Clinical Significance of Aging-Related Secretory Phenotypic Factors in Diagnosing Type 2 Diabetes Mellitus-Associated Peri-Implantitis: A Retrospective Analysis.

Abstract

Aims/Background Type 2 diabetes mellitus (T2DM) has been reported as a critical contributor to peri-implantitis. Hyperglycemia and associated metabolic changes in diabetes promote cellular senescence. This study aims to investigate the significance of aging-related secretory factors, known as senescence-associated secretory phenotypes (SASPs), in peri-implant crevicular fluid (PICF) in diagnosing type 2 diabetes mellitus-associated peri-implantitis (T2DM-PI). Methods This study included 72 patients with T2DM-PI (designated as a T2DM-PI group) and 45 patients with peri-implantitis (as a control group). The patients were selected at the Linping Campus of the Second Affiliated Hospital of Zhejiang University School of Medicine between December 2021 and December 2023. Patients in both groups were further divided into the middle-aged group and the elderly group. Furthermore, patients were stratified as the middle-aged peri-implantitis (M-PI) group, the middle-aged type 2 diabetes mellitus-associated peri-implantitis (M-DPI) group, the elderly peri-implantitis (E-PI) group, and the elderly type 2 diabetes mellitus-associated peri-implantitis (E-DPI) group. Baseline characteristics and the level of SASPs in PICF were compared between the two groups. We analyzed the factors influencing the occurrence of peri-implantitis in type 2 diabetes, conducted multiple collinearity testing on the selected variables, and incorporated variables with a variance inflation factor (VIF) <5 into a multi-factor binary logistic regression analysis to identify independent risk factors for type 2 diabetes mellitus-associated peri-implantitis. Furthermore, a receiver operating characteristic (ROC) curve was constructed to assess the diagnostic value of SASP levels in patients with T2DM-PI. Results Compared to the control group, the level of SASPs was significantly higher in the T2DM-PI group, with elevated SASP levels positively correlated with the severity of periodontal indicators. Binary logistic regression analysis identified body mass index (BMI), interleukin (IL)-1β, tumor necrosis factor (TNF)-α, and matrix metalloproteinase 8 (MMP8) as independent risk factors for the occurrence of T2DM-PI in the middle-aged group (p < 0.05). BMI was found to be an independent risk factor for T2DM-PI in the elderly group (p < 0.05). The ROC curve analysis revealed that IL-1β had the highest diagnostic accuracy among the middle-aged T2DM-PI, with an area under the curve (AUC) of 0.861, a sensitivity of 85.40%, and a specificity of 82.10%. BMI demonstrated the highest diagnostic accuracy in elderly T2DM-PI, with an AUC of 0.904, a sensitivity of 100%, and a specificity of 70.60%. Conclusion Elevated SASP levels in PICF are associated with the severity of periodontal index outcomes in patients with T2DM-PI. Furthermore, SASP levels hold significant diagnostic performance for T2DM-PI.