Clinical Periodontal Evaluation and Assessment of Dipeptidyl-Peptidase-4 and Galectin-3 in Gingival Crevicular Fluid of Periodontitis Patients with Heart Failure and Diabetes

Abstract

Background/Objectives: Periodontitis, a prevalent chronic inflammatory disease affecting tooth-supporting structures, has been increasingly linked to systemic conditions such as diabetes mellitus (DM) and cardiovascular diseases (CVDs). This study aimed to evaluate the periodontal status and levels of dipeptidyl peptidase-4 (DPP-4) and galectin-3 (Gal-3) in gingival crevicular fluid (GCF) of patients with periodontitis, heart failure (HF), and diabetes, exploring their potential as biomarkers for disease association. Methods: A cross-sectional study was conducted on 88 patients categorized into four groups: periodontally and systemically healthy (control, C); periodontitis (P); periodontitis and HF (P+HF); and periodontitis, HF, and diabetes (P+HF+D). Periodontal status was assessed using probing pocket depth (PPD) and Gingival Index (GI). GCF samples were collected and analyzed for DPP-4 and Gal-3 levels using ELISA. Statistical analyses were performed to assess differences between groups and potential correlations. Results: Results indicated significantly higher levels of DPP-4 in all test groups compared to controls (p < 0.0001), with the highest levels in the P+HF+D group. Similarly, Gal-3 levels were elevated in periodontitis patients, particularly in those with HF (p < 0.0001), and there was no significant difference between P+HF and P+HF+D groups. No significant differences were observed between smokers and non-smokers regarding these markers. Positive correlations were found between the periodontal parameters and the immunological markers in all test groups. Conclusions: The findings suggest that DPP-4 and Gal-3 may serve as potential biomarkers for periodontitis in association with heart failure and diabetes, with DPP-4 being more upregulated in the association with diabetes and Gal-3 with heart failure.