Hyperuricemia as a potential plausible risk factor for periodontitis

Chen, Ziyun; Ye, Lu-wen; Zhao, Li; Liang, Zhanhua; Takata, Yasuyuki; Gao, Jie

doi:10.1016/j.mehy.2020.109591

Cited by 17 publications

(17 citation statements)

References 66 publications

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“…Moreover, periodontal disease can increase blood sugar levels, leading to longer periods of time where the body is operating at hyperglycemic conditions, which impairs the function of the innate immune system and may increase viral replication [ 37 ]. In this sense, periodontitis is significantly more frequent in individuals with T2DM, and individuals who suffer periodontitis have an increased risk of developing T2DM and diabetic complications [ 81 ].…”

Section: Resultsmentioning

confidence: 99%

Should We Be Concerned about the Association of Diabetes Mellitus and Periodontal Disease in the Risk of Infection by SARS-CoV-2? A Systematic Review and Hypothesis

et al. 2021

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The objective of this article was to conduct a systematic review of the literature to contrast the existing evidence regarding the relationship between periodontal disease (PD) and diabetes mellitus (DM) with the possibly increased risk of SARS-CoV-2 infection, as well as to establish a hypothesis that explains the ways in which this interaction could take place. A literature search up from 1 January 2020 to 21 March 2021 was conducted in three electronic databases, namely, PubMed, Web of Science, and Scopus, in order to identify studies on periodontal disease alone or in conjunction with diabetes mellitus, reporting any relation with SARS-CoV-2 infection as a primary outcome. Only articles published in the English language were included. Due to the lack of studies, we decided to collect all the theoretical and clinical evidence suggesting a possible biological pathway evidencing the relationship among PD, DM, and SARS-CoV-2 infection. From a total of 29 articles, 12 were included for final review studies (five reviews, two hypotheses, one Special Issue, one perspective, one commentary, one case–control study, and one case report). In addition, this systematic review article hypothesizes the correlation between PD and type 2 diabetes mellitus (T2DM) by expression of angiotensin-converting enzyme 2 (ACE2) in periodontal tissue and the risk of SARS-CoV-2 infection. T2DM is a metabolic disorder characterized by high blood glucose levels resulting from altered insulin secretion or action. Likewise, periodontitis and T2DM are inflammatory disorders with a bidirectional association, and both diseases have a similar immunomodulatory cascade and cytokine profile. ACE2 is a crucial component of the renin–angiotensin system (RAS) and the key factor of entry in the cells by the new SARS-CoV-2. ACE2 is widely distributed in the lung and kidneys, and interestingly has a great distribution in the oral cavity, principally in the tongue and periodontal tissue. ACE2 in periodontal tissue plays a crucial role between health and disease. Moreover, the ACE2/Ang-(1-7)/MasR axis is downregulated in the dysbiotic and inflammatory periodontal environment. Nevertheless, the balance of ACE2 activity is modified in the context of concurrent diabetes, increasing the expression of ACE2 by the uncontrolled glycemia chronic in T2DM. Therefore, the uncontrolled hyperglycemia possibly increases the risk of developing periodontitis and triggering overexpression of ACE2 in periodontal tissue of T2DM patients, with these events potentially being essential to SARS-CoV-2 infection and the development of mild-to-severe form of COVID-19. In this sense, we would like to point out that the need for randomized controlled trials is imperative to support this association.

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Section: Resultsmentioning

confidence: 99%

Should We Be Concerned about the Association of Diabetes Mellitus and Periodontal Disease in the Risk of Infection by SARS-CoV-2? A Systematic Review and Hypothesis

et al. 2021

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“…In the latter case, it can be a sign of immunologicalmetabolic dysregulation, linking the clinical status of the periodontium to systemic pathologies. 43 Polyphenols are plant metabolites that are not synthesized endogenously. Therefore, their concentration in vivo reflects the supply and absorption of these compounds from food.…”

Section: Discussionmentioning

confidence: 99%

Gingival fluid and saliva concentrations of selected non-enzymatic antioxidants in periodontitis

et al. 2022

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Background. Due to their low specificity, non-enzymatic antioxidants play a significant role in the protection of organisms against free radicals. They are normally sourced from the diet, and independently react with oxidizing molecules and their products.Objectives. The study aimed to determine the concentrations of selected non-enzymatic antioxidants (uric acid (UA), reduced glutathione (GSH) and polyphenols) in the gingival fluid and saliva of patients diagnosed with periodontitis according to the current criteria. Material and methods.This prospective case-control study included 50 patients with periodontitis, who were divided into 2 groups depending on disease severity, along with 25 healthy controls. Unstimulated saliva, stimulated saliva and gingival crevicular fluid (GCF) were collected from all subjects, and nonenzymatic antioxidant concentrations were determined.Results. Significantly lower concentrations of all tested non-enzymatic antioxidants were observed in the gingival fluid as well as in the unstimulated and stimulated saliva of patients with periodontitis (p < 0.05). Moreover, the concentration of GSH was a parameter that differentiated the various degrees of periodontitis (p < 0.05). A significantly lower concentration of GSH was found in the stimulated saliva of patients with moderate progression as compared to those with fast progression of the disease (p < 0.05). Conclusions.The continuation of research on the GSH concentrations in the gingival fluid and saliva may be useful in the context of biomarkers for periodontitis progression.

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“…Second, UA levels tended to be increased in blood whereas decreased in saliva in the presence of periodontitis [24]. Third, periodontal treatment caused various changes in UA levels relative to baseline [25]. Therefore, a systematic review on previous ndings would be imperative for integrating the paradoxical data.…”

Section: Introductionmentioning

confidence: 99%

Association between periodontitis and uric acid levels in blood and oral fluids: A systematic review and meta-analysis

Zhao

Mei

et al. 2023

Preprint

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Background Uric acid, a formerly-known antioxidant that has recently been linked with many inflammatory diseases as a pro-inflammatory and -oxidative mediator in pathological conditions. It is imperative to reassess the association between periodontitis and uric acid in locally and systematically. The aim of this systematic review was to systemically evaluate the association of periodontitis with the uric acid (UA) levels in blood, saliva and gingival crevicular fluid (GCF). Methods Relevant clinical studies up to July 1, 2022 were identified and retrieved from electronic databases, with periodontitis, uric acid, hyperuricemia and gout as the keywords. Weighted (WMD) or standardized mean difference (SMD) was calculated using fixed- or random-effect models. Methodological heterogeneity was assessed. Results Fifteen eligible retrospective studies (blood, n = 7; saliva, n = 8; GCF, n = 1) were enrolled, which included 1302 patients with periodontitis and 916 controls. Meta-analysis demonstrated a statistically enhanced blood UA content (WMD = 0.49 mg/dL, 95% CI: 0.02 to 0.96, P = 0.042) but decreased salivary UA level (SMD = -0.95, 95% CI: -1.23 to -0.68, P < 0.001) in periodontitis versus control. Statistical heterogeneity was significant among studies involving blood (I2 = 94.3%, P < 0.001) but not saliva (I2 = 33.8%, P = 0.196). Conclusions Periodontitis is associated with higher UA levels in blood and lower UA levels in saliva. The indicative mechanisms need to be verified by further clinical and experimental studies. (Registration no. CRD42020172535 in Prospero).

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Hyperuricemia as a potential plausible risk factor for periodontitis

Cited by 17 publications

References 66 publications

Should We Be Concerned about the Association of Diabetes Mellitus and Periodontal Disease in the Risk of Infection by SARS-CoV-2? A Systematic Review and Hypothesis

Should We Be Concerned about the Association of Diabetes Mellitus and Periodontal Disease in the Risk of Infection by SARS-CoV-2? A Systematic Review and Hypothesis

Gingival fluid and saliva concentrations of selected non-enzymatic antioxidants in periodontitis

Association between periodontitis and uric acid levels in blood and oral fluids: A systematic review and meta-analysis

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