The Expression And Clinical Correlation Of Resistin Level In Gingival Crevicular Fluid Between Periodontitis Patients With Type 2 Diabetes Mellitus And Controls

Objective: Currently,a large number of studies have confirmed that there is an interaction between periodontitis(P)and type 2 diabetes mellitus(T2DM),but the mechanism is not completely clear.Resistin(RETN),as a type of adipokine,has been found to be closely related to inflammation,insulin resistance and obesity.The study mainly detect the RETN concentration in gingival crevicular fluid which is from periodontitis patients with type 2 diabetes mellitus and controls,analyze the correlation between RETN and periodontal examination indexes as well as blood sugar indexes,and search for significant variables on the expression level of RETN.It is hoped that we can understand the correlation between the periodontitis and T2 DM,and provide a theoretical basis for the diagnosis and treatment of patients with periodontitis and type2 diabetes mellitus.Method: 79 subjects from Department of Endocrinology and Department of Stomatology as well as physical examination center in People’s Hospital of Liaoning Province from November 2019 to October 2020 were recruited to participate the research,the age was controlled from 30 to 70 years old.They were divided into 4groups as follows:(1)P+T2DM group,n=20;(2)P group,n=18;(3)T2DM group,n=19;(4)healthy(H)group,n=22.General data such as age,gender,course of T2 DM,the history of smoking and periodontal treatment were collected.Periodontal examination were taken for all subjects and and orthopantomography were taken for periodontitis patients,then record the number of missing teeth(MT).Ten epidemiological index teeth(11,16,17,26,27,31,36,37,46,47)were selected for detail examination,then bleeding index(BI)、 probing depth(PD)and clinical attachment loss(CAL)were measured.Six epidemiological index teeth(lip and cheek surfaces of 16,11,26,31 and tongue surfaces of 36,46)were examined,and simplified soft debris index(DI-S)and simplified calculus index(CI-S)were recorded.Fasting plasma glucose(FPG)and glycated hemoglobin(Hb A1c)were collected in each group.The expression level of RETN in gingival crevicular fluid was determined by double antibody clamp ELISA.SPSS 23.0 software was used for statistical analysis of the data.Results:1.Analysis of the mean concentration of RETN in gingival crevicular fluid showed that,the increasing order of the expression level of RETN in gingival crevicular fluid was as this sequence: H group(12.03 ng/ml)、T2DM group(16.62 ng/ml)、P group(21.75 ng/ml)、P+T2DM group(33.11 ng/ml),there were significant differences between each two groups(P<0.05).2.Correlation analysis between the expression of RETN in gingival crevicular fluid and periodontal clinical indices as well as blood sugar related index in each group found that,the expression level of RETN in P group was positively related with PD、CAL、 BI and CI-S(P < 0.05),the RETN in T2 DM group was positively related with FPG and Hb A1c(P<0.05).and the RETN in P+T2DM group was positively related with PD、CAL、BI、FPG and Hb A1 c.3.The analysis of significant variables that affecting the expression level of RETN in gingival crevicular fluid found that: in the P group,CAL and CI-S are the important factors that affect the expression level of RETN(P < 0.05);in T2 DM group,FPG and Hb A1 c were the significant factors that affect the expression level of RETN(P < 0.05),in the P+T2DM group,PD and FPG are the important factors that affect the expression level of RETN(P < 0.05).4.The analysis of periodontal indexes and blood sugar related indicators showed that PD,CAL,BI,CI-S,DI-S and MT in P+T2DM group and P group were significantly higher than those in T2 DM group and H group(P < 0.05),and PD,CAL and CI-S in P+T2DM group were significantly higher than those in P group(P < 0.05).There was no statistical difference between the T2 DM group and the H group in any periodontal clinical examination indexes.FPG and Hb A1 c in P+T2DM group and T2 DM group were significantly higher than those in P group and H group(P <0.05),FPG and Hb A1 c of group P+T2DM were significantly higher than those of group T2DM(P< 0.05).There was no statistical difference between the P group and the H group in any blood sugar related indicators.Conclusion:1.The expression level of resistin in gingival crevicular fluid of patients with periodontitis is significantly higher than people who has healthy periodontal condition,which may be involved in the occurrence and development of periodontitis to some extent.2.The expression level of resistin in gingival crevicular fluid of patients with periodontitis and type 2 diabetes is significantly higher than other groups,which may be related to the occurrence and development of periodontitis and T2 DM to some extent.