Plasma levels of tumour necrosis factor-α in patients with chronic periodontitis and type 2 diabetes

• Published in: Journal of clinical periodontology Vol. 34; no. 1; pp. 18 - 24
• Main Authors: Engebretson, S., Chertog, R., Nichols, A., Hey-Hadavi, J., Celenti, R., Grbic, J.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.01.2007; Blackwell
• Subjects: Biological and medical sciences; Blood Glucose - analysis; Body Mass Index; Chronic Disease; chronic periodontitis; Cross-Sectional Studies; Dental Plaque Index; Dentistry; Diabetes Mellitus, Type 2 - blood; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; endotoxin; Endotoxins - blood; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Facial bones, jaws, teeth, parodontium: diseases, semeiology; Female; gingival crevicular fluid; Gingival Crevicular Fluid - immunology; Gingival Hemorrhage - blood; Glycated Hemoglobin A - analysis; human; Humans; Insulin Resistance; Interleukin-1beta - analysis; Interleukin-1beta - blood; interleukin-1β; Male; Medical sciences; Middle Aged; Non tumoral diseases; Otorhinolaryngology. Stomatology; Periodontal Attachment Loss - blood; Periodontal Pocket - blood; Periodontitis - blood; plasma; Tumor Necrosis Factor-alpha - blood; tumor necrosis factor-α; type 2 diabetes; Endocrinopathy; Type 2 diabetes; Human; Stomatology; Crevicular fluid; chronic periodontitis; tumor necrosis factor-a; Cytokine; Metabolic diseases; Interleukin 1β; Dentistry; Endotoxin; Blood plasma; interleukin-1β plasma; Toxin; Periodontal disease; Chronic; Association; Periodontitis; Tumor necrosis factor; gingival crevicular fluid; Tumor necrosis factor α; Gingival fluid
• ISSN: 0303-6979; 1600-051X
• DOI: 10.1111/j.1600-051X.2006.01017.x

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‐1β (IL‐1β), 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‐1β (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.