2025 Volume 75 Issue 2 Pages 88-96
Objective: Diabetes mellitus is one of the risk factors for cerebral infarction, and protection of the vascular endothelial function is important for its prevention. Adiponectin, known to have vascular endothelial protective effects, is decreased in patients with type 2 diabetes mellitus. In this study, we focused on LOX-1 ligand containing apoB (LAB), a risk factor for cerebral infarction, and investigated the relationship between LAB and adiponectin following periodontal treatment in type 2 diabetes mellitus patients.
Methods: Patients with type 2 diabetes who attended Niigata University Medical and Dental Hospital were recruited in this study. The inclusion criteria were: 1) HbA1c of 6.0% or higher, 2) no insulin injection or change in diabetes treatment within the past 2 months, 3) no cerebral infarction, 4) current number of teeth 10 or more, and 5) presence of 4 or more teeth with a periodontal pocket of 4 mm or more. Twenty-seven patients who met these conditions were included in the study. They underwent periodontal treatment every 2 weeks from the baseline to 6 weeks. Periodontal examination was performed at the baseline, 12 weeks, and 24 weeks using a 6-point method. The periodontal inflamed surface area (PISA) was calculated, and blood tests were performed. Patients were divided into two groups: a good glucose control group with HbA1c<7.0% (good group) and poor glucose control group with HbA1c≥7.0% (poor group).
Results: The good group demonstrated significant decreases in PISA (p=0.008) and LAB (p=0.016) at 24 weeks compared with the baseline. However, no significant decrease was observed in LOX-indexⓇ or other laboratory values with respect to general conditions in either group. Further multiple regression analysis revealed a significant correlation between the reduction in LAB and increase in adiponectin levels across all participants.
Discussion and Conclusion: In patients with type 2 diabetes mellitus who maintain good glycemic control, periodontal treatment resulted in a significant decrease in LAB, a known risk factor for atherosclerotic diseases, especially cerebral infarction. Furthermore, changes in LAB levels showed a significant negative correlation with those in adiponectin levels. These findings suggest a potential relationship between vascular endothelial function and adiponectin following periodontal treatment in well-controlled diabetic patients.
