An immunological evaluation of type II diabetic patients with periodontal disease

Peridontal disease is a frequent complication of diabetes, and diabetic sub jects often exhibit decreased immune response with increased susceptibility to infection. We evaluated the possible relationship between immune respon se and periodontal disease in 40 type II diabetic patients, mean (+/- SD) a ge 59 +/- 8 years and mean disease duration 17 +/- 4 years, with good metab olic control (mean fasting plasma glucose, 10.5 +/- 3.8 mM/L, mean HbA(1c), 8.1 +/- 1.66%), and in 40 age and gender-matched controls. Interproximal a lveolar bone loss (ABL), as the percentage of bone loss from the cement ena mel junction (CEJ) to the apex, was measured with a modified Schei ruler at the deepest point on the mesial/distal surface of the teeth, except third molars, on a panoramic radiograph. Immunological evaluation involved study of NADPH neutrophil superoxide production, neutrophil chemotaxis, lymphocyt e subpopulations, immunoglobulins and complement. Diabetic patients showed significant differences compared with controls regarding ABL (30.6 +/- 14.7 % versus 17.6 +/- 4.3%; p < 0.0001) and the T-helper/T-suppressor ratio (2. 3 +/- 1.0% versus 1.8 +/- 0.8%; p < 0.05). Other parameters of cell-mediate d immunity and humoral immune response did not show any significant variati ons. No correlation between immunological and radiographic analysis paramet ers were found. Further studies are needed to verify the exact role played by immunological factors in type II diabetic patients with periodontal dise ase. (C) 1999 Elsevier Science Inc.