Periodontal Treatment and Serum MMPs in Diabetic and Non-diabetic Subjects

Objectives: Studies suggest that diabetes may contribute to elevated matrix metalloproteinase (MMP) levels in the serum. However it remains unclear whether periodontitis contributes to these elevated levels. Methods: We studied 45 patients with type 2 diabetes and moderate to advanced chronic periodontitis and 28 subjects with similar periodontal disease severity but without diabetes. Serum was collected at baseline and 1 month following non-surgical periodontal therapy. MMPs-1,-2,-3,-7,-8,-9,-12, and -13 were evaluated using the Luminex® analyzer and a commercially available mutiplex kit. Serum MMP levels, metabolic markers, and clinical measures of periodontal disease were examined using a Spearman Rank correlation and Mann-Whitney U Test. Results: Baseline MMPs-1, -3, -7, -8, -12, and -13 levels were significantly elevated in non-diabetic subjects when compared with diabetic subjects, while MMP-9 was significantly higher in diabetic subjects. Among periodontal disease measures, MMPs -7(p=0.02), -8 (p=0.003), and -9 (p=0.04), showed a significant positive correlation with %sites bleeding on probing (%BOP) for non-diabetics but not for diabetic subjects, while MMP-3 was significantly correlated with %BOP for diabetic subjects (p=0.01). Among metabolic markers, HDL showed a significant negative correlation with MMP-9 (p=0.008) in diabetic subjects. For diabetic subjects after therapy MMP-1, -2, -3, and -7 were significantly increased while MMP-8 was reduced. No significant changes following treatment were noted for non-diabetic subjects. Conclusions: These results indicate that chronic periodontitis may influence circulating MMP levels, and that therapy may influence these levels. The effects of therapy however, were observed only among diabetic subjects.

Supported by Columbia University Office of Clinical Trials Pilot Award (SE), K23-DE00449 (SE), and R21-DE017340 (SE).