Investigation of inflammatory stress and periodontal tissue destruction in individuals with periodontitis and metabolic syndrome

Aim: Metabolic syndrome and periodontitis are diseases that negatively affect the quality of life and are increasingly seen in societies. Since both diseases are associated with systemic inflammation and insulin resistance, they have the potential to affect each other. It is known that some parameters that are thought to increase in periodontal disease also increase in metabolic syndrome. The aim of this study is to evaluate the effect of IL-20 on periodontal destruction in individuals with metabolic syndrome, considering the relationship between metabolic syndrome and periodontitis. Material and Method: A total of 80 subjects who were systemically and periodontally healthy (KG, n=20), systemically healthy and periodontitis (PG, n=20), metabolic syndrome and periodontally healthy (MG, n=20), metabolic syndrome and periodontitis (MPG, n=20) were included in our study. Gingival crevicular fluid (GCF) and serum samples were collected from the participants for biochemical analysis. For statistical analysis, Kruskal-Wallis H test, Bonferroni corrected Post-Hoc Test, Spearman analysis and Chi-square test were used. Result: IL-20 values measured in GCF and serum were significantly higher in MPG (p=0.001). A significant positive correlation was found between periodontal parameters and level of IL-20 measured in GCF and serum (p<0.01). RANKL and RANKL/OPG levels in GCF and serum were found to increase in periodontitis (p=0.001), and showed a positive correlation with IL-20 and clinical parameters (p<0.01). In addition to the increase in serum MMP-8 levels in periodontitis, this biomarker was also found to be elevated in metabolic syndrome independent of periodontitis status, the highest MMP-8 value was observed in MPG (p=0.001), and it was positively correlated with IL-20 values and all clinical parameters (p<0.01). It was found that serum TOS values were also increased in cases of periodontitis and metabolic syndrome, the highest TOS value was observed in MPG (p=0.012), and showed a positive correlation with IL-20 values and all clinical parameters (p<0.01). TAS values were found to be higher in KG and PG and lowest in MPG (p=0.010). OSI values were found to be increased in both periodontitis and metabolic syndrome (p=0.001), positively correlated with GCF IL-20 (p<0.05) and serum IL-20 (p< 0.01) values. Conclusion: IL-20 was associated with both periodontitis and metabolic syndrome. We think that IL-20 may increase bone resorption by both affecting the RANKL/OPG ratio and increasing oxidative stress. Keywords: Metabolic syndrome, periodontitis, IL-20, RANKL, oxidative stress, GCF