Inflammation
Periodontal inflammation area correlates with both IL-6 and Lp(a) in diabetic patients, more strongly in those with retinopathy (World J Diabetes 2024)
Original title: Correlation of periodontal inflamed surface area with glycated hemoglobin, interleukin-6 and lipoprotein(a) in type 2 diabetes with retinopathy
This cross-sectional study compared 40 type 2 diabetes patients with retinopathy against 40 without, assessing periodontal parameters (bleeding on probing, pocket depth, clinical attachment loss, plaque index, periodontal inflamed surface area or PISA) alongside HbA1c, glucose, lipid profile, serum IL-6 and serum Lp(a). Periodontitis was more prevalent in patients with retinopathy than without (47.5% vs. 27.5%), and periodontal severity, clinical attachment loss, PISA, IL-6 and Lp(a) were all higher in the retinopathy group, despite similar plaque scores between groups. PISA correlated positively with IL-6 (r = 0.651, P < 0.0001) and with Lp(a) (r = 0.59, P < 0.001), and clinical attachment loss correlated with both IL-6 (r = 0.527, P < 0.0001) and Lp(a) (r = 0.631, P < 0.001). The authors suggest a bidirectional relationship in which diabetic retinopathy contributes to more severe periodontal destruction, and periodontitis in turn may influence retinopathy progression, with Lp(a) and IL-6 tracking this shared inflammatory process.
Original abstract
Background: The two-way relationship between periodontitis and type 2 diabetes mellitus (T2DM) is well established. Prolonged hyperglycemia contributes to increased periodontal destruction and severe periodontitis, accentuating diabetic complications. An inflammatory link exists between diabetic retinopathy (DR) and periodontitis, but the studies regarding this association and the role of lipoprotein(a) [Lp(a)] and interleukin-6 (IL-6) in these conditions are scarce in the literature.
Aim: To determine the correlation of periodontal inflamed surface area (PISA) with glycated Hb (HbA1c), serum IL-6 and Lp(a) in T2DM subjects with retinopathy.
Methods: This cross-sectional study comprised 40 T2DM subjects with DR and 40 T2DM subjects without DR. All subjects were assessed for periodontal parameters [bleeding on probing (BOP), probing pocket depth, clinical attachment loss (CAL), oral hygiene index-simplified, plaque index (PI) and PISA], and systemic parameters [HbA1c, fasting plasma glucose and postprandial plasma glucose, fasting lipid profile, serum IL-6 and serum Lp(a)].
Results: The proportion of periodontitis in T2DM with and without DR was 47.5% and 27.5% respectively. Severity of periodontitis, CAL, PISA, IL-6 and Lp(a) were higher in T2DM with DR group compared to T2DM without DR group. Sig-nificant difference was observed in the mean percentage of sites with BOP between T2DM with DR (69%) and T2DM without DR (41%), but there was no significant difference in PI (P > 0.05). HbA1c was positively correlated with CAL (r = 0.351, P = 0.001), and PISA (r = 0.393, P ≤ 0.001) in study subjects. A positive correlation was found between PISA and IL-6 (r = 0.651, P < 0.0001); PISA and Lp(a) (r = 0.59, P < 0.001); CAL and IL-6 (r = 0.527, P < 0.0001) and CAL and Lp(a) (r = 0.631, P < 0.001) among study subjects.
Conclusion: Despite both groups having poor glycemic control and comparable plaque scores, the periodontal parameters were higher in DR as compared to T2DM without DR. Since a bidirectional link exists between periodontitis and DM, the presence of DR may have contributed to the severity of periodontal destruction and periodontitis may have influenced the progression of DR.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.