Salivary TNF-α as a marker of periodontal disease in type 2 diabetes mellitus patients: A cross-sectional study

Background: Diabetes mellitus (DM) is a chronic metabolic disease that has shown an increase in its prevalence all over the world. The severity of periodontitis in DM patients is greater, especially in patients with uncontrolled DM. Bacteria present in the oral cavity induce the production of prostaglandins or cytokines, including tumor necrosis factor-α (TNF-α) and interleukin-1 (inflammatory mediators) which in turn stimulate the production and activation of enzymes which damage gingival connective tissue and produce osteoclasts that can absorb bone. Objective: This study aimed to analyze the associations between tumor necrosis factor-alpha (TNF-α) and type 2 diabetes mellitus (T2DM), and its effect on periodontal disease. Methods: A cross-sectional study was done among 35 patients with T2DM and 15 control subjects who had visited the department for routine treatment. Measurements of fasting blood sugar (FBS), body mass index (BMI), periodontal index (PI), and TNF-α levels were measured using an enzyme-linked immunosorbent assay (ELISA). Results: A significant positive correlation (p = 0.003) between the PI score and the concentration of TNF-α (in ng/l) was noted. On the other hand, a weak negative correlation between BMI (p-value 0.376) and FBS (p-value 0.757) parameters was detected; however, this correlation was insignificant. Conclusion: By this, it can be inferred that TNF-α concentration is positively associated with periodontitis in T2DM patients. The association between TNF-α and periodontitis in T2DM patients highlights the potential for using TNF-α levels to monitor disease progression and response to treatment. This could lead to more targeted and effective management strategies for both diabetes and periodontal health.