Published online Apr 15, 2024. doi: 10.4239/wjd.v15.i4.686
Peer-review started: December 20, 2023
First decision: January 10, 2024
Revised: January 19, 2024
Accepted: March 1, 2024
Article in press: March 1, 2024
Published online: April 15, 2024
Processing time: 113 Days and 20.6 Hours
The two-way relationship between periodontitis and type 2 diabetes mellitus (T2DM) is well established. Prolonged hyperglycemia contributes to increased periodontal destruction and severe periodontitis, accentuating diabetic complications. An inflammatory link exists between diabetic retinopathy (DR) and perio
To determine the correlation of periodontal inflamed surface area (PISA) with glycated Hb (HbA1c), serum IL-6 and Lp(a) in T2DM subjects with retinopathy.
This cross-sectional study comprised 40 T2DM subjects with DR and 40 T2DM subjects without DR. All subjects were assessed for periodontal parameters [bleeding on probing (BOP), probing pocket depth, clinical attachment loss (CAL), oral hygiene index-simplified, plaque index (PI) and PISA], and systemic parameters [HbA1c, fasting plasma glucose and postprandial plasma glucose, fasting lipid profile, serum IL-6 and serum Lp(a)].
The proportion of periodontitis in T2DM with and without DR was 47.5% and 27.5% respectively. Severity of periodontitis, CAL, PISA, IL-6 and Lp(a) were higher in T2DM with DR group compared to T2DM without DR group. Sig-nificant difference was observed in the mean percentage of sites with BOP between T2DM with DR (69%) and T2DM without DR (41%), but there was no significant difference in PI (P > 0.05). HbA1c was positively correlated with CAL (r = 0.351, P = 0.001), and PISA (r = 0.393, P ≤ 0.001) in study subjects. A positive correlation was found between PISA and IL-6 (r = 0.651, P < 0.0001); PISA and Lp(a) (r = 0.59, P < 0.001); CAL and IL-6 (r = 0.527, P < 0.0001) and CAL and Lp(a) (r = 0.631, P < 0.001) among study subjects.
Despite both groups having poor glycemic control and comparable plaque scores, the periodontal parameters were higher in DR as compared to T2DM without DR. Since a bidirectional link exists between periodontitis and DM, the presence of DR may have contributed to the severity of periodontal destruction and periodontitis may have influenced the progression of DR.
Core Tip: Periodontal inflamed surface area (PISA) estimates the periodontal inflammatory burden. Prolonged hyperglycemia contributes to increased periodontal destruction and accentuates diabetic complications. An inflammatory link may exist between diabetic retinopathy (DR) and periodontitis. This study assessed correlation between PISA with glycated Hb (HbA1c), interleukin-6 (IL-6) and lipoprotein(a) [Lp(a)] in type 2 diabetes mellitus (T2DM) subjects with and without DR. Significant positive correlation between PISA with HbA1C, IL-6 and Lp(a) were observed. Proportion and severity of periodontitis, PISA, IL-6 and Lp(a) were higher in DR compared to T2DM without DR. Presence of DR may have contributed to the severity of periodontitis and periodontitis may have influenced the progression of DR.