The salivary redox biomarkers related to periodontal conditions among Insulin resistance and controlled Type 2 diabetic according 2017 classification

Background: Periodontal disease is highly prevalent among insulin-resistant and type 2 diabetes mellitus (T2DM) subjects. However, the pathogenesis and associated factors of periodontal disease among these subjects are not well known. Recently, it has been re-ported that oxidative stress-antioxidant (redox) imbalance may play an important role in the pathogenesis of periodontal disease. Objective: Determine the relation between three salivary redox biomarkers; total antioxidant capacity (TAC), total oxidative status (TOS), advanced glycation end products (AGEs), and periodontal disease parameters in IR and controlled T2DM (C-T2DM) subjects. Methods: An analytical observational study was conducted on 180 participants aged between 35 and 65 years; males and females were di-vided into three groups, each consisting of 60 individuals: Insulin resistance group (IR), controlled-type2 diabetics group (C-T2DM), and healthy control group. Periodontal pa-rameters were examined: Dental plaque index (PLI), bleeding on probing percentage (BOP%), probing pocket depth (PPD), and clinical attachment level (CAL), according to these, three subgroups presenting (healthy periodontium, gingivitis, or periodontitis) were conducted. Un-stimulated saliva was collected, and Enzyme-linked immunosorbent assay (ELISA) was used to determine salivary AGEs, while colorimetric assays were used to determine salivary TAC and TOS. The data were analyzed using SPSS version 21. Results: A significant correlation between TOS and PLI and an inverse correlation between TAC and PLI in the periodontitis subgroup of the control subjects were found. In multiple regression analysis, salivary AGEs and CAL were inversely associated in the C-T2DM group. Conclusion: Salivary TOS and AGEs were the highest in the periodontitis subgroup of the IR and C-T2DM groups, while, the salivary TAC was found the lease in the both IR and C-T2DM groups when compared to the control group. In- addition to that, there were a relationship between salivary redox biomarkers and periodontal parameters. However, salivary AGEs were considered a significant independent predictor for CAL in C-T2DM.