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Plasma levels of tumour necrosis factor‐ α in patients with chronic periodontitis and type 2 diabetes
Author(s) -
Engebretson S.,
Chertog R.,
Nichols A.,
HeyHadavi J.,
Celenti R.,
Grbic J.
Publication year - 2007
Publication title -
journal of clinical periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.456
H-Index - 151
eISSN - 1600-051X
pISSN - 0303-6979
DOI - 10.1111/j.1600-051x.2006.01017.x
Subject(s) - periodontitis , medicine , chronic periodontitis , type 2 diabetes , tumor necrosis factor alpha , insulin resistance , diabetes mellitus , inflammation , endocrinology , body mass index , type 2 diabetes mellitus , necrosis , obesity , tumor necrosis factor α , gastroenterology
Objectives: Studies suggest that elevated circulating tumour necrosis factor‐ α (TNF‐ α ) may contribute to insulin resistance in patients with type 2 diabetes. The source of plasma TNF has been thought to be adipocytes associated with obesity, but inflammation and infection result in TNF‐ α production as well. Methods: We studied 46 patients with type 2 diabetes and chronic periodontitis to determine the relationship between plasma TNF‐ α levels and clinical measures of periodontitis, gingival crevicular fluid (GCF) interleukin‐1 β (IL‐1 β ), plasma endotoxin, serum glucose, and glycated haemoglobin (HbA1c). TNF‐ α levels were measured using a high sensitivity enzyme‐linked immunosorbent assay. Results: TNF‐ α showed a significant positive correlation with attachment loss ( r =0.40, p =0.009), plasma endotoxin ( r =0.33, p =0.03), and GCF IL‐1 β ( r =0.33, p =0.035), but not probing depth ( r =0.28, p =0.07), bleeding on probing ( r =0.30, p =0.053), plaque index ( r =0.22, p =0.17), serum glucose, HbA1c ( r =0.10, p =0.50), or body mass index ( r =0.077, p =0.62). A dose–response relationship was observed between periodontitis severity and TNF‐ α ( p =0.012). Conclusion: The finding that chronic periodontitis is associated with plasma TNF‐ α levels in subjects with type 2 diabetes supports the hypothesis that periodontal infection and inflammation may contribute to insulin resistance.