Gestational diabetes alters subgingival pathobiont composition

This cross-sectional study assesses the relationship between gestational diabetes mellitus (GDM) and periodontal dysbiosis by evaluating specific periodontal pathobionts (Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, and Treponema denticola), clinical periodontal parameters, and periodontal inflamed surface area (PISA).

101 GDM and 98 non-GDM women of 16-36 weeks gestation were included. Clinical periodontal parameters were measured, and PISA values calculated. Subgingival plaque samples, collected from the deepest pockets, were analyzed, to assess the amount of periodontopathogens. Associations were assessed using binary logistic regression and path analysis.

The GDM group showed higher clinical parameters and PISA values (p < 0.001). While P. gingivalis levels were similar in both groups (p = 0.924) and unrelated to the presence of GDM in path analysis (p = 0.055), P. intermedia and T. denticola levels were found higher in the non-GDM group (p < 0.05, p < 0.001) and negatively associated with the presence of GDM (p < 0.001, p = 0.002). P. intermedia increased with gestation week (p = 0.044). Elevated T. forsythia levels were observed to increase GDM risk 1.208-fold in regression analysis (p = 0.002).

Increasing sex hormone levels accompanied by the presence of GDM may alter subgingival pathobiont composition. In patients with GDM, there is a heightened burden of T. forsythia in subgingival zones, where P. intermedia finds less favorable conditions.