Evaluation of fetuin-A and high-sensitivity C-reactive protein levels in gingival crevicular fluid in periodontitis diabetic and nondiabetic patients: an observational diagnostic accuracy study

Abstract

Introduction Periodontitis is one of the most common chronic inflammatory diseases worldwide although its pathogenesis is still unclear. Diabetes complicates periodontitis changing its grade as a modifying factor. Gingival crevicular fluid (GCF) is regarded now as an important biological fluid especially in periodontal diseases. Hence, the aim of this study was to compare and correlate GCF fetuin-A and high-sensitivity C-reactive protein (hs-CRP) levels in nondiabetic periodontitis patients and diabetic periodontitis patients with healthy participants revealing their possible role in periodontal disease diagnosis. Patients and methods Thirty periodontitis stage III grade B/C patients categorized into two groups according to whether having diabetes mellitus or not were compared to 15 systemically and periodontally healthy participants. Clinical parameters were recorded. Assessment of GCF levels of fetuin-A and hs-CRP were done utilizing an enzyme-linked immunosorbent assay kit. Receiver operating characteristic curve was performed revealing sensitivity, specificity, predictive value, and diagnostic accuracy of both markers. Results GCF fetuin-A levels showed statistically significant difference between the three groups (P < 0.001) with the highest level in healthy group followed by the nondiabetic periodontitis group then the diabetic periodontitis group. While for hs-CRP level, it showed significantly higher results in nondiabetic periodontitis group and the diabetic periodontitis group than in healthy group with no statistically significant difference between both periodontitis groups. Conclusions Both markers have diagnostic ability in discriminating periodontitis against healthy individuals. However, the diagnostic ability in discriminating diabetic patients with periodontitis against nondiabetic periodontitis patients, fetuin-A showed outstanding ability, while the ability of hs-CRP was acceptable.