levels in Groups I, II, and III was 92.41 ± 19.30 ng/L, 118.53 ± 21.93 ng/L, and 147.67 ± 16.35 ng/L, respectively. Periostin decreased, and TNF-α increased in periodontal disease; moreover, periostin level correlated negatively with all the site-specific clinical parameters whereas TNF-α positively correlated (P < 0.001). Conclusions: TNF-α strongly and negatively downregulates periostin in a chronically inflamed locale leading to compromised integrity of the periodontium.
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Prakash et al. (2019) conducted a case-control in Chronic periodontitis and Type II diabetes mellitus (n=60). Chronic periodontitis with or without Type II diabetes mellitus vs. Systemically and periodontally healthy individuals was evaluated on Gingival crevicular fluid (GCF) periostin and TNF-α levels (p=<0.001). Chronic periodontitis with Type II diabetes was associated with decreased GCF periostin (16.77 vs 27.52 ng/mL) and increased TNF-α (147.67 vs 92.41 ng/L) compared to healthy controls (P<0.001).
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