Research Paper Volume 12, Issue 24 pp 25956—25980

Periodontitis in elderly patients with type 2 diabetes mellitus: impact on gut microbiota and systemic inflammation

Jinyou Li1, *, , Haifeng Lu2, *, , Huanwen Wu3, , Shunmei Huang1, , Lufang Chen1, , Qifeng Gui1, , Wenjing Zhou1, , Yichen Yang1, , Yue Wu1, , Hua Zhang2, , Qin Zhang1, , Yunmei Yang1, ,

  • 1 Zhejiang Provincial Key Laboratory for Diagnosis and Treatment of Aging and Physic-Chemical Injury Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
  • 2 State Key Laboratory for Diagnosis and Treatment of Infectious Disease, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
  • 3 Deanery of Biomedical Sciences, The University of Edinburgh, Edinburgh, UK
* Equal contribution

Received: August 21, 2020       Accepted: September 29, 2020       Published: November 25, 2020      

https://doi.org/10.18632/aging.202174
How to Cite

Copyright: © 2020 Li et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Elderly patients with type 2 diabetes mellitus (T2DM) exhibit considerable periodontitis frequency, which causes tooth loss and poor quality of life. To investigate the impact of periodontitis on gut microbiota, we used 16S rRNA amplicon sequencing to characterize the composition and structure of gut microbiota among elderly patients with T2DM and periodontitis (T2DM_P), elderly patients with T2DM alone (T2DM_NP), and healthy volunteers. We identified 34 key gut microbiota markers that distinguished participants with different periodontal conditions and investigated their connections to other gut bacteria, as well as their clinical correlates. The most striking differences in co-occurrence networks between the T2DM_P and T2DM_NP groups comprised interactions involving dominant genera in the oral cavity (i.e., Streptococcus and Veillonella). Of the 34 identified key gut microbiota markers that distinguished participants with different periodontal conditions, 25 taxa were correlated with duration of diabetes, dry mouth or the peripheral levels of pro-inflammatory cytokines (e.g., tumor necrosis factor-α, interferon-γ, prostaglandin E2, interleukin-17, and interleukin-6) and metabolic parameters (e.g., hemoglobin A1c), respectively. Our findings suggest that gut microbial shifts driven by periodontitis may contribute to systemic inflammation and metabolic dysfunction during the progression of T2DM.

Abbreviations

CPI: Community Periodontal Index; FBG: fasting blood glucose; HbA1c: Hemoglobin A1c; TG: total triglyceride; TCHO: cholesterol; HDL-c: high-density lipoprotein cholesterol; LDL-c: low-density lipoprotein cholesterol; VLDL-c: very low-density lipoprotein cholesterol; PGE2: Prostaglandin E2; LTB4: Leukotriene B4; TNF-α: Tumor necrosis factor α; IL-6: Interleukin 6; IFN-γ: interferon-γ; IL-17: Interleukin 17; IL-22: Interleukin 22; BALP: bone alkaline phosphatase; OC: osteocalcin; BMI: body mass index; LDA: Linear Discriminant Analysis; OTU: Operational Taxonomic Unit; ROC: Receiver Operating Characteristic; AUC: Area Under Curve.