Comparative Analysis of Thromboxane B2 (TXB2) and Prostaglandin E2 (PGE2) Levels in the Gingival Crevicular Fluid (GCF) of Diabetic Patients With Chronic Periodontitis: An Enzyme Immunoassay Study

Introduction: A persistent systemic hyperglycemia as observed in patients with type 2 diabetes mellitus (DM) has been associated with periodontal inflammation. Therefore, the primary objective of the present study was to assess the levels of thromboxane B2 (TXB2) and prostaglandin E2 (PGE2) in the gingival crevicular fluid (GCF) of type 2 DM and non-diabetic patients with chronic periodontitis. The secondary objectives were to correlate these levels with various parameters such as age, gender, glycated hemoglobin (HbA1c) levels, probing depth (PD), and fasting blood sugar levels and to determine the significant predictors for PGE2 and TXB2 levels. Materials and methods: This case-control, cross-sectional study was conducted on 60 patients who were divided into three groups: group 1 (n=20) comprising type 2 DM patients with chronic periodontitis, group 2 (n=20) composed of non-diabetic patients with chronic periodontitis, and group 3 (n=20) as controls comprising of periodontally and systemically healthy individuals. HbA1c, fasting blood glucose levels, PD, and PGE2 and TXB2 levels were checked in GCF for all the patients. The data was subjected to statistical analysis.

Results: The two-way analysis of variance test results revealed statistically significant differences across groups for all parameters. The levels of both biomarkers showed a positive correlation with HbA1c, PD, fasting blood sugar levels, and duration of type 2 DM. Furthermore, PD and fasting blood sugar levels showed the strongest influence on both PGE2 and TXB2 levels. For PGE2, fasting blood sugar levels (p=0.006) and PD (p<0.001) were significant predictors. For TXB2, significant predictors included HbA1c (p=0.003), fasting blood sugar levels (p=0.015), and PD (p<0.001).

Conclusion: PGE2 and TXB2 levels were significantly increased in type 2 DM with chronic periodontitis, compared with non-diabetic patients with chronic periodontitis and periodontally healthy patients.