Advances in Research on the Mechanism of Association Between Periodontitis and Diabetes Mellitus
Abstract
Periodontitis and diabetes mellitus are both chronic diseases with a rather high prevalence and they are closely associated with each other. On one hand, diabetes mellitus poses as a risk factor for periodontitis. On the other hand, periodontitis has a negative impact on glucose control in diabetic patients. The two-way relationship has aroused a lot of research interest in recent years. Herein, approaching the issue by looking at the effect of periodontitis on diabetes, we summarized the mechanism of the traditional periodontal pocket-blood circulation pathway and reviewed the role of the oral-gut axis in the mechanism, which has been proposed in recent years. In addition, regarding the impact of diabetes on periodontitis, we summarized new findings concerning changes in oral microbiota, abnormal levels of cytokines and adipokines, oxidative stress, unbalanced osteogenic and osteoclastic activities, and the accumulation of advanced glycation end-products. We hope this paper will be helpful for further studies on the mechanism of association between periodontitis and diabetes.
Keywords: Diabetes, Periodontitis, Systemic inflammation, Gut microbiota
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GENCO R J, SANZ M. Clinical and public health implications of periodontal and systemic diseases: an overview. Periodontol 2000,2020, 83(1): 7–13. doi: 10.1111/prd.12344.
SUN H, SAEEDI P, KARURANGA S, et al. IDF diabetes Atlas: global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract,2022,183: 109119. doi: 10. 1016/j.diabres.2021.109119.
STÖHR J, BARBARESKO J, NEUENSCHWANDER M, et al. Bidirectional association between periodontal disease and diabetes mellitus: a systematic review and meta-analysis of cohort studies. Sci Rep, 2021,11(1): 13686. doi: 10.1038/s41598-021-93062-6.
WU C Z, YUAN Y H, LIU H H, et al. Epidemiologic relationship between periodontitis and type 2 diabetes mellitus. BMC Oral Health, 2020,20(1): 204. doi: 10.1186/s12903-020-01180-w.
CHOI Y H, MCKEOWN R E, MAYER-DAVIS E J, et al. Association between periodontitis and impaired fasting glucose and diabetes. Diabetes Care,2011,34(2): 381–386. doi: 10.2337/dc10-1354.
GEORGE A K, NARAYAN V, KURIAN N, et al. A pilot study on glycemia and insulin resistance in patients with severe periodontitis. J Indian Soc Periodontol,2021,25(5): 393–398. doi: 10.4103/jisp. jisp_419_20.
SANTONOCITO S, POLIZZI A, MARCHETTI E, et al. Impact of periodontitis on glycemic control and metabolic status in diabetes patients: current knowledge on early disease markers and therapeutic perspectives. Mediators Inflamm,2022,2022: 4955277. doi: 10.1155/2022/ 4955277.
American Diabetes Association. Microvascular complications and foot care: standards of medical care in diabetes-2018. Diabetes Care,2018, 41(Suppl 1): S105–S118. doi: 10.2337/dc18-S010.
American Diabetes Association. Cardiovascular disease and risk management: standards of medical care in diabetes-2018. Diabetes Care, 2018,41(Suppl 1): S86–S104. doi: 10.2337/dc18-S009.
NOMA H, SAKAMOTO I, MOCHIZUKI H, et al. Relationship between periodontal disease and diabetic retinopathy. Diabetes Care, 2004,27(2): 615. doi: 10.2337/diacare.27.2.615.
GRAZIANI F, GENNAI S, SOLINI A, et al. A systematic review and meta-analysis of epidemiologic observational evidence on the effect of periodontitis on diabetes An update of the EFP-AAP review. J Clin Periodontol,2018,45(2): 167–187. doi: 10.1111/jcpe.12837.
PAGE R C. The pathobiology of periodontal diseases may affect systemic diseases: inversion of a paradigm. Ann Periodontol,1998,3(1): 108–120. doi: 10.1902/annals.1998.3.1.108.
HORLIANA A C, CHAMBRONE L, FOZ A M, et al. Dissemination of periodontal pathogens in the bloodstream after periodontal procedures: a systematic review. PLoS One,2014,9(5): e98271. doi: 10.1371/journal. pone.0098271.
TOMÁS I, DIZ P, TOBÍAS A, et al. Periodontal health status and bacteraemia from daily oral activities: systematic review/meta-analysis. J Clin Periodontol,2012,39(3): 213–228. doi: 10.1111/j.1600-051X.2011. 01784.x.
ARIMATSU K, YAMADA H, MIYAZAWA H, et al. Oral pathobiont induces systemic inflammation and metabolic changes associated with alteration of gut microbiota. Sci Rep,2014,4(18): 4828. doi: 10.1038/srep04828.
KOMAZAKI R, KATAGIRI S, TAKAHASHI H, et al. Periodontal pathogenic bacteria, Aggregatibacter actinomycetemcomitans affect non-alcoholic fatty liver disease by altering gut microbiota and glucose metabolism. Sci Rep,2017,7(1): 13950. doi: 10.1038/s41598-017-14260-9.
LI L, BAO J, CHANG Y, et al. Gut microbiota may mediate the influence of periodontitis on prediabetes. J Dent Res,2021,100(12): 1387–1396. doi: 10.1177/00220345211009449.
BAO J, LI L, ZHANG Y, et al. Periodontitis may induce gut microbiota dysbiosis via salivary microbiota. Int J Oral Sci,2022,14(1): 32. doi: 10. 1038/s41368-022-00183-3.
LÖE H. Periodontal disease. The sixth complication of diabetes mellitus. Diabetes Care,1993,16(1): 329–334. doi: 10.2337/diacare.16.1.329.
KEBEDE T G, PINK C, RATHMANN W, et al. Does periodontitis affect diabetes incidence and haemoglobin A1c change? an 11-year follow-up study. Diabetes Metab,2018,44(3): 243–249. doi: 10.1016/j. diabet.2017.11.003.
POLAK D, SHAPIRA L. An update on the evidence for pathogenic mechanisms that may link periodontitis and diabetes. J Clin Periodontol, 2018,45(2): 150–166. doi: 10.1111/jcpe.12803.
QIN H, LI G, XU X, et al. The role of oral microbiome in periodontitis under diabetes mellitus. J Oral Microbiol,2022,14(1): 2078031. doi: 10. 1080/20002297.2022.2078031.
GU M, WANG P, XIANG S, et al. Effects of type 2 diabetes and metformin on salivary microbiota in patients with chronic periodontitis. Microb Pathog,2021,161(Pt B): 105277. doi: 10.1016/j.micpath.2021. 105277.
AEMAIMANAN P, AMIMANAN P, TAWEECHAISUPAPONG S. Quantification of key periodontal pathogens in insulin-dependent type 2 diabetic and non-diabetic patients with generalized chronic periodontitis. Anaerobe,2013,22: 64–68. doi: 10.1016/j.anaerobe.2013.06.010.
XIAO E, MATTOS M, VIEIRA G H A, et al. Diabetes enhances IL-17 expression and alters the oral microbiome to increase its pathogenicity. Cell Host Microbe,2017,22(1): 120–128.e4. doi: 10.1016/j.chom.2017.06. 014.
POLAK D, SANUI T, NISHIMURA F, et al. Diabetes as a risk factor for periodontal disease-plausible mechanisms. Periodontol 2000,2020,83(1): 46–58. doi: 10.1111/prd.12298.
BAHAMMAM M A, ATTIA M S. Effects of systemic simvastatin on the concentrations of visfatin, tumor necrosis factor-α, and interleukin-6 in gingival crevicular fluid in patients with type 2 diabetes and chronic periodontitis. J Immunol Res,2018,2018: 8481735. doi: 10.1155/2018/ 8481735.
DUARTE P M, De OLIVEIRA M C, TAMBELI C H, et al. Overexpression of interleukin-1beta and interleukin-6 may play an important role in periodontal breakdown in type 2 diabetic patients. J
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