<p>Antioxidant and Anti-Inflammatory Properties of Melatonin in Patients with Type 2 Diabetes Mellitus with Periodontal Disease Under Non-Surgical Periodontal Therapy: A Double-Blind, Placebo-Controlled Trial</p>

Abstract

Background and Aim: The imbalance between pro-oxidant and antioxidant systems often leads to further oxidative damage in the pathogenesis of both diabetes and periodontal disease. This study aimed to investigate the antioxidant and anti-inflammatory properties of melatonin in type 2 diabetes mellitus (T2DM) patients with periodontal disease (PD) under non-surgical periodontal therapy (NSPT). Materials and Methods: In this double-blind clinical trial study, 50 T2DM patients with PD were randomly allocated to intervention and control groups and received 250 mg/day (2 tablets) either melatonin or placebo 1 h before bedtime for 8 weeks. The NSPT was performed for all patients in both groups at the beginning of the study. The serum levels of interleukin-1b (IL-1b), malondialdehyde (MDA), total antioxidant capacity (TAC), superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) were measured pre-and post-intervention. Results: Supplementation with melatonin in adjunct to NSPT significantly increased the serum levels of TAC, SOD, CAT, and GPx in the intervention group (P = 0.02, 0.008, 0.004 and 0.004, respectively). The mean changes of SOD, CAT, and GPx were significantly (P = 0.02, 0.04 and 0.04, respectively) greater in the intervention group compared with the control group. Also, after adjusting for confounding factors, the results did not change in terms of significance (P < 0.05). After the intervention, serum levels of MDA and IL-1b were significantly reduced in the intervention group (P < 0.001 and P = 0.008, respectively). The intervention group exhibited lower mean changes of MDA compared with the control group, and these changes were statistically significant (P = 0.008). In addition, after adjusting for confounding factors, the results did not change in terms of significance. Conclusion: The adjunctive effects of melatonin and NSPT may improve inflammatory and antioxidant parameters in T2DM patients with PD.

Melatonin is a potential adjuvant to improve clinical outcomes in individuals with obesity and diabetes with coexistence of Covid-19

“…In a double-blind, placebo-controlled trial, supplementation with melatonin was found to significantly increase the serum activities of SOD, CAT, and GPx and decrease lipid peroxidation in diabetic patients with periodontal disease. This effect was accompanied by lower IL-1b levels in melatonin-treated patients than in control individuals (Zare Javid et al, 2020). The treated patients were administered 6 mg melatonin confirming a previous study using 5 mg as an immediate-or sustained-released dose in patients with T2 diabetes (Rybka et al, 2016).…”

“…It is an effective antioxidant and has powerful free radical scavenging activity (Zare Javid et al, 2020). It also stimulates the messenger RNA (mRNA) levels of various antioxidant enzymes.…”

Effect of Locally Delivered Melatonin as an Adjunct to Nonsurgical Therapy on GCF Antioxidant Capacity and MMP-9 in Stage II Periodontitis Patients: A Randomized Controlled Clinical Trial

“…Similarly, melatonin application was reported to protect the periodontal tissues against ROS injury resulting from inflammatory reactions by reducing the elevated oxidative stress levels in these patients and that it may reduce alveolar bone loss [ 26 ]. Moreover, melatonin supplementation adjunctive to nonsurgical periodontal therapy significantly increased the serum levels of TAC compared with the baseline [ 27 ].…”

Melatonin Inhibits Glucose-Induced Apoptosis in Osteoblastic Cell Line Through PERK-eIF2α-ATF4 Pathway

“…Indeed, treatment with MLT has been shown to restore metabolic dysfunction in elderly patients with hypertension (Shatilo et al, 2010), indicating a role of MLT/MT1/MT2 in metabolic regulation. Clinical trials of MLT supplementation in diabetes patients unequivocally indicated its role in regulating antioxidant enzymes (SOD, CAT, and GPx) and in increasing the overall antioxidant capacity (Rybka et al, 2016;Zare Javid et al, 2020).…”