Salivary RANKL/OPG, MIP-1α and Serum Lipids in Periodontitis: Evidence Across Diabetic and Non-Diabetic Populations
DOI:
https://doi.org/10.53274/IJCRD.2025.6204Keywords:
- Periodontitis; Type 2 diabetes mellitus; MIP-1α
Abstract
Abstract
Background: Periodontitis represents a complex inflammatory disease with significant metabolic implications, particularly in type 2 diabetes mellitus patients. Salivary biomarkers offer potential diagnostic insights beyond traditional clinical parameters.
Objectives: This review examines the performance of salivary biomarkers and serum lipid associations in periodontal disease, comparing diabetic and non-diabetic populations while evaluating enzymatic marker profiles.
Methods: We conducted a narrative review using structured searches of PubMed, Embase, and Cochrane Library through August 2024, focusing on bone remodeling markers, enzymatic profiles, and lipid associations.
Results: Macrophage inflammatory protein-1α demonstrated strong diagnostic performance (AUC 0.94, 94.9% sensitivity, 92.7% specificity at 1.12 pg/mL cutoff) with 18-fold elevation in periodontitis patients. RANKL levels and RANKL/osteoprotegerin ratios were significantly elevated in periodontal disease. Meta-analysis of 103,468 participants revealed 15% increased dyslipidemia odds with periodontitis, though with substantial heterogeneity. Matrix metalloproteinases, antioxidant enzymes, and inflammatory proteases demonstrated variable diagnostic utility, accompanied by significant methodological limitations. While small trials demonstrated reductions in inflammatory markers following periodontal therapy, the largest randomized trial, involving 290 type 2 diabetes patients, showed no significant improvements in lipid profiles.
Conclusions: Bone remodeling markers, particularly MIP-1α, show promise as adjunctive diagnostic tools, though extensive standardization and validation across diverse populations remain essential. Enzymatic profiles face substantial technical and interpretive challenges, which limit their clinical utility. Population-specific approaches appear necessary given differential responses in diabetic versus non-diabetic patients, with therapeutic lipid benefits remaining questionable in diabetic populations.
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