Serum Cytokine Concentrations in Periodontal Patients with Type 1 Diabetes

Objectives:   Type 1 diabetes mellitus (T1DM) is a risk factor for periodontal disease.  We have identified a significantly increased risk for aggressive periodontitis (AP) in a north-east UK population of young adults with T1DM. Dysregulated inflammatory responses in the periodontium as a result of the hyperglycaemic state may contribute to increased susceptibility to periodontitis. The aim of this pilot study was to measure serum cytokine concentrations in T1DM patients to better understand the pathogenic links between the two diseases.

Methods:   Young adults (aged 16-35 years) with T1DM and either gingivitis or aggressive periodontitis (AP) were recruited (diagnoses were reached using well defined classification criteria following clinical and radiographic examination).  Venous blood samples were collected and serum extracted prior to analysis of interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-a), IL-1b and interferon-g (IFN-g) using high sensitivity cytokine array technology. Glycated haemoglobin (HbA1c) was also determined as a measure of glycaemic control.

Results:   Data for 29 T1DM patients are reported.  The mean (±SD) age was 29.4±4.6 years, with no significant difference between groups.  6 patients were smokers (4 in the gingivitis group and 2 in the AP group).  Mean (±SD) serum cytokine concentrations are shown below, and did not differ significantly between groups (p>0.05).

	IL-6 (pg/ml)	TNF-a (pg/ml)	IL-1b (pg/ml)	IFN-g (pg/ml)
Gingivitis (n=18)	1.27±1.23	6.00±2.54	0.04±0.09	3.96±1.51
AP (n=11)	0.74±0.21	4.65±2.03	0.02±0.05	2.99±1.66

Mean HbA1c scores were 8.9±2.5% and 8.9±1.5% in the gingivitis and AP groups, respectively. A significant correlation was identified between HbA1c values and serum TNF-a concentrations (p<0.05).

Conclusion:   From this preliminary report of an ongoing study of T1DM patients, we found no evidence to support the hypothesis that serum cytokine concentrations differ between T1DM patients with gingivitis and those with AP.

Supported by a grant from the Newcastle Hospitals Healthcare Charity