Correlation of serum C - reactive protein with clinical parameters in diabetic patients having chronic periodontitis before and after treatment

Authors

  • Arkhawan Ali Abdulhaq Periodontics Department, College of Dentistry, Hawler Medical University
  • Ziwar Ahmed Salih Periodontics Department, College of Dentistry, Hawler Medical University
  • Solaf Abdulqadir Mustafa Periodontics Department, College of Dentistry, Hawler Medical University

DOI:

https://doi.org/10.15218/edj.2020.10

Keywords:

Non-surgical periodontal therapy, diabetes mellitus, CRP level, chronic periodontitis

Abstract

Background and Objectives: Chronic periodontitis is an infectious disease characterized by inflammation within the supporting tissues of the teeth, progressive attachment loss, and bone loss. C-reactive protein, are acute phase proteins monitored as a marker of inflammatory status. The present study was performed to determine whether presence of periodontitis and non-surgical periodontal therapy could influence the serum levels of CRP in type II diabetes mellitus disease patients.

Materials and methods: A total of 60 subjects were selected for study. Venous blood samples were taken at base line and 3 months after non-surgical periodontal therapy for the type II diabetic patients with the clinical signs of chronic periodontitis (group I, n=30) and patients with chronic periodontitis having no diabetic mellitus (group II, n=30) to estimate serum C-reactive protein (CRP) level. Clinical parameters such as glycated hemoglobin (HBA1c ≥ 6.5% ), random blood sugar (RBS) and clinical periodontal parameters (Gingival Index, Probing pocket depth, Clinical attachment level and Plaque Index) for the group I and II were measured.

Results: at base line, type II diabetes mellitus patients group I (T2DMCP) were compared to the non-diabetic patients with chronic periodontitis group II (NDMCP) based on the clinical periodontal parameters (GI,PPD, CAL and PI )scores and CRP level, HBA1c , (RBS) with the 3months after treatment. All the result was statically significant except for the GI and PPD scores at base line which was statically non-significant. The result also shows significant decrease in all the periodontal parameters and CRP level at base line as compared to 3months after treatment when group I was compared to group II while there was no significant change in the CRP level in group I and HBA1c in group II at base line as compared to 3months treatment. Conclusion: The present study concludes that total CRP level were decreased after non-surgical periodontal therapy.

References

1. Könönen E, Paju S, Pussinen P, Hyvonen M, Di Tella P, Suominen-TaipaleL. Population-based study of salivary carriage of periodontal pathogens in adults. J Clin Micro 2007; 45(8): 2446-51.

2. Newman M, Takei H, Klokkevold P, Caranza F. Caranza’s clinical periodontology. Chronic periodontitis 2009; 10(9): 494.

3. Azarpazhooh A, LeakeJL. Systematic review of the association between respiratory disease and oral health. J periodontal 2006; 77:14651482.

4. Bahekar AA, Singh S, Saha S, et al. The prevalence and incidence of coronary heart disease is significantly increased in periodontitis: a meta-analysis. Am Heart J 2007;154:830–837.

5. Bassani DG, Olinto MT, Kreiger N. Periodontal disease and perinatal outcomes: a case-control study. J ClinPeriodontol 2007; 34:31–39.

6. Beck JD, Elter JR, Heiss G. Relationship of periodontal disease to carotid artery intima-media wall thickness: the Atherosclerosis risk in communities (ARIC) study. Arterioscler Thromb Vasc Biol 2001; 21:1816, 2001.

7. Beck JD, Offenbacher S, Williams R, et al. Periodontitis: a risk factor for coronary heart disease? Ann Periodontol 1998; 3:127–141.

8. Beck JD, OffenbacherS. The association between periodontal diseases and cardiovascular diseases: a state-of-the-art review. Ann Periodontol 2001; 6:9–15.

9. Boggess KA, Lieff S, Murtha AP, et al. Maternal periodontal disease is associated with an increased risk for preeclampsia. Obstet Gynecol 2003; 101:227–231.

10. Calabrese N, D’Aiuto F, Calabrese A, et al. Effects of periodontal therapy on glucose management in people with diabetes mellitus. Diabetes Metab 2011; 37:456–459.

11. Canakci V, Canakci CF, Yildrim A, et al. Periodontal disease increases the risk of severe pre-eclampsia among pregnant women. J Clin Periodontol 2007; 34:639–645.

12. Chambrone L, Guglielmetti MR, Pannuti CM, et al. Evidence grade associating periodontitis to preterm birth and/or low birth weight: I. A systematic review of prospective cohort studies. J Clin Periodontol 2011; 38:795–808.

13. Chambrone L, Pannuti CM, Guglielmetti MR, et.al. Evidence grade associating periodontitis with preterm birth and/or low birth weight: II: a systematic review of randomized trials evaluating the effects of periodontal treatment. J Clin Periodontol 2011; 38:902–914.

14. Brochut P, Marin I, Baehni P C, Mombelli A. Predictive value of clinical and microbiological parameters for the treatment outcome of scaling and root planing. J Clin Periodontol 2005; 32: 695–701.

15. Giannobile WV, Beikler T, Kinney JS, Ramseier CA, Morelli T, Wong DT. Saliva as a diagnostic tool for periodontal disease: current state and future directions. Periodontol 2000 50:52-64.

16. Ramamoorthy R D, Nallasamy V, Reddy R, Esther N, and Maruthappan Y. A review of Creactive protein: A diagnostic indicator in periodontal medicine. J Pharma Bioallied Sci 2012; 4(2):422-426.

17. Nupur A, Veerendra K, Sheela G. Effect of periodontal therapy on hemoglobin and erythrocyte levels in chronic generalized periodontitis patients: An interventional study. J Indian Soc Periodontol 2009;13(1):6-11.

18. Aljohani HA. Association between hemoglobin level and severity of chronic periodontitis. Med Sci 2010; 17(1).53-64. ISSN: 1319-1004.

19. Lindhe J, Niklaus P L, Karring T (2008). Clinical periodontology and implant dentistry. 5 th ed, Blackwell publishing company: Blackwell Munksgard.

20. Bortlod P, Ishkawa I, De Deios N (2003). Current trends in periodontal diagnosis, disease recognition and management, proceedings of the 5th Asian pacific society of periodontology meeting, Cebu. The Philippines. 1-2 December.

21. D'Aiuto F, Nibali L, Parkar M, Suvan J, Tonetti MS. Short-term ef-fects of intensive periodontal therapy on serum inflammatory markers and cholesterol. J Dent Res 2005; 84:269-73.

22. Grossi SG, Genco RJ. Periodontal disease and diabetes mellitus: a two-way relationship. Ann Periodontol 1998; 3:51-61.

23. Kalra N, Pradeep AR, Priyanka N, Kumari M. Association of stem cell factor and highsensitivity C reactive protein concentrations in crevicular fluid and serum in patients with chronic periodon-titis with and without type 2 diabetes. J Oral Sci 2013; 55:57-62.

24. Allen EM, Matthews JB, O' Halloran DJ, Griffiths HR, Chapple IL. Oxidative and inflammatory status in Type 2 diabetes patients with periodontitis. J Clin Periodontol 2011; 38:894-901.

25. Kardesler L, Buduneli N, Cetinkalp S, Kinane DF. Adipokines and inflammatory mediators after initial periodontal treatment in patients withtype 2 diabetes and chronic periodontitis. J Periodontol 2010; 81:24.

26. Forner L, Larsen T, Kilian M, Holmstrup P. Incidence of bacteremia after chewing, tooth brushing and scaling in individuals with periodontal inflammation. J Clin Periodontol 2006; 33:401-7.

27. Loos BG. Systemic markers of inflammation in periodontitis. J Periodontol 2005; 76:2106-15.

28. Chen L, Luo G, Xuan D, Wei B, Liu F, Li J, et al. Effects of non-sur-gical periodontal treatment on clinical response, serum inflammatory parameters, and metabolic control in patients with type 2 diabetes: a randomized study. J Periodontol 2012; 83:435-43.

29. Barzilay JI, Abraham L, Heckbert SR, Cushman M, Kuller LH, Resnick HE, et al. The relation of markers of inflammation to the development of glucose disorders in the elderly: the Cardiovascular Health Study. Diabetes 2001;50:2384.

30. Chen L, Wei B, Li J, Liu F, Xuan D, Xie B, et al. Association of periodontal parameters with metabolic level and systemic inflammatory markers in patients with type 2 diabetes. J Periodontol 2010;81:364-71.

31. D'Aiuto F, Parkar M, Nibali L, Suvan J, Lessem J, Tonetti MS. Peri- odontal infections cause changes in traditional and novel cardiovascular risk factors: results from a randomized controlled clinical trial. Am Heart J 2006; 151:97

32. Kamil W, Al Habashneh R, Khader Y, Al Bayati L, Taani D. Effects of nonsurgical periodontal therapy on C-reactive protein and serum lipids in Jordanian adults with advanced periodontitis. J Periodontal Res 2011; 46:616-21.

33. Ide M, McPartlin D, Coward PY, Crook M, Lumb P, Wilson RF. Effect of treatment of chronic periodontitis on levels of serum markers of acute-phase inflammatory and vascular responses. J Clin Periodontol 2003; 30:334-40.

34. Yamazaki K, Honda T, Oda T, Ueki-Maruyama K, Nakajima T, Yo-shie H, et al. Effect of periodontal treatment on the C-reactive protein and proinflammatory cytokine levels in Japanese periodontitis patients. J Periodontal Res 2005; 40:53-8.

35. Fredriksson MI, Gustafsson AK, Bergström KG, Asman BE. Constitutionally hyperreactive neutrophils in periodontitis. J Periodontol 2003; 74:219-24.

36. Sun WL, Chen LL, Zhang SZ, Wu YM, Ren YZ, Qin GM. Inflammatory cytokines, adiponectin, insulin resistance and metabolic control after periodontal intervention in patients with type 2 diabetes and chronic periodontitis. Intern Med 2011;50:1569-74.

Downloads

Published

2020-06-06

How to Cite

1.
Abdulhaq AA, Salih ZA, Mustafa SA. Correlation of serum C - reactive protein with clinical parameters in diabetic patients having chronic periodontitis before and after treatment. EDJ [Internet]. 2020 Jun. 6 [cited 2024 Nov. 23];3(1):71-8. Available from: https://edj.hmu.edu.krd/index.php/journal/article/view/82

Issue

Section

Original Articles

Most read articles by the same author(s)