The role of visfatin levels in gingival crevicular fluid as a potential biomarker in the relationship between obesity and periodontal disease

Abstract

Objectives Visfatin is an adipokine that plays an important role in immune functions as a growth factor, enzyme, and pro-inflammatory mediator. We aimed to determine the levels of visfatin, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) in gingival crevicular fluid (GCF) in both obese/non-obese patients, with/without generalized chronic periodontitis (GCP). Methodology Patients were categorized as obese (O) (n=31) or non-obese (nO) (n=19). Groups were divided into four subgroups according to periodontal conditions: (1) periodontally healthy without obesity (nO-Ctrl); (2) GCP without obesity (nO-CP); (3) periodontally healthy with obesity (O-Ctrl); and (4) GCP with obesity (O-CP). Demographic variables, anthropometric and laboratory data were recorded. Periodontal parameters were measured at baseline and 3 rd months after either non-surgical periodontal treatment or calorie -restricted diet therapy. At the same time, GCF samples were taken from patients to analyze TNF-alpha, IL-6,and visfatin levels. Results Periodontal parameters were significantly higher in the O group than in the nO group (P<0.05). IL-6 levels were higher in the O group than in the nO group (P<0.001). The visfatin levels of the obese patients were reduceddecreased following the treatments (P<0.05). Cholesterol levels were higher in the O group than in the nO groups (P<0.05). IL-6 levels were higher in O-CP and O-Ctrl groups than in the nO-Ctrl group (P<0.05). Compared to the other groups, visfatin levels were significantly higher in the O-CP group but decreased following treatment (P<0.05). Conclusions Our findings suggest that visfatin and IL-6 levels in GCF are associated with the pathogenesis of obesity and periodontitis. Within the limits of this study, we considered that there might be an association between the lipid profile and periodontitis on systemically healthy individuals.

Mendelian randomization highlights the causal association of obesity with periodontal diseases

“…Obesity contributes an increased level of pro-inflammatory mediators (e.g., tumour necrosis factor alpha, visfatin, leptin, and resistin) and a decreased level of anti-inflammatory markers like adiponectin, thereby accounting for a low-grade systemic inflammation that contributes to the breakdown of periodontal tissues (Ganesan et al, 2021). Indeed, clinical findings confirm a higher level of inflammatory cytokines in the cervical gingival fluid of obese individuals (Atabay et al, 2017;Cetiner et al, 2019). Moreover, an exaggerated local immune response has been shown to account for the increased periodontal bone loss in obese mice with periodontal infection (Amar et al, 2007).…”

Associação entre doença periodontal e obesidade

“…Foram excluídos os trabalhos que avaliaram a associação da doença periodontal com outras alterações sistêmicas, como Alzheimer, asma, câncer, diabetes, doença hepática, doença renal, helicobacter pilori, síndrome coronariana, préeclâmpsia, psoríase, rinite alérgica, trabalhos que avaliaram a associação da cárie e obesidade e trabalhos que avaliaram peri-implantite. Foram selecionados treze artigos para serem incluídos nessa revisão, sendo um ensaio clínico, uma meta-análise, dois estudos de coorte, dois caso-controle, cinco estudos transversais e duas revisões sistemáticas 2,6,[8][9][10][11][12][13][14][15][16][17][18]…”

“…Já a visfatina, que também é um mediador secretado pelo tecido adiposo, está relacionada ao início do desenvolvimento do fator de crescimento de células B. Esse marcador pode aumentar os seus níveis mediante os fatores inflamatórios como, por exemplo, na doença periodontal. Existem relações da obesidade e periodontite com os níveis de fluido crevicular gengival (FCG) de adipocitoquinas, sendo que, quando os níveis de adipócitos aumentam, a partir da visfatina, causam a liberação de citocinas, que são conhecidas por desempenharem um papel importante na periodontite e podem desencadear o seu desenvolvimento 6 .…”

Correlation of salivary visfatin levels in obese and NON-OBESE population with periodontal status

“… 20 Similarly, Ceitner D et al, observed that there was a significant increase in Visfatin levels as the BMI increases. 21 …”