Mechanisms linking periodontitis and diabetes

Background + Aims

• Periodontitis is a chronic inflammatory disease that leads to tissue and bone destruction. It is more severe in individuals living with type 1 diabetes mellitus (T1DM) due to heightened systemic inflammation.
• Osteoprotegerin (OPG) is a regulator of bone metabolism and inflammation. Serum OPG levels may reflect tissue destruction in systemic inflammatory conditions, including periodontitis and diabetes.
• This study aimed to examine whether serum OPG and soluble receptor activator of nuclear factor kappa B ligand (sRANKL) levels are associated with periodontal inflammation and tissue destruction in people with T1DM.
• Researchers hypothesised that serum OPG levels would correlate with the severity of periodontal destruction, while sRANKL and the sRANKL/OPG ratio would also be linked to periodontal status.

Materials + Methods

• A cross-sectional study conducted on 80 participants with T1DM (aged 18–74 years) from healthcare facilities in Finland.
• Data Collection:
  • Clinical periodontal examination assessed probing pocket depth (PPD), attachment loss (AL), and bleeding on probing (BOP).
  • Serum OPG and sRANKL levels were measured using ELISA.
  • Glycaemic management was evaluated using three-year and one-year averages of HbA1c levels.
• Participant Groups:
  • Classified based on periodontal severity (no/mild, moderate, severe).
  • Smokers and non-smokers were analysed separately due to the confounding effect of smoking.
• Statistical Analysis:
  • Linear regression models tested the association between periodontal parameters and serum markers.
  • Adjustments were made for age, gender, body mass index (BMI), smoking, and glycaemic control.

Results

• Serum OPG levels were positively correlated with periodontal attachment loss and severity of periodontitis.
• Subjects with severe periodontitis had higher OPG levels (135 pg/ml) compared to those with mild/no periodontitis (96 pg/ml).
• There was no significant association between serum sRANKL and sRANKL/OPG with periodontal inflammation or tissue destruction.
• Smokers showed weaker associations between OPG and periodontitis, potentially due to residual confounding or reduced sample size in non-smoking analysis.
• Age and HbA1c levels showed modest correlations with OPG levels.
• The findings suggest that serum OPG is a systemic marker of periodontal tissue destruction in individuals with T1DM.

Limitations