Interrelationship between diabetes and periodontitis: role of hyperlipidemia

Diabetes mellitus and periodontitis are both common, chronic diseases. It is generally accepted that the inter-relationship between diabetes mellitus and periodontitis is a two-way relationship, i.e. the presence of one condition tends to increases the risk and severity of the other, and vice versa. Mechanisms for this two-way relationship are largely unknown. Hyperlipidemia is a group of disorders characterized by an excess of lipids in the bloodstream. Hyperlipidemia increases the risk of diabetes and peridontitis. On the other hand, diabetes and periodontitis could result in hyperlipidemia. The purposes of this review were: (1) examine the two-way relationship between diabetes mellitus and periodontitis; (2) discuss the potential synergistic interactions of hyperlipidemia to both diabetes mellitus and periodontitis; and (3) explore the mechanisms through which hyperlipidemia affects the development of both diseases. The effects of hyperlipidemia on insulin secretion and pro-inflammatory cytokines production (TNF-α, IL-1β) play an important role on the pathogenesis of diabetes and periodontitis. A model is proposed suggesting the important role of hyperlipidemia in the two-way relationship between diabetes and periodontitis. As our understanding of the inter-relationship expands between hyperlipidemia, diabetes, and periodontitis, therapeutic strategies aimed at limiting hyperlipidemia should be advocated for the clinical management of diabetes and periodontitis.