Effect Of Basic Periodontal Therapy On The Level Of Adipokines And HOMA-IR In Type 2 Diabetes Patients With Periodontitis

Objective: Diabetes is a metabolic disorder caused by impaired glucose metabolism,characterized by multiple drinking,multiple meals,multiple urine,and wasting,seriously affect the physical and mental health of patients.Type 2 diabetes is the main type of diabetes,the incidence occupies more than 90% diabetes patients.Periodontitis is characterized by the destruction of periodontal connective tissue,which can result in tooth loss.Approximately80% of adults in China have periodontitis,and chronic peridontitis is the most common type.It is recognized today that there is a bidirectional relationship between diabetes and periodontitis.The exact mechanism of diabetes and periodontitis is not clear.Our research is to investigate the impact on leptin and visfatin concentration,insulin resistance index in patients with type 2 diabetes and chronic periodontitis by basic periodontal therapy,to better understand the systemic and local inflammatory condition of patients with type 2 diabetes and chronic periodontitis,and offer a new idea to investigate the mechanism of diabetes and periodontitis.Materials and Methods: Thirty patients of type 2 diabetes with chronic periodontitis from the Affiliated Hospital of Qingdao University were enrolled,they were divided randomly into observation group and control group.The observation group received the basic periodontal therapy,including oral health education,scaling and root planning.And the patients in control group only received oral health education.The periodontal indexes before and after treatment were measured,including plaque index,pocket depth,and attachment loss.Serum and GCF samples were selected before and after treatment.The leptin and visfatin contents were tested by ELISA kit.The periodontal indexes,Hb A1 c,HOMA-IR and adipokines of the two groups before and after treatment were compared,and analyze the correlation of adipokines and other indexes.Results: At 3 months after treatment,the periodontal indexs improved significantly in observation group,and the concentration of serum leptin,visfatin decreased significantly(P<0.05).The GCF leptin level were significantly higher than baseline,and the concentration of GCF visfatin were significantly decreased(P < 0.05)in observation group.And after treatment,HOMA-IR and Hb A1 c level of observation group improved significantly,thedifferences were statistically significant(P<0.05).The concentration of serum visfatin had a positive correlation with Hb A1 c level.And the leptin level in GCF had a negative correlation with PD.In control group,there was no significant difference between the baseline and after treatment in PLI,PD,AL,leptin,visfatin,Hb Alc and HOMA-IR(P>0.05).Conclusions: The basic periodontal therapy can improve the periodontal inflammation,Hb A1 c and HOMA-IR level.The basic periodontal therapy can increase the GCF leptin and decrease the GCF visfatin in type 2 diabetes patients with periodontitis,which may be related to the control of periodontal condition.The glycemic control improvement may be associated with serum leptin and visfatin level.