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Review | Open Access

Periodontitis as a promoting factor of T2D: current evidence and mechanisms

Yuan Su1,2Leilei Ye2Chen Hu3Yanli Zhang2Jia Liu2Longquan Shao2( )
Stomatology Center, Shunde Hospital, Southern Medical University (The First People’s Hospital of Shunde), Foshan, China
Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China

These authors contributed equally: Yuan Su, Leilei Ye

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Abstract

Periodontitis is an infectious disease caused by an imbalance between the local microbiota and host immune response. Epidemiologically, periodontitis is closely related to the occurrence, development, and poor prognosis of T2D and is recognized as a potential risk factor for T2D. In recent years, increasing attention has been given to the role of the virulence factors produced by disorders of the subgingival microbiota in the pathological mechanism of T2D, including islet β-cell dysfunction and insulin resistance (IR). However, the related mechanisms have not been well summarized. This review highlights periodontitis-derived virulence factors, reviews how these stimuli directly or indirectly regulate islet β-cell dysfunction. The mechanisms by which IR is induced in insulin-targeting tissues (the liver, visceral adipose tissue, and skeletal muscle) are explained, clarifying the influence of periodontitis on the occurrence and development of T2D. In addition, the positive effects of periodontal therapy on T2D are overviewed. Finally, the limitations and prospects of the current research are discussed. In summary, periodontitis is worthy of attention as a promoting factor of T2D. Understanding on the effect of disseminated periodontitis-derived virulence factors on the T2D-related tissues and cells may provide new treatment options for reducing the risk of T2D associated with periodontitis.

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International Journal of Oral Science
Article number: 25
Cite this article:
Su Y, Ye L, Hu C, et al. Periodontitis as a promoting factor of T2D: current evidence and mechanisms. International Journal of Oral Science, 2023, 15: 25. https://doi.org/10.1038/s41368-023-00227-2

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Received: 04 March 2023
Revised: 12 April 2023
Accepted: 26 April 2023
Published: 15 June 2023
© The Author(s) 2023

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