Evaluation of salivary MMP levels in periodontitis patients with uncontrolled diabetes

Background/Aim: Type 2 diabetes mellitus (T2DM) and periodontitis are both characterized as chronic inflammatory disorders that have a mutually influential association. Dysregulation of glucose levels in individuals with T2DM has a significant impact on the pathophysiology and equilibrium of inflammatory mediators. Multiple mediators are produced throughout the inflammatory cascade of periodontitis and T2DM, including matrix metalloproteinases (MMPs). Objective of this study was to determine if the levels of MMP-3, -8, -9 are attributed to grade III periodontitis patients with uncontrolled T2DM. Material and Methods: Non-smoker 75 individuals with Grade III periodontitis were recruited and were divided into three groups according to the stages of their periodontal status. 75 systemically healthy individuals without periodontitis were served as control. Periodontal clinical metrics, plaque score, gingival bleeding index, probing pocket depth, and clinical attachment level, for each participant were recorded. Blood and whole saliva samples (WSS) were obtained from every participant. Hemoglobin A1c (HbA1c) levels were determined using blood samples, whereas levels of MMP-3, -8, -9 were determined using WSS. Levels of MMPs were assessed using an enzymelinked immunosorbent assay (ELISA) method. Results: Overall MMP levels and clinical periodontal scores of the Stage III periodontitis patients were significantly higher than healthy individuals (p<0,01). Stage III Grade C periodontitis patients had severely increased MMP-3, -8, -9 levels (196,2 ± 2,8; 292,9±1,9; 128,6 ± 3,5 ng/mL, respectively) in comparison to healthy participants (5,2 ± 2,3; 4,3 ± 3,1; 6,1 ± 2,5 ng/mL, respectively) (p<0,01). No significant difference was found when Stage III Grade C and B patients were compared regarding the levels of MMP-3 and -9 (p>0,05). Conclusions: Findings of our investigation indicate a potential association between T2DM and increased levels of MMP-3, -8, and -9, which may contribute to the progression of periodontal tissue degradation. In the limitations of our study, MMP-8 exhibited more sensitivity as a marker for periodontal inflammation among the other MMPs that were investigated in this study.