Аннотация:Abstract Objectives: Studies suggest that elevated circulating tumour necrosis factor‐ α (TNF‐ α ) may contribute to insulin resistance in patients with type 2 diabetes. The source of plasma TNF has been thought to be adipocytes associated with obesity, but inflammation and infection result in TNF‐ α production as well. Methods: We studied 46 patients with type 2 diabetes and chronic periodontitis to determine the relationship between plasma TNF‐ α levels and clinical measures of periodontitis, gingival crevicular fluid (GCF) interleukin‐1 β (IL‐1 β ), plasma endotoxin, serum glucose, and glycated haemoglobin (HbA1c). TNF‐ α levels were measured using a high sensitivity enzyme‐linked immunosorbent assay. Results: TNF‐ α showed a significant positive correlation with attachment loss ( r =0.40, p =0.009), plasma endotoxin ( r =0.33, p =0.03), and GCF IL‐1 β ( r =0.33, p =0.035), but not probing depth ( r =0.28, p =0.07), bleeding on probing ( r =0.30, p =0.053), plaque index ( r =0.22, p =0.17), serum glucose, HbA1c ( r =0.10, p =0.50), or body mass index ( r =0.077, p =0.62). A dose–response relationship was observed between periodontitis severity and TNF‐ α ( p =0.012). Conclusion: The finding that chronic periodontitis is associated with plasma TNF‐ α levels in subjects with type 2 diabetes supports the hypothesis that periodontal infection and inflammation may contribute to insulin resistance.
