Does metabolic control affect salivary adipokines in type 2 diabetes mellitus?

Adipokines produced by adipose tissue initiate pro-inflammatory events and contribute to the pathogenesis of diabetic periodontitis.

The aim of this study was to evaluate the effect of the metabolic status on the level of salivary adipokines in type 2 diabetes mellitus (T2DM) patients.

A total of 239 individuals, including 161 T2DM patients and 78 healthy (H) controls, participated in the study. The metabolic control status was evaluated in each person. Periodontal measurements were recorded. Periodontal epithelial surface area (PESA), periodontal inflamed surface area (PISA) and the total dental index (TDI) were calculated. The salivary adiponectin, tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), and vaspin levels were determined.

The T2DM patients had higher periodontal parameters and adiponectin, TNF-α, IL-6, and vaspin levels as compared with the H controls (p < 0.05). As the metabolic control worsened, periodontal pocket depth (PPD) and clinical attachment level (CAL) increased. When covariates (age, gender, body mass index - BMI, education level, smoking, dental visit and tooth brushing frequency) were adjusted, only the TNF-α and vaspin levels were significantly higher in the T2DM patients (p < 0.05). In the T2DM patients, positive correlations were found between the TNF-α level and the percentage of bleeding on probing (BOP%), PPD, PESA, and PISA, and between the adiponectin level and PISA. Moreover, there was a negative relationship between the salivary volume and TDI. While the correlations IL-6-TNF-α, vaspin-triglycerides and vaspin-tooth brushing frequency were positive, the statistically significant associations vaspin-IL-6 and vaspin-low-density lipoprotein (LDL) were negative (p < 0.05).

The severity of periodontal disease increases as the metabolic control status worsens. The levels of salivary adipokines were changed by T2DM, while being independent from the metabolic control.