Salivary Inflammatory Markers and Microbiome In Children With Type 2 Diabetes

Objectives: Understanding of the association between obesity, type 2 diabetes (T2D) and periodontal disease is evolving. Most of the scientific literature pertaining to this association is confined to the adult patient population. This association is virtually unexplored in the pediatric and adolescent T2D patients. We therefore hypothesized that children with T2D have higher rates of gingivitis or incipient periodontal disease, elevated salivary inflammatory markers, and an altered salivary microbiome compared to children without T2D and to obese children.
Methods: Three cohorts of children, ages 10-19 years, were studied: normal weight (C), obese (Ob), and obese with T2D (T2D). Each subject completed a dental health survey, received a clinical dental examination, and provided unstimulated saliva for assessment of selected inflammatory biomarkers and microbiome.
Results: The diabetes group was less likely to have had a dental visit within the last 6 months. Body mass index (BMI) Z-scores and waist circumference/height ratios were similar between the Ob and T2D cohorts. The number of carious lesions and fillings were similar for all three groups. The gingival index was significantly different between T2D vs C but not between T2D vs Ob (p=0.068). No differences were noted in biomarkers of inflammation between the groups. Microbial diversity between the groups was unremarkable, although several differences in the proportions of a few bacterial genera were noted. Lachnospiraceae was found to be positively correlated with salivary IL-1β levels within the T2D cohort.
Conclusions: While gingival inflammation was elevated in children with T2D compared to normal weight and obese children without T2D, little difference between the groups was noted with respect to salivary biomarkers of inflammation and salivary microbiome composition.