Chronic Periodontitis in Patients with Type 2 Diabetes: Analysis of the FokI Polymorphism and Perception of Quality of Life

Santos, Romário Correia dos; Pinho, Roberto Carlos Mourão; Cimões, Renata

doi:10.1590/pboci.2020.149

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ORIGINAL ARTICLE • Pesqui. Bras. Odontopediatria Clín. Integr. 20 • 2020 • https://doi.org/10.1590/pboci.2020.149 copy

Chronic Periodontitis in Patients with Type 2 Diabetes: Analysis of the FokI Polymorphism and Perception of Quality of Life

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To analyze whether the FokI polymorphism (rs228570) present in the vitamin D receptor gene in type 2 diabetics is related to chronic periodontitis's clinical status and evaluates the influence of chronic periodontitis on the perception of quality of life.

Material and Methods:

It is a clinical and laboratory study, composed of a sample of 59 individuals with previous diagnosis of type 2 Diabetes Mellitus and chronic periodontitis, of both sexes. On clinical examination, socio-epidemiological data and quality of life of patients with the Oral Health Impact Profile (OHIP-14) were recorded and a periogram was performed. Subsequently, saliva was collected spontaneously in sterile Falcon tubes (15 ml) and stored in the freezer at -20 °C. The purification of the genetic material was done with a PROMEGA kit (Wizard^®), and the polymorphism studied was FokI (rs228570), found in the vitamin D receptor promoting region, with rs: 228570. After extraction of saliva DNA and purification, genotyping was performed by real-time PCR using specific allele probes (TaqMan^® System).

Results:

The polymorphism of the vitamin D receptor gene was not positively associated with the severity and clinical characteristics of periodontitis, but suggested a relationship with the extent of the disease. Periodontitis also had no positive association with patients' perception of quality of life.

Conclusion:

The perception of quality of life of patients with chronic periodontitis and type 2 diabetes mellitus was compromised by the systemic condition, secondary to oral health, although some dimensions of OHIP-14 have been more frequently mentioned, such as psychological discomfort, physical pain and physical disability.

Keywords:
Diabetes Mellitus, Type 2; Chronic Periodontitis; Polymorphism, Genetic

Variables	VDR	N	Mean	SD	Minimum	Maximum	p-value
Age	GG	30	60.4	9.6	44.0	80.0	Reference
	GA	25	56.9	10.7	20.0	70.0	0.374
	AA	3	55.7	7.1	48.0	62.0	0.346
	Total	58	58.6	10.1	20.0	80.0
Income (Wages)	GG	28	1.2	0.6	0.0	2.2	Reference
	GA	23	1.2	0.4	0.5	2.0	0.830
	AA	3	2.4	1.7	1.0	4.3	0.134
	Total	54	1.3	0.7	0.0	4.3
How Long Diabetic	GG	26	10.8	8.4	0.0	37.0	Reference
	GA	23	13.4	8.2	3.0	30.0	0.227
	AA	3	19.0	6.1	12.0	23.0	0.056
	Total	52	12.4	8.3	0.0	37.0
Mean PD	GG	30	2.7	0.9	1.4	5.2	Reference
	GA	25	2.2	0.4	1.3	2.9	0.023*
	AA	3	2.2	0.7	1.7	3.0	0.316
	Total	58	2.5	0.7	1.3	5.2
Mean CAL	GG	30	4.6	2.0	1.6	10.2	Reference
	GA	25	3.9	1.6	1.8	7.8	0.250
	AA	3	4.1	1.6	2.4	5.3	0.802
	Total	58	4.3	1.8	1.6	10.2
Bleeding Index (%)	GG	30	15.9	16.0	0.0	50.0	Reference
	GA	25	11.6	9.1	0.0	28.1	0.709
	AA	3	9.3	9.2	2.3	19.7	0.637
	Total	58	13.7	13.2	0.0	50.0
Plaque Index (%)	GG	30	25.7	28.4	0.0	100.0	Reference
	GA	25	26.5	26.4	0.0	100.0	0.641
	AA	3	57.1	37.4	31.8	100.0	0.077
	Total	58	27.7	28.3	0.0	100.0

Severity of Periodontal Condition	VDR (Fok l) rs229570						Total
	GG		GA		AA		Total		p-value
	N	%	N	%	N	%	N	%
Severity of Periodontitis
Light	4	13.3	6	24.0	1	33.3	11	19.0	0.810
Moderate	12	40.0	10	40.0	1	33.3	23	39.7
Severe	14	46.7	9	36.0	1	33.3	24	41.4
Periodontitis Extension
Localized	1	3.3	5	20.0	2	66.7	8	13.8	0.012^* * Statistically Significant.
Generalized	29	96.7	20	80.0	1	33.3	50	86.2
Total	30	100	25	100	3	100	58	100

	Severity of Periodontitis								p-valor
OHIP	Light		Moderate		Severe		Total
	N	%	N	%	N	%	N	%
Functional Limitation
No	8	66.7	21	91.3	20	83.3	49	83.1	0.201¹ 1 Pearson's chi-square test;
Yes	4	33.3	2	8.7	4	16.7	10	16.9
Physical Pain
No	5	41.7	19	82.6	16	66.7	40	67.8	0.048¹ 1 Pearson's chi-square test; ^* * Statistically Significant.
Yes	7	58.3	4	17.4	8	33.3	19	32.2
Psychological Discomfort
No	7	58.3	18	78.3	14	58.3	39	66.1	0.288¹ 1 Pearson's chi-square test;
Yes	5	41.7	5	21.7	10	41.7	20	33.9
Physical Disability
No	8	66.7	18	78.3	17	70.8	43	72.9	0.733¹ 1 Pearson's chi-square test;
Yes	4	33.3	5	21.7	7	29.2	16	27.1
Psychological Disability
No	7	58.3	19	82.6	18	75.0	44	74.6	0.293¹ 1 Pearson's chi-square test;
Yes	5	41.7	4	17.4	6	25.0	15	25.4
Social Disability
No	10	83.3	23	100.0	22	91.7	55	93.2	0.097² 2 Likelihood Ratio Test,
Yes	2	16.7	0	0.0	2	8.3	4	6.8
Handcap
No	9	75.0	21	91.3	20	83.3	50	84.7	0.431² 2 Likelihood Ratio Test,
Yes	3	25.0	2	8.7	4	16.7	9	15.3
Total	12	100.0	23	100.0	24	100.0	59	100.0

Variables	Total OHIP				Total		p-value
	No Impact		With Impact		Total
	N	%	N	%	N	%
Severity of Periodontitis
Light	3	11.5	9	27.3	12	20.3	0.090¹ 1 Pearson's chi-square test;
Moderate	14	53.8	9	27.3	23	39.0
Severe	9	34.6	15	45.5	24	40.7
Total	26	100.0	33	100.0	59	100.0
Periodontitis Extension
Localized	3	11.5	6	18.2	9	15.3	0.718² 2 Fisher's exact test;
Generalized	23	88.5	27	81.8	50	84.7
Total	26	100.0	33	100.0	59	100.0
VDR
GG	12	46.2	18	56.3	30	51.7	0.617³ 3 Likelihood Ratio Test.
GA	13	50.0	12	37.5	25	43.1
AA	1	3.8	2	6.3	3	5.2
Total	26	100.0	32	100.0	58	100.0

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[1] Author to whom correspondence should be addressed: Renata Cimões, Av Prof. Moraes Rego, s/n, Cidade Universitária, Recife, PE, Brazil. 50670-901. Phone: +55 8121268817. E-mail: renata.cimões@globo.com.