Correlation between lipid peroxidation and inflammatory markers profile in diabetes mellitus type 2 patients with chronic periodontal disease

Abstract

The aim of this study is to evaluate the influence of lipid peroxidation on the systemic and local inflammatory markers profile in patients with type 2 Diabetes mellitus (DM) and chronic periodontitis. The sample will be composed of 90 patients subdivided into three groups: Group 1 (diabetes with good metabolic control), Group 2 (diabetes with poor metabolic control) and Group 3 (control/ systemically healthy). The metabolic control of the groups 1 and 2 will be evaluated by the glycated hemoglobin (HbA1c), being categorized as diabetes with poor metabolic control when HbA1c ³ 8.0%. All the subjects will go through a complete periodontal examination and physical and laboratory evaluation in order to verify fasting plasma glucose, lipid profile and levels of lipid peroxidation, that can be expressed by the levels of oxidized LDL and Malondialdehyde (MDA). Periodontal examination will consist of visible plaque index, gingival bleeding index, bleeding on probing, probing depth (PD) and clinical attachment levels (CAL). Samples of gingival crevicular fluid will be collected in 4 sites without periodontal disease (PD d 3mm, without loss of attachment and with no bleeding on probing) and 4 sites with periodontal disease (PD 5mm, CAL e 4mm, with bleeding on probing), in order to evaluate the quantity of metalloproteinase (MMP)-8, -9, -13, interleukin (IL)-1, -4, -5, -6, -8, -10, -12, -18, -32 and tumor necrosis factor-alpha (TNF- ±). In plasma it will be measured the quantity of IL-1², -2, -4, -5 -6, -10, -12, -32 e TNF-a. The groups will be compared as the concentration of the cytokines and lipid peroxidation levels (oxidized LDL and MDA) in gingival crevicular fluid and plasma. A statistical test will be applied to evaluate the correlation between the levels of lipid peroxidation and the concentration of each cytokine. This study may contribute for a better understanding of the conditions related to the greater severity of periodontal disease in patients with diabetes. (AU)