Possible role of gingival crevicular fluid levels of Chemerin and Fibroblast growth factor 21 as biomarkers of periodontal disease in diabetic and non-diabetic patients. A diagnostic accuracy study

Abstract

Background:The relation between diabetes mellitus and periodontitis has been discussed for years. Many adipokines were reported to play a major role in periodontal inflammation. Chemerin is one of these adipokines which is blamed to be involved in inflammatory conditions such as diabetes. Fibroblast growth factor 21 (FGF21) is another adipokine which is believed to induce regulation of glucose. The current study aimed to spot the light on the potential role of gingival crevicular fluid (GCF) level of FGF21 and chemerin as biomarkers of periodontal disease activity and an attempt to understand their role in the link between periodontitis and diabetes. Methods: The study was conducted on 45 individuals, 15 diabetic patients with periodontitis, 15 periodontitis patients and 15 healthy controls. GCF samples were collected from all participants for assessment of chemerin and FGF 21. Samples were analysed using enzyme linked immunosorbent assay (ELISA). Results: Periodontitis patients with diabetes had significant higher levels of chemerin and FGF21 than the periodontitis patients without diabetes followed by healthy controls. ROC analysis showed a 100% diagnostic accuracy for chemerin and FGF21. Conclusion: FGF21 and chemerin in GCF are valuable biomarkers of periodontal disease suggesting a role in the link between diabetes and periodontitis.

The elevation of fibroblast growth factor 21 is associated with generalized periodontitis in patients with treated metabolic syndrome

“…In addition to metabolic parameters, the main outcome of the current study demonstrated a higher level of serum FGF21 in generalized periodontitis group, when compared to group with localized periodontitis. It was in concordance with the previous report conducted in Cairo [ 18 ]. The findings suggested that the elevation of FGF21 in GCF might act as a protective mechanism to oppose periodontal inflammation in diabetic patients with periodontitis.…”

“…Recently, there have been few attempts determining the level of FGF21 in periodontitis patients. One study showed the higher level of FGF21 in gingiva crevicular fluid (GCF) was collected from diabetic patients combined with periodontitis than those without periodontitis [ 18 ]. Moreover, after receiving periodontal treatment, the level of FGF21 in GCF was decreased, suggestive the anti-inflammation effect of FGF21 [ 18 ].…”

“…One study showed the higher level of FGF21 in gingiva crevicular fluid (GCF) was collected from diabetic patients combined with periodontitis than those without periodontitis [ 18 ]. Moreover, after receiving periodontal treatment, the level of FGF21 in GCF was decreased, suggestive the anti-inflammation effect of FGF21 [ 18 ]. However, the other studies measuring FGF21 level in serum found that diabetic group demonstrated increased FGF21 following periodontal therapy as a result of improved glycemic control [ 19 , 20 ].…”

Effect of non-surgical periodontal therapy on salivary resistin and chemerin levels in type 2 diabetes mellitus with chronic periodontitis

“…This persistent inflammatory response is the main cause of A two-way relationship exists between PD and DM. 2 Adipose tissue is a metabolically active and complicated endocrine organ that secretes bioactive chemicals known as adipokines. As with periodontitis and diabetes, the interaction of pro-inflammatory and anti-inflammatory adipokines can result in a low-grade inflammatory disease.…”

Chemerin as a Biomarker for Periodontitis in Systemically Healthy and Type 2 Diabetic Patients

“…Failure of the immune system to remove the cause of inflammation results in a persistent inflammatory response and overexpression of pro-inflammatory cytokines. This chronic inflammatory response is the crucial cause of periodontitis and DM coexistence (6) .…”