Author(s): Sanjeela R. Guru, Suchetha Aghanashini, Nitin Saroch

Email(s): , ,

DOI: 10.52711/0974-360X.2023.00339   

Address: Sanjeela R. Guru1, Suchetha Aghanashini2, Nitin Saroch3
1Professor, Department of Periodontics, Vydehi Institute of Dental Sciences and Research Centre, Whitefield, Bangalore - 560066, Karnataka, India.
2Professor and Head, Department of Periodontics, DA Pandu Memorial R V Dental College and Hospital, J.P. Nagar, Bangalore - 560078, Karnataka, India.
3Professor and Head, Department of Periodontics, MN DAV Dental College, Solan, Solan -173223, Himachal Pradesh, India.
*Corresponding Author

Published In:   Volume - 16,      Issue - 4,     Year - 2023

Periodontitis is a disease of periodontium resulting from pathogenic microorganisms combined with other risk factors. For many years, the relationship of obesity with periodontal disease has been debated. Recently, obesity is considered a risk factor for periodontitis. The pathomechanistic association studies have shown a link between adipose tissue secreted adipokines and periodontal disease, although the inherent mechanisms are obscure. Thus, this review aims to get an overview of the association between adipokines and periodontal disease. Adipokines, bioactive molecules secreted by adipose tissue, regulate energy outflow and insulin sensitivity apart from modulation of inflammation and healing. Obesity causes chronic low-grade inflammation and increases adipokines. Recent studies have also shown that adipokines, such as leptin, adiponectin, and visfatin, could play a role in periodontal disease progression and may be used as biomarkers. They increase the production of pro-inflammatory factors, creating a hyperinflammatory state that affects systemic diseases and enhances the risk for periodontitis and compromises healing post periodontal therapy. Understanding the function of adipokines may better help us interpret the triad of obesity with periodontitis and type 2 diabetes. Moreover, periodontal disease treatment may imply positive effects on the overall health of the individual.

Cite this article:
Sanjeela R. Guru, Suchetha Aghanashini, Nitin Saroch. Adipokines in Periodontal disease – Culprits or Accomplice?. Research Journal of Pharmacy and Technology 2023; 16(4):2061-7. doi: 10.52711/0974-360X.2023.00339

Sanjeela R. Guru, Suchetha Aghanashini, Nitin Saroch. Adipokines in Periodontal disease – Culprits or Accomplice?. Research Journal of Pharmacy and Technology 2023; 16(4):2061-7. doi: 10.52711/0974-360X.2023.00339   Available on:

1.    Holt SC, Ebersole JL. Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia: the ‘red complex’, a prototype polybacterial pathogenic consortium in periodontitis. Periodontology 2000. 2005;38(1):72-122.doi: 10.1111/j.1600-0757.2005.00113.x.
2.    Zareen NI, Prakasam G. Oral Biofilms. Research Journal of Pharmacy and Technology. 2016;9(10): 1812-14. doi: 10.5958/0974-360X.2016.00368.1.
3.    Pihlstrom BL, et al. Periodontal diseases. Lancet. 2005 Nov 19;366(9499): 1809-20. doi: 10.1016/S0140-6736(05)67728-8.
4.    Chávarry NG, et al. The relationship between diabetes mellitus and destructive periodontal disease: a meta-analysis. Oral Health and Preventive Dentistry. 2009;7(2): 107-27.
5.    Mounika S, Gopinath. Periodontitis as a Risk Factor of Atherosclerosis. Research Journal of Pharmacy and Technology. 2016; 9(11): 2017-19.
6.    Mounika S, Savitha G. Association of Periodontal Diseases and Metabolic Syndrome. Research Journal of Pharmacy and Technology. 2015 August;8(8): 994-96. doi: 10.5958/0974-360X.2015.00166.3.
7.    Deschner J, et al. The role of adipokines in periodontal infection and healing. Molecular Oral Microbiology. 2014 Dec;29(6): 258-69. doi: 10.1111/omi.12070.
8.    Saito T, et al. Relationship between upper body obesity and periodontitis. Journal of Dental Research. 2001 Jul;80(7): 1631-6. doi: 10.1177/00220345010800070701.
9.    Brum RS, et al. Biomarkers in biological fluids in adults with periodontitis and/or obesity: A meta-analysis. Journal of Indian Society Periodontology. 2020 May-June;24(3): 191-215. doi: 10.4103/jisp.jisp_512_19.
10.    Bhattacharya K, et al. Pathophysiology of Obesity: Endocrine, Inflammatory and Neural regulators. Research Journal of Pharmacy and Technology. 2020;3(9): 4469-78. doi: 10.5958/0974-360X.2020.00789.1.
11.    Mohan M. The Role of Leptin on Obesity: A Review. Research Journal of Pharmacy and Technology. 2014 Dec;7(12): 1501-5.
12.    Myers MG Jr, et al. Obesity and leptin resistance: distinguishing cause from effect. Trends in Endocrinology & Metabolism. 2010 Nov;21(11): 643-51. doi: 10.1016/j.tem.2010.08.002.
13.    Moschos S, et al. Leptin in immunology. The Journal of Immunology. 2005;174(6): 3137-42. doi: 10.4049/jimmunol.174.6.3137.
14.    Ambad R, et al. Association of Leptin in Diabetes Mellitus and Obesity. Research Journal of Pharmacy and Technology. 2020;13(12): 6295-99. doi: 10.5958/0974-360X.2020.01095.1.
15.    Purwar P, et al. The effects of periodontal therapy on serum and salivary leptin levels in chronic periodontitis patients with normal body mass index. Acta Odontologica Scandinavica. 2015;73(8): 633-41. doi: 10.3109/00016357.2015.1030768.
16.    Johnson RB, Serio FG. Leptin within healthy and diseased human gingiva. Journal of Periodontology. 2001;72(9): 1254-7. doi: 10.1902/jop.2000.72.9.1254.
17.    Karthikeyan BV, Pradeep AR. Gingival crevicular fluid and serum leptin: their relationship to periodontal health and disease. Journal of Clinical Periodontology. 2007;34(6): 467-72. doi: 10.1111/j.1600-051X.2007.01078.x.
18.    Shimada Y, et al. The effect of periodontal treatment on serum leptin, interleukin‐6, and C‐reactive protein. Journal of Periodontology. 2010;81(8): 1118-23. doi: 10.1902/jop.2010.090741.
19.    Kardeşler L, et al. Adipokines and inflammatory mediators after initial periodontal treatment in patients with type 2 diabetes and chronic periodontitis. Journal of Periodontology. 2010;81(1): 24-33. doi: 10.1902/jop.2009.090267.
20.    Selvarajan S, et al. Association Between Gingival Crevicular Fluid Leptin Levels and Periodontal Status - A Biochemical Study on Indian Patients. Journal of Clinical and Diagnostic Research. 2015 May;9(5): ZC48-53. doi: 10.7860/JCDR/2015/12335.5941.
21.    Shi D, et al. Association between plasma leptin level and systemic inflammatory markers in patients with aggressive periodontitis. Chinese Medical Journal (Engl). 2015;128(4): 528-532. doi: 10.4103/0366-6999.151110.
22.    Teles FR, et al. Relationships among interleukin‐6, tumor necrosis factor‐α, adipokines, vitamin D, and chronic periodontitis. Journal of Periodontology. 2012;83(9): 1183-91. doi: 10.1902/jop.2011.110346.
23.    Gonçalves TE, et al. Local and serum levels of adipokines in patients with obesity after periodontal therapy: one-year follow-up. Journal of Clinical Periodontology. 2015 May;42(5): 431-9. doi: 10.1111/jcpe.12396.
24.    Sheng T, et al. Association Between Single Nucleotide Polymorphisms (SNPs) in the Promoter of Adiponectin Gene, Hypoadiponectinemia, and Diabetes. Research Journal of Science and Technology. 2016 Jan– Mar;8(1): 34-40. doi: 10.5958/2349-2988.2016.00004.8.
25.    Mantzoros CS, et al. Circulating adiponectin levels are associated with better glycemic control, more favorable lipid profile, and reduced inflammation in women with type 2 diabetes. The Journal of Clinical Endocrinology & Metabolism .2005;90(8): 4542-8. doi: 10.1210/jc.2005-0372.
26.    Wolf AM, et al. Adiponectin induces the anti-inflammatory cytokines IL-10 and IL-1RA in human leukocytes. Biochemical and Biophysical Research Communications. 2004;323(2): 630-5. doi: 10.1016/j.bbrc.2004.08.145.
27.    Maeda N, et al. Diet-induced insulin resistance in mice lacking adiponectin/ACRP30. Nature Medicine. 2002;8(7): 731-7. doi: 10.1038/nm724.
28.    Wang Z, et al. The role of adiponectin in periodontitis: Current state and future prospects. Biomedicine & Pharmacotherapy. 2021 May;137: 111358. doi: 10.1016/j.biopha.2021.111358.
29.    Yamaguchi N, et al. Adiponectin inhibits osteoclast formation stimulated by lipopolysaccharide from Actinobacillus actinomycetemcomitans. FEMS Immunology and Medical Microbiology. 2007;49(1): 28-34. doi: 10.1111/j.1574-695X.2006.00164.x.
30.    Zhu J, et al. Association of circulating leptin and adiponectin with periodontitis: a systematic review and meta-analysis. BMC Oral Health. 2017;17(1): 104. doi: 10.1186/s12903-017-0395-0.
31.    Vivekananda L, Faizuddin M. Effect of Weight Reduction on the Serum Adiponectin and Tumor Necrosis Factor-α Levels and the Clinical Parameters of Obese Patients with and without Periodontal Disease. Journal of International Society of Preventive and Community Dentistry. 2019 Mar-Apr;9(2): 166-171. doi: 10.4103/jispcd.JISPCD_447_18.
32.    Duzagac E, et al. Is obesity associated with healing after non-surgical periodontal therapy? A local vs. systemic evaluation. Journal of Periodontal Research. 2016 Oct;51(5): 604-12. doi: 10.1111/jre.12340.
33.    Abdella NA, Mojiminiyi OA. Clinical Applications of Adiponectin Measurements in Type 2 Diabetes Mellitus: Screening, Diagnosis, and Marker of Diabetes Control. Disease Markers. 2018 Jul 5;2018:5187940. doi: 10.1155/2018/5187940.
34.    Patel L, et al. Resistin is expressed in human macrophages and directly regulated by PPARγ activators. Biochemical and Biophysical Research Communications. 2003;300(2): 472-6. doi: 10.1016/s0006-291x(02)02841-3.
35.    Silswal N, et al. Human resistin stimulates the pro-inflammatory cytokines TNF-α and IL-12 in macrophages by NF-κB-dependent pathway. Biochemical and Biophysical Research Communications. 2005;334(4): 1092-101. doi: 10.1016/j.bbrc.2005.06.202.
36.    Devanoorkar A, et al. Resistin: a potential biomarker for periodontitis influenced diabetes mellitus and diabetes induced periodontitis. Disease Markers. 2014;2014: 930206. doi: 10.1155/2014/930206.
37.    Furugen R, et al. The relationship between periodontal condition and serum levels of resistin and adiponectin in elderly Japanese. Journal of Periodontal Research. 2008;43(5): 556-62. doi: 10.1111/j.1600-0765.2008.01085.x.
38.    Zimmermann GS, et al. Local and circulating levels of adipocytokines in obese and normal weight individuals with chronic periodontitis. Journal of Periodontology. 2013 May;84(5): 624-33. doi: 10.1902/jop.2012.120254.
39.    Offenbacher S, et al. Changes in gingival crevicular fluid inflammatory mediator levels during the induction and resolution of experimental gingivitis in humans. Journal of Clinical Periodontology.2010;37(4): 324-33. doi: 10.1111/j.1600-051X.2010.01543.x.
40.    Thommesen L, et al. Expression and regulation of resistin in osteoblasts and osteoclasts indicate a role in bone metabolism. Journal of Cellular Biochemistry. 2006;99(3): 824-34. doi: 10.1002/jcb.20915.
41.    Al-Kraity WRH, Jawad MM. Comparison Visfatin level between Obese and Non Obese, Hypertensive and Normotensive patients with Ischemic Heart Disease. Research Journal of Science and Technology. 2019;12(7): 3547-50. doi: 10.5958/0974-360X.2019.00604.8.
42.    Moschen AR, et al. Visfatin, an adipocytokine with proinflammatory and immunomodulating properties. Journal of Immunology. 2007;178(3): 1748-58. doi: 10.4049/jimmunol.178.3.1748.
43.    Özcan E, et al. Porphyromonas gingivalis and Epstein‐Barr virus are associated with increased levels of visfatin in gingival crevicular fluid. Journal of Periodontology. 2016;87(4): 443-51. doi: 10.1902/jop.2015.150424.
44.    Pradeep AR, et al. Gingival crevicular fluid and serum visfatin concentration: their relationship in periodontal health and disease. Journal of Periodontology. 2011;82(9): 1314-9. doi: 10.1902/jop.2011.100690.
45.    Özcan E, et al. Increased visfatin expression is associated with nuclear factor-kappa B and phosphatidylinositol 3-kinase in periodontal inflammation. Clinical Oral Investigations. 2017;21(4):1113-21. doi: 10.1007/s00784-016-1871-7.
46.    Raghavendra NM, et al. Effect of non surgical periodontal therapy on gingival crevicular fluid and serum visfatin concentration in periodontal health and disease. Disease Markers. 2012;32(6): 383-8. doi: 10.3233/DMA-2012-0897.
47.    Abolfazli N, et al. Effect of non-surgical periodontal therapy on serum and salivary concentrations of visfatin in patients with chronic periodontitis. Journal of Dental Research Dental Clinics Dental Prospects. 2015;9(1): 11. doi: 10.15171/joddd.2015.003.
48.    Boucher J, et al. Apelin, a newly identified adipokine up-regulated by insulin and obesity. Endocrinology. 2005;146(4): 1764-71. doi: 10.1210/en.2004-1427.
49.    Koguchi W, et al. Cardioprotective effect of apelin-13 on cardiac performance and remodeling in end-stage heart failure. Circulation Journal. 2012;76(1):137-44. doi: 10.1253/circj.cj-11-0689.
50.    Leeper NJ, et al. Apelin prevents aortic aneurysm formation by inhibiting macrophage inflammation. American Journal of Physiology-Heart and Circulatory Physiology. 2009;296(5): H1329-35. doi: 10.1152/ajpheart.01341.2008.
51.    Visser YP, et al. Apelin attenuates hyperoxic lung and heart injury in neonatal rats. American Journal of Respiratory and Critical Care Medicine. 2010;182(10): 1239-50. doi: 10.1164/rccm.200909-1361OC.
52.    Heinonen MV, et al. Effect of diet-induced weight loss on plasma apelin and cytokine levels in individuals with the metabolic syndrome. Nutrition, Metabolism & Cardiovascular Diseases. 2009;19(9): 626-33. doi: 10.1016/j.numecd.2008.12.008.
53.    Jaikanth C, et al. Emergence of omentin as a pleiotropic adipocytokine. Experimental and Clinical Endocrinology and Diabetes. 2013;121(07): 377-83. doi: 10.1055/s-0033-1345123.
54.    Yamawaki H, et al. Omentin, a novel adipocytokine inhibits TNF-induced vascular inflammation in human endothelial cells. Biochemical and Biophysical Research Communications. 2011;408(2): 339-43. doi: 10.1016/j.bbrc.2011.04.039.
55.    Sarhat ER, et al. Wadi. Altered Serum Markers of Omentin and Chemerinin Chronic Renal Failure Patients on Hemodialysis. Research Journal of Science and Technology. 2018;11(4): 1667-1670. doi: 10.5958/0974-360X.2018.00310.4.
56.    Xie H, et al. Omentin-1 exerts bone-sparing effect in ovariectomized mice. Osteoporosis International. 2012;23(4): 1425-36. doi: 10.1007/s00198-011-1697-8.
57.    Assadi M, et al. Correlation of circulating omentin-1 with bone mineral density in multiple sclerosis: the crosstalk between bone and adipose tissue. PLOS ONE. 2011;6(9): e24240. doi: 10.1371/journal.pone.0024240.
58.    Dikker O, et al. Evaluation of the relation between omentin-1 and vitamin D in postmenopausal women with or without osteoporosis. Experimental and Clinical Endocrinology & Diabetes. 2018;126(05): 316-20. doi: 10.1055/s-0043-120110.
59.    Doğan ŞB, et al. Levels of vaspin and omentin-1 in gingival crevicular fluid as potential markers of inflammation in patients with chronic periodontitis and type 2 diabetes mellitus. Journal of Oral Science. 2016;58(3): 379-89.
60.    De Taeye BM, et al. Bone marrow plasminogen activator inhibitor-1 influences the development of obesity. Journal of Biological Chemistry. 2006;281(43): 32796-805. doi: 10.1074/jbc.M606214200.
61.    Debnath P, et al. Plasminogen activator inhibitor-1 polymorphisms as a risk factor for chronic periodontitis in North Indian population. Journal of Oral Biology and Craniofacial Research. 2019 Apr-Jun;9(2): 226-229. doi: 10.1016/j.jobcr.2018.04.003.
62.    Omran DM, et al. Relationship between Ghrelin and Leptin with Insulin Resistance in Obese Patients and Non-Obese Individuals. Research Journal of Science and Technology. 2018; 11(1): 281-3. doi: 10.5958/0974-360X.2018.00052.5.

Recomonded Articles:

Research Journal of Pharmacy and Technology (RJPT) is an international, peer-reviewed, multidisciplinary journal.... Read more >>>

RNI: CHHENG00387/33/1/2008-TC                     
DOI: 10.5958/0974-360X 

56th percentile
Powered by  Scopus

SCImago Journal & Country Rank

Recent Articles


Not Available