The relationship between periodontal disease and oxidative stress and HIF-1 alpha levels in adolescents with Type 1 diabetes mellitus

Diabetes mellitus (DM) and periodontal disease are crucial public health problems that are common in the world. Oxidative stress has an important role in periodontal disease and DM pathology. It has also been frequently investigated in inflammatory diseases as hypoxia can modulate the inflammatory response via HIF. In our study, we aimed to evaluate the relationship between metabolic status, clinical periodontal parameters and salivary oxidative stress and hypoxia in T1DM and healthy controls. Our study included 101 T1DM and 102 systemic healthy adolescents aged 12-18 years with at least 5 years of follow-up. Sociodemographic, clinical and metabolic data were collected. Total antioxidant level (TAS), total oxidant level (TOS) and hypoxia-inducible factor-1 alpha (HIF-1ɑ) levels were determined in unstimulated saliva. While no difference was observed between the systemic healthy control (S) and T1DM groups in terms of clinical periodontal and salivary volume parameters (p>0.05), TOS and OSI were statistically significant in the T1DM group (p<0.05). When the study groups are grouped according to the presence of systemic and periodontal disease (Ss: control-healthy gingivitis, Sg: control-gingivitis, T1DMs: T1DM-healthy gingivitis, T1DMg: T1DM-gingivitis), PI, GI, SKI, SCD and PIA values are in Sg and T1DMg groups. Statistically significant difference was found compared to gingival healthy groups. TOS and OSI were found to be increased and statistically significant in the T1DM group followed for more than 10 years (p<0.05). A positive correlation was found between TAS and HIF1-alpha in the S group, and between salivary volume and TOS, OSI and HIF-1alpha in the T1DM group. Since the oral care of individuals is similar, the effect of T1DM on clinical periodontal parameters may not be seen. It has been determined that salivary volume, TOS and OSI values are affected by systemic disease and T1DM follow-up period and may lead to further studies.