Citation Information :
Laddha R, Mahajania M, Khadse A, Bajaj R, Jawade R, Choube S. Assessment of Sirtuin 3 and Sirtuin 4 Level in Patients with Diabetes Mellitus and Periodontitis: A Clinical Study. J Contemp Dent Pract 2018; 19 (10):1199-1203.
Aim: Periodontitis is considered as infection in periodontal supporting structure leading to tooth mobility and ulcerated periodontal pockets. The present study was conducted to assess Sirtuin 3 (SIRT 3) and SIRT 4 level in patients with diabetes mellitus (DM) and periodontitis.
Materials and methods: The present study was conducted on 60 subjects. Subjects were divided into four groups, groups I to IV. Each group comprised of 15 subjects. In all subjects, fasting blood glucose level was assessed. Plaque index (PI), bleeding on probing (BOP), gingival index (GI), and clinical attachment level (CAL) were measured. The SIRT 3 and SIRT 4 were estimated by Western blot analysis.
Results: In group I, mean age was 44.13 ± 1.35 years, in group II, it was 43.53 ± 1.45 years, in group III it was 43.93 ± 1.22 years, and in group IV, it was 44.47 ± 0.74 years. The mean BOP score was significantly higher in group IV (5.74 ± 0.30) compared with group I (1.92 ± 0.44), group II (2.25 ± 0.22), and group III (5.31 ± 0.54). A statistically significant (p < 0.001) difference was observed in mean PI score in group I (2.25 ± 0.23), group II (2.26 ± 0.13), group III (4.37 ± 0.60), and group IV (3.25 ± 0.16). Mean GI score was significantly higher in group IV (8.89 ± 0.89) as compared with group I (0.78 ± 0.23), group II (0.95 ± 0.18), and group III (8.69 ± 1.13). A statistically significant difference was seen in mean CAL in group III (5.66 ± 0.64) and group IV (6.37 ± 0.30). Mean fasting blood sugar (mg/dL) in group I was 80.40 ± 13.05, in group II, it was 160.40 ± 27.20, in group III, it was 77.00 ± 12.78, and in group IV, it was 264.20 ± 53.17. The nonsignificant mean expression of SIRT 3 was seen in group I (29.20 ± 3.14), group II (29.19 ± 2.18), group III (28.89 ± 2.77), and group IV (29.59 ± 5.82). In group I, the mean level of SIRT 4 was 28.93 ± 12.55, in group II, it was 28.82 ± 9.14, in group III, it was 28.88 ± 6.03, and in group IV, it was 29.05 ± 10.68.
Conclusion: Association of DM and periodontitis is well known. The SIRT 3 and SIRT 4 are useful indicators of glycemic level in patients with DM.
Clinical significance: The SIRT 3 and SIRT 4 in DM show variation in their level. Early assessment may be proved beneficial in patients who are not responding to other drugs.
Taylor JJ, Preshaw PM, Lalla E. A review of the evidence for pathogenic mechanisms that may link periodontitis and diabetes. J Clin Periodontol 2013 Apr;40 (Suppl 14):S113-S134.
Dandona P, Aljada A, Bandyopadhyay A. Inflammation: the link between insulin resistance, obesity and diabetes. Trends Immunol 2004 Jan;25(1):4-7.
Nasrin N, Wu X, Fortier E, Feng Y, Bare’ OC, Chen S, Ren X, Wu Z, Streeper RS, Bordone L. SIRT4 regulates fatty acid oxidation and mitochondrial gene expression in liver and muscle cells. J Biol Chem 2010 Oct 15;285(42):31995-32002.
Someya S, Yu W, Hallows WC, Xu J, Vann JM, Leeuwenburgh C, Tanokura M, Denu JM, Prolla TA. Sirt3 mediates reduction of oxidative damage and prevention of age-related hearing loss undercaloric restriction. Cell 2010 Nov 24;143(5):802-812.
Papapanou PN. Periodontal diseases: epidemiology. Ann Periodontol 1996 Nov;1(1):1-36.
Kornman KS, Giovinef FS. Genetic variations in cytokine expression: a risk factor for severity of adult periodontitis. Ann Periodontol 1998 Jul;3(1):327-338.
Saito T, Shimazaki Y, Kiyohara Y, Kato I, Kubo M, Iida M, Koga T. The severity of periodontal disease is associated with the development of glucose intolerance in non-diabetics: the Hisayama study. J Dent Res 2004 Jun;83(6):485-490.
Faria-Almeida R, Navarro A, Bascones A. Clinical and metabolic changes after conventional treatment of type 2 diabetic patients with chronic periodontitis. J Periodontol 2006 Apr;77(4):591-598.
Singh S, Kumar V, Kumar S, Subbappa A. The effect of periodontal therapy on the improvement of glycemic control in patients with type 2 diabetes mellitus: a randomized controlled clinical trial. Int J Diabetes Dev Ctries 2008 Apr;28(2): 38-44.
Ebersole JL, Cappelli D. Acute phase reactants in infections and inflammatory diseases. Periodontology 2000 2000 Jun;23:19-49.
Sima C, Glogauer M. Diabetes mellitus and periodontal diseases. Curr Diab Rep 2013 Jun;13(3):445-452.
Lamster IB, Lalla E, Borgnakke WS, Taylor GW. The relationship between oral health and diabetes mellitus. J Am Dent Assoc 2008 Oct;139 (Suppl):19S-24S.
Wilson AG. Epigenetic regulation of gene expression in the inflammatory response and relevance to common disease. J Periodontol 2008 Aug;79(8 Suppl):1514-1519.
Haigis MC, Sinclair DA. Mammalian sirtuins: biological insights and disease relevance. Annu Rev Pathol 2010;5: 253-295.
North BJ, Verdin E. Interphase nucleo-cytoplasmic shuttling and localization of SIRT2 during mitosis. PloS One 2007 Aug 29;2(8):e784.
Chiu AV, Saigh MA, McCulloch CA, Glogauer M. The role of NrF2 in the regulation of periodontal health and disease. J Dent Res 2017 Aug;96(9):975-983.
Lee YM, Shin SI, Shin KS, Lee YR, Park BH, Kim EC. The role of sirtuin 1 in osteoblastic differentiation in human periodontal ligament cells. J Periodontal Res 2011 Dec;46(6):712-721.