Abstract
Background
The underlying mechanisms for increased osteopenia and fracture rates in patients
with diabetes are not well understood, but may relate to chronic systemic inflammation.
We assessed the effect of treating periodontal disease (POD), a cause of chronic inflammation,
on inflammatory and bone turnover markers in patients with diabetes.
Materials and Methods
Using an investigator-administered questionnaire, we screened a cross-section of patients
presenting for routine outpatient diabetes care. We recruited 22 subjects with POD.
Inflammatory and bone turnover markers were measured at baseline and 3 months following
POD treatment (scaling, root planing and subantimicrobial dose doxycycline).
Results
There were nonsignificant reductions in high-sensitivity C-reactive protein (6.34–5.52 mg/L, P = 0.626) and tumor necrosis factor-alpha (10.37–10.01 pg/mL, P = 0.617). There were nonsignificant increases in urinary C-terminal telopeptide (85.50–90.23 pg/mL, P = 0.684) and bone-specific alkaline phosphatase (7.45–8.79 pg/mL, P = 0.074). Patients with >90% adherence with doxycycline were 6.4 times more likely
to experience reduction in tumor necrosis factor-alpha (P = 0.021) and 2.8 times more likely to experience reductions in high-sensitivity C-reactive
protein (P = 0.133).
Conclusions
Treatment of POD in patients with diabetes resulted in nonsignificant lowering of
inflammatory markers and nonsignificant increase in bone turnover markers. However,
adherence to doxycycline therapy resulted in better treatment effects.
Key Indexing Terms
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Article info
Publication history
Published online: February 24, 2016
Accepted:
February 2,
2016
Received:
October 4,
2015
Footnotes
☆This study was funded by NIH/NIGMS, United States, grant number 1U54GM104944-01.
☆☆Some of the findings included in this article were presented in poster format at the American Diabetes Association Annual Conference, Boston, MA, June 5-9, 2015.
★The authors have no financial or other conflicts of interest to disclose.
Identification
Copyright
© 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
