Periodontitis affects glucoregulatory hormones in severely obese individuals

Int J Obes (Lond). 2019 May;43(5):1125-1129. doi: 10.1038/s41366-018-0253-4. Epub 2018 Nov 19.

Abstract

Objective: To evaluate the effect of periodontitis (PD) on glucoregulatory hormones in obesity, never explored so far, a cross-sectional study was conducted in 110 severely obese, non-diabetic individuals.

Methods: We collected clinical periodontal parameters, including probing pocket depth (PPD), bleeding on probing (BOP), clinical attachment level (CAL). Insulin, glucagon, GLP-1 and GIP were measured after 3 days of standardized diet.

Results: Forty-seven subjects had periodontitis (PD+) and 63 did not (PD-). PD+ showed 30.3% of gingival sites with PPD > 4 mm, 55.2% of BOP sites and a mean CAL loss of 4.1 mm. Compared with PD-, PD+ had higher glucagon (26.60 [25.22] vs 3.93 [7.50] ng/l, p < 0.0001) and GIP levels (10.56 [13.30] vs 6.43 [8.43] pmol/l, p < 0.001), while GLP-1 was reduced (11.78 [10.07] vs 23.34 [16.80] pmol/l, p < 0.0001). Insulin did not differ. In PD+, after adjustment for confounders, PPD was positively related to glucagon (β = 0.424, p = 0.002) and inversely to GLP-1 (β = -0.159, p = 0.044).

Conclusions: We describe for the first time an impaired incretin axis coupled with a relative hyperglucagonemia in obese non-diabetic individuals with PD, that might contribute to deteriorate their glucose tolerance and partially explain the higher risk of diabetes observed in these patients.

MeSH terms

  • Adult
  • Blood Glucose / physiology*
  • Cross-Sectional Studies
  • Female
  • Gastric Inhibitory Polypeptide / metabolism*
  • Glucagon / metabolism
  • Humans
  • Incretins / metabolism
  • Insulin / metabolism
  • Male
  • Middle Aged
  • Obesity, Morbid / complications
  • Obesity, Morbid / metabolism
  • Obesity, Morbid / physiopathology*
  • Periodontitis / etiology
  • Periodontitis / metabolism
  • Periodontitis / physiopathology*

Substances

  • Blood Glucose
  • Incretins
  • Insulin
  • Gastric Inhibitory Polypeptide
  • Glucagon