An Assessment of Salivary Leptin and Resistin Levels in Type Two Diabetic Patients with Chronic Periodontitis (A Comparative Study)

Background: Type 2 diabetes mellitusand chronic periodontitis hold a close relationship that has been the focus of many researches. Currently there is an appreciation to the role of adipose tissue-derived substances "the adipokines" in immune-inflammatory responses; also, there is an interest in using the simple non-invasive saliva in diagnosing and linking oral and general health problems. The current study aims to determine the periodontal health status in the chronic periodontitis patients with and without poorly or well controlled type 2 diabetes mellitus, measure the salivary levels of two adipokines "leptin and resistin", pH and flow rate and then correlate between these clinical periodontal, biochemical and physical parameters in each study and control groups. Materials and Methods: Seventy five males were recruited for the study, with an age range of (35-50) years. The subjects were divided into four groups: two non-diabetic groups: one of them with healthy periodontium and systemically healthy (Control, 15 subjects) and the other with chronic periodontitis (20 patients) and two type 2 diabetic groups: well controlled (20 patients) and poorly controlled (20 patients) both of them with chronic periodontitis.Unstimulated whole salivary samples were collected from all of the participants; salivary flow rate and pH were measured and then biochemically analyzed for assessment of resistin and leptin levels.Clinical periodontal parameters included: the plaque index, the gingival index, the bleeding on probing, the probing pocket depth and the clinical attachment level had been recorded for all subjects at four sites per tooth except for the third molars. Results: The results of clinical periodontal examination revealed that the group of chronic periodontitis with poorly controlled type 2 diabetes mellitus had the worst periodontal health status. The biochemical analysis demonstrated that the lowest level of salivary leptin was foundin the chronic periodontitis with poorly controlled type 2 diabetes mellitus group. In addition, the highest level of salivary resistin was demonstrated in chronic periodontitis with well controlled type 2 diabetes mellitus group. When the salivary flow rate and pH were measured, it was found that they were decreased in the study groups as compared to the control group. A non-significant moderate negative correlation between salivary leptin with pH in the control group was found. While, salivary resistin demonstrated a high significant moderate positive correlation with the gingival index in the non-diabeticchronic periodontitis group and a non-significant moderate negative correlation with salivary flow ratein the control group. Finally, the study found that the correlation between salivary leptin and resistin was non-significant weak negative in each of the study and control groups. Conclusion: It can be concluded that poorly controlled type 2 diabetic patients have more periodontal tissue destruction and less salivary flow rate than well controlled type 2 diabetic patients and non-diabetic patients all of them with chronic periodontitis. Salivary Resistin and Leptin hormones may be useful biochemical markers of periodontal tissue destruction and this will provide better opportunities in early diagnosis, monitoring and efficient management of periodontal diseases and T2DM