Glycaemic status affects the subgingival microbiome of diabetic patients

• Published in: Journal of clinical periodontology Vol. 45; no. 8; pp. 932 - 940
• Main Authors: Longo, Priscila L., Dabdoub, Shareef, Kumar, Purnima, Artese, Hilana P. C., Dib, Sergio A., Romito, Giuseppe A., Mayer, Marcia Pinto Alves
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01-08-2018
• Subjects: 16SrRNA sequencing; Biofilms; Body mass index; Chronic Periodontitis; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2; Gingiva; Gum disease; Humans; microbiome; Microbiomes; Microbiota; Patients; periodontal pocket; Periodontitis; Propionic acid; Pyruvic acid; Smoking; Streptococcus infections; type 2 diabetes mellitus; type 2 diabetes mellitus; periodontal pocket; microbiome; 16SrRNA sequencing; periodontitis
• ISSN: 0303-6979; 1600-051X
• DOI: 10.1111/jcpe.12908

Aim
Periodontitis is correlated with type 2 diabetes mellitus (T2DM), but little is known about glycaemic status effect on subgingival microbiota associated with periodontitis. This study evaluated if periodontal microbiome of T2DM patients is affected by glycaemic status.
Materials and methods
Twenty‐one T2DM non‐smoking patients with chronic periodontitis and body mass index ≤40 kg/m2 were allocated into two groups according to systemic glycaemic status: inadequate (DMI‐ HbA1c ≥ 8%) and adequate (DMA‐ HbA1c <7.8%). Subgingival biofilm was collected from sites with moderate (PD = 4–6 mm) and severe disease (PD ≥ 7 mm) in two quadrants. The V5–V6 hypervariable region of the 16SrRNA was sequenced using the GS‐FLX‐454 Titanium platform. Sequences were compared with HOMD database using QIIME and PhyloToAST pipelines. Statistical comparisons were made using two‐sample t‐tests.
Results
DMA microbiome presented higher diversity than DMI. Inadequate glycaemic control favoured fermenting species, especially those associated with propionate/succinate production, whereas those forming butyrate/pyruvate was decreased in DMI. Higher abundances of anginosus group and Streptococcus agalactiae in DMI may indicate that subgingival sites can be reservoir of potentially invasive pathogens. Altered subgingival microbiome in DMI may represent an additional challenge in the periodontal treatment of these patients and in the prevention of more invasive infections.
Conclusion
Glycaemic status in T2DM patients seems to modulate subgingival biofilm composition.