ASSOCIATION BETWEEN POOR ORAL HYGIENE AND SYSTEMIC INFLAMMATION IN DIABETIC PATIENTS

Abstract

Background: Type 2 diabetes mellitus (T2DM) is associated with chronic low-grade systemic inflammation, which significantly contributes to disease progression and complications. Emerging evidence suggests a link between poor oral hygiene and elevated systemic inflammatory markers in diabetic individuals, mediated by increased oral bacterial load.

Objective: To investigate the association between oral bacterial load and systemic inflammation in patients with T2DM, and to determine whether oral microbial burden independently contributes to heightened inflammatory responses.

Methods: This cross-sectional study was conducted at a tertiary care hospital in Lahore from July 2024 to March 2025. A total of 100 adults with T2DM were enrolled based on defined inclusion and exclusion criteria. Oral bacterial load was quantified using quantitative real-time PCR (qRT-PCR) targeting 16S rRNA gene sequences from subgingival plaque samples. Systemic inflammation was assessed by measuring serum levels of high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) using ELISA. Data were analyzed using Pearson correlation and multivariate linear regression, with statistical significance set at p<0.05.

Results: Participants had a mean age of 52.3 ± 7.1 years and mean HbA1c of 8.1 ± 1.2%. High oral bacterial load (>8 log10 copies/mL) was observed in 38% of participants. Significant positive correlations were found between bacterial load and hs-CRP (r=0.58), IL-6 (r=0.61), and TNF-α (r=0.56), all p<0.001. Regression analysis confirmed bacterial load as an independent predictor of systemic inflammation.

Conclusion: Oral bacterial load is significantly associated with systemic inflammation in T2DM patients. These findings highlight the importance of oral health in managing systemic complications of diabetes.