• Kenneth E Izuora, Echezona E Ezeanolue, Michael F Neubauer, Civon L Gewelber, Gayle L Allenback, Guogen Shan, and Guillermo E Umpierrez.
• Department of Internal Medicine, University of Nevada School of Medicine, Las Vegas, Nevada. Electronic address: kizuora@medicine.nevada.edu.
• Am. J. Med. Sci. 2016 Jun 1; 351 (6): 589594589-94.

BackgroundThe underlying mechanisms for increased osteopenia and fracture rates in patients with diabetes are not well understood, but may relate to chronic systemic inflammation. We assessed the effect of treating periodontal disease (POD), a cause of chronic inflammation, on inflammatory and bone turnover markers in patients with diabetes.Materials And MethodsUsing an investigator-administered questionnaire, we screened a cross-section of patients presenting for routine outpatient diabetes care. We recruited 22 subjects with POD. Inflammatory and bone turnover markers were measured at baseline and 3 months following POD treatment (scaling, root planing and subantimicrobial dose doxycycline).ResultsThere were nonsignificant reductions in high-sensitivity C-reactive protein (6.34-5.52mg/L, P = 0.626) and tumor necrosis factor-alpha (10.37-10.01pg/mL, P = 0.617). There were nonsignificant increases in urinary C-terminal telopeptide (85.50-90.23pg/mL, P = 0.684) and bone-specific alkaline phosphatase (7.45-8.79pg/mL, P = 0.074). Patients with >90% adherence with doxycycline were 6.4 times more likely to experience reduction in tumor necrosis factor-alpha (P = 0.021) and 2.8 times more likely to experience reductions in high-sensitivity C-reactive protein (P = 0.133).ConclusionsTreatment of POD in patients with diabetes resulted in nonsignificant lowering of inflammatory markers and nonsignificant increase in bone turnover markers. However, adherence to doxycycline therapy resulted in better treatment effects.Copyright © 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

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