Adrenomedullin, periodontitis, diabetes-unraveling the equivocal relationship: A clinicobiochemical cross-sectional study

Abstract

Context:Antimicrobial proteins and peptides constitute a diverse class of host-defense molecules that act early to combat invasion and infection with bacteria and other microorganisms. Among the various antimicrobial peptides in the oral cavity, adrenomedullin (ADM), a cationic peptide, is found in gingival crevicular fluids (GCFs) in amounts twice as high in periodontal disease sites as healthy sites. Studies have also shown that plasma levels of ADM increased in patients with type 2 diabetes mellitus as compared with controls.Aims:This clinico-biochemical study was undertaken to try to decipher the probable link between ADM, diabetes and periodontitis.Materials and Methods:The study comprised of 90 patients who were divided into three groups based on community periodontal index scores and diabetes status. Probing pocket depth and clinical attachment level were measured in all subjects. GCF was collected from all the participants using micropipettes and blood samples were collected from subjects in Groups III, for analysis of glycated hemoglobin. ADM levels were measured in GCF samples by the enzyme-linked immunosorbent assay.Statistical Analysis Used:The data obtained were subjected to analysis of variance, Bonferroni test and Pearson's correlation.Results:An increase in GCF levels of ADM from periodontal health to disease and in periodontitis patients with type 2 diabetes was noted.Conclusions:Increase in GCF levels of ADM from periodontal health to disease and in periodontitis patients with type 2 diabetes reinforces the perio-systemic interlink concept.

Host Defence Peptides in Diabetes Mellitus Type 2 Patients with Periodontal Disease. A Systematic Review

“…From a total of 12 studies, 10 were observational studies (6 cross-sectional [ 30 , 31 , 32 , 33 , 34 , 35 ] and four case-control [ 36 , 37 , 38 , 39 ]), 1 was an animal study [ 40 ], and 1 was an in vitro study [ 41 ]. Different fluids/tissues were used for the HDPs’ analysis, including GCF [ 30 , 31 , 34 , 36 , 37 , 38 ], saliva [ 33 , 35 , 39 ], GT [ 32 ], and human oral epithelial cells [ 41 ]. However, one study [ 40 ] used both blood and GT for the analysis.…”

“…However, one study [ 40 ] used both blood and GT for the analysis. Three studies investigated adrenomedullin [ 30 , 36 , 38 ], two studies investigated HBD 1 [ 33 , 34 ], and study each investigated hBD 1 and hBD 3 [ 31 ], hBD 2, hBD 3 and hCAP18/LL-37 [ 32 ], hBD 2 [ 35 ], hCAP18/LL-37 [ 37 ], hBD 1, hBD 2, hBD 3 and hCAP18/LL-37 [ 39 ], and hBD 3 [ 40 ] and lipocalin 2 [ 41 ].…”

Effect of scaling and root planing on gingival crevicular fluid level of YKL-40 acute phase protein in chronic periodontitis patients with or without type 2 diabetes mellitus: A clinico-biochemical study

“…GCF has been harvested from the gingival crevice or periodontal pocket using capillary micropipette tubes which is an atraumatic and noninvasive method. [ 14 ] We preferred ELISA test designed on the principle of “sandwich method” in our study because it offers a highly sensitive and specific method to analyze the contents of GCF. To assess the role of YKL-40 in the present study among periodontitis patients with and without diabetes, pre- and post-treatment records of PI and GI were undertaken.…”

Effect of scaling and root planing on gingival crevicular fluid levels of adrenomedullin in chronic periodontitis patients with and without diabetes mellitus type 2: A clinico-biochemical study

“…Type 2 DM diagnosis was according to the HbA1c level (7%–8%). [1617] Individuals with other systemic diseases such as hypertension, subjects on antibiotic therapy in the past 3 months, those who had periodontal treatment in the preceding 6 months, subjects on immunosuppressive therapy, pregnant and lactating mothers, and smokers were excluded.…”

“…Its plasma level is usually elevated in certain conditions such as DM, periodontal disease (PD), and renal diseases. [101112131415]…”