{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:50:09Z","timestamp":1792785009589,"version":"4.5.0"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,11,5]],"date-time":"2020-11-05T00:00:00Z","timestamp":1604534400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,11,5]],"date-time":"2020-11-05T00:00:00Z","timestamp":1604534400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Promotion of University Research and Scientific Excellence (PURSE II) Grant supported this study"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Previous studies have suggested excess GH\/IGF1 secretion in patients with acromegaly is protective for periodontal health. Diabetes is prevalent comorbidity in patients of acromegaly and is associated with worsening of periodontal disease. The present study evaluates the periodontal health and cytokines status in treatment-naive active acromegaly patients with and without diabetes. Eleven patients, each of acromegaly with and without diabetes and 20 healthy controls were enrolled. Periodontal parameters were assessed. GCF and blood samples for IL-6, TGF-\u03b21, and PDGF were obtained. Serum GH, IGF1, HbA1c, pituitary hormones and MRI sella were performed in patients with acromegaly. There was no significant difference in periodontal status of patients with acromegaly and healthy controls. However, a significant increase in serum IL-6 (p\u2009=\u20090.019) and TGF-\u03b21 (p\u2009=\u20090.025) levels in patients with acromegaly was observed and all patients had concurrent hypogonadism. Nevertheless, the patients with acromegaly having diabetes had modestly higher CAL and PD and serum IL-6 levels (p\u2009=\u20090.051), but it could not exert adverse effects on periodontal health in presence of GH\/IGF1 excess. GH\/IGF1 excess did not exert a protective effect on periodontal status in acromegaly, possibly due to concurrent hypogonadism and opposing cytokines; however, it could mask the ill-effects of diabetes on periodontal health.<\/jats:p>","DOI":"10.1038\/s41598-020-76067-5","type":"journal-article","created":{"date-parts":[[2020,11,5]],"date-time":"2020-11-05T06:03:19Z","timestamp":1604556199000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Impact of concurrent diabetes on periodontal health in patients with acromegaly"],"prefix":"10.1038","volume":"10","author":[{"given":"Akanksha","family":"Jain","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shipra","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anil","family":"Bhansali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mili","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish","family":"Jain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nandini","family":"Bhaskar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rose Kanwaljeet","family":"Kaur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,11,5]]},"reference":[{"key":"76067_CR1","doi-asserted-by":"crossref","first-page":"540398","DOI":"10.1155\/2012\/540398","volume":"2012","author":"G Lugo","year":"2012","unstructured":"Lugo, G., Pena, L. & Cordido, F. Clinical manifestations and diagnosis of acromegaly. Int. J. Endocrinol. 2012, 540398 (2012).","journal-title":"Int. J. Endocrinol."},{"key":"76067_CR2","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1007\/s11102-016-0754-x","volume":"20","author":"A Lavrentaki","year":"2017","unstructured":"Lavrentaki, A., Paluzzi, A., Wass, J. A. & Karavitaki, N. Epidemiology of acromegaly: Review of population studies. Pituitary 20, 4\u20139 (2017).","journal-title":"Pituitary"},{"key":"76067_CR3","doi-asserted-by":"crossref","first-page":"2558","DOI":"10.1056\/NEJMra062453","volume":"355","author":"S Melmed","year":"2006","unstructured":"Melmed, S. Medical progress: Acromegaly. N. Engl. J. Med. 355, 2558\u20132573 (2006).","journal-title":"N. Engl. J. Med."},{"key":"76067_CR4","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/S1010-5182(02)00182-8","volume":"31","author":"S Dostalova","year":"2003","unstructured":"Dostalova, S., Sonka, K., Smahel, Z., Weiss, V. & Marek, J. Cephalometric assessment of cranial abnormalities in patients with acromegaly. J. Craniomaxillofac. Surg. 31, 80\u201387 (2003).","journal-title":"J. Craniomaxillofac. Surg."},{"key":"76067_CR5","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1902\/annals.1999.4.1.32","volume":"4","author":"TF Flemmig","year":"1999","unstructured":"Flemmig, T. F. Periodontitis. Ann. Periodontol. 4, 32\u201338 (1999).","journal-title":"Ann. Periodontol."},{"issue":"44","key":"76067_CR6","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1111\/j.1600-0757.2006.00193.x","volume":"2000","author":"BL Mealey","year":"2007","unstructured":"Mealey, B. L. & Ocampo, G. L. Diabetes mellitus and periodontal disease. Periodontology 2000(44), 127\u2013153 (2007).","journal-title":"Periodontology"},{"key":"76067_CR7","first-page":"588","volume":"115","author":"S Bascil","year":"2014","unstructured":"Bascil, S., Serinsoz, H. & Tutuncu, N. B. Acromegaly is protective for periodontal tissue\u2014Advanced chronic periodontitis is rare in acromegalics. Bratisl. Lek. Listy 115, 588\u2013592 (2014).","journal-title":"Bratisl. Lek. Listy"},{"key":"76067_CR8","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1007\/s00784-008-0216-6","volume":"13","author":"DL Lima","year":"2009","unstructured":"Lima, D. L., Montenegro, R. M. Jr., Vieira, A. P., Albano, M. F. & Rego, D. M. Absence of periodontitis in acromegalic patients. Clin. Oral Investig. 13, 165\u2013169 (2009).","journal-title":"Clin. Oral Investig."},{"key":"76067_CR9","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1007\/s12020-019-02060-2","volume":"66","author":"Y Ozdemir","year":"2019","unstructured":"Ozdemir, Y., Keceli, H. G., Helvaci, N., Erbas, T. & Nohutcu, R. M. The tendency of reduced periodontal destruction in acromegalic patients showing similar inflammatory status with periodontitis patients. Endocrine 66, 622\u2013633 (2019).","journal-title":"Endocrine"},{"key":"76067_CR10","doi-asserted-by":"crossref","first-page":"42","DOI":"10.4274\/tjem.2687","volume":"19","author":"HEM Serins\u00f6z","year":"2015","unstructured":"Serins\u00f6z, H. E. M., Ba\u015fc\u0131l, S., Bak\u0131ner, O., Bozk\u0131rl\u0131, E. & T\u00fct\u00fcnc\u00fc, N. B. Low prevalence of periodontitis in acromegaly: Growth hormone may exert a protective effect. Turk. J. Endocrinol. Metab. 19, 42\u201348 (2015).","journal-title":"Turk. J. Endocrinol. Metab."},{"key":"76067_CR11","first-page":"55","volume":"19","author":"C Ohlsson","year":"1998","unstructured":"Ohlsson, C., Bengtsson, B. A., Isaksson, O. G., Andreassen, T. T. & Slootweg, M. C. Growth hormone and bone. Endocr. Rev. 19, 55\u201379 (1998).","journal-title":"Endocr. Rev."},{"key":"76067_CR12","first-page":"546","volume":"95","author":"KR Arya","year":"1997","unstructured":"Arya, K. R., Pathare, A. V., Chadda, M. & Menon, P. S. Diabetes in acromegaly\u2014A study of 34 cases. J. Indian Med. Assoc. 95, 546\u2013547 (1997).","journal-title":"J. Indian Med. Assoc."},{"key":"76067_CR13","doi-asserted-by":"crossref","first-page":"360","DOI":"10.4103\/0028-3886.158210","volume":"63","author":"P Dutta","year":"2015","unstructured":"Dutta, P. et al. Clinical profile and outcome of patients with acromegaly according to the 2014 consensus guidelines: Impact of a multi-disciplinary team. Neurol. India 63, 360\u2013368 (2015).","journal-title":"Neurol. India"},{"key":"76067_CR14","doi-asserted-by":"crossref","first-page":"1429","DOI":"10.1590\/S0100-879X2001001100009","volume":"34","author":"A Kreze","year":"2001","unstructured":"Kreze, A., Kreze-Spirova, E. & Mikulecky, M. Risk factors for glucose intolerance in active acromegaly. Braz. J. Med. Biol. Res. 34, 1429\u20131433 (2001).","journal-title":"Braz. J. Med. Biol. Res."},{"key":"76067_CR15","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1902\/annals.1998.3.1.51","volume":"3","author":"SG Grossi","year":"1998","unstructured":"Grossi, S. G. & Genco, R. J. Periodontal disease and diabetes mellitus: A two-way relationship. Ann. Periodontol. 3, 51\u201361 (1998).","journal-title":"Ann. Periodontol."},{"key":"76067_CR16","doi-asserted-by":"crossref","first-page":"329","DOI":"10.2337\/diacare.16.1.329","volume":"16","author":"H Loe","year":"1993","unstructured":"Loe, H. Periodontal disease. The sixth complication of diabetes mellitus. Diabetes Care 16, 329\u2013334 (1993).","journal-title":"Diabetes Care"},{"key":"76067_CR17","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1111\/j.1600-0765.1991.tb02072.x","volume":"26","author":"PM Bartold","year":"1991","unstructured":"Bartold, P. M. & Haynes, D. R. Interleukin-6 production by human gingival fibroblasts. J. Periodontal. Res. 26, 339\u2013345 (1991).","journal-title":"J. Periodontal. Res."},{"key":"76067_CR18","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1111\/j.1600-0765.1991.tb01649.x","volume":"26","author":"RC Page","year":"1991","unstructured":"Page, R. C. The role of inflammatory mediators in the pathogenesis of periodontal disease. J. Periodontal. Res. 26, 230\u2013242 (1991).","journal-title":"J. Periodontal. Res."},{"key":"76067_CR19","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1111\/j.1600-0765.1992.tb01823.x","volume":"27","author":"PM Bartold","year":"1992","unstructured":"Bartold, P. M., Narayanan, A. S. & Page, R. C. Platelet-derived growth factor reduces the inhibitory effects of lipopolysaccharide on gingival fibroblast proliferation. J. Periodontal. Res. 27, 499\u2013505 (1992).","journal-title":"J. Periodontal. Res."},{"key":"76067_CR20","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1902\/jop.2003.74.3.323","volume":"74","author":"ML Pinheiro","year":"2003","unstructured":"Pinheiro, M. L. et al. Quantification and localization of platelet-derived growth factor in gingiva of periodontitis patients. J Periodontol 74, 323\u2013328 (2003).","journal-title":"J Periodontol"},{"key":"76067_CR21","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1111\/j.1600-051X.2012.01935.x","volume":"39","author":"AN Harb","year":"2012","unstructured":"Harb, A. N. et al. Association between the insulin-like growth factor axis in serum and periodontitis in the Study of Health in Pomerania: An exploratory study. J. Clin. Periodontol. 39, 931\u2013939 (2012).","journal-title":"J. Clin. Periodontol."},{"key":"76067_CR22","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1023\/A:1009965803750","volume":"2","author":"IM Holdaway","year":"1999","unstructured":"Holdaway, I. M. & Rajasoorya, C. Epidemiology of acromegaly. Pituitary 2, 29\u201341 (1999).","journal-title":"Pituitary"},{"key":"76067_CR23","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1016\/j.archoralbio.2009.02.007","volume":"54","author":"AR Pradeep","year":"2009","unstructured":"Pradeep, A. R., Daisy, H. & Hadge, P. Gingival crevicular fluid levels of monocyte chemoattractant protein-1 in periodontal health and disease. Arch. Oral Biol. 54, 503\u2013509 (2009).","journal-title":"Arch. Oral Biol."},{"key":"76067_CR24","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.cyto.2009.05.012","volume":"47","author":"AR Pradeep","year":"2009","unstructured":"Pradeep, A. R., Daisy, H. & Hadge, P. Serum levels of monocyte chemoattractant protein-1 in periodontal health and disease. Cytokine 47, 77\u201381 (2009).","journal-title":"Cytokine"},{"issue":"Suppl","key":"76067_CR25","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1902\/jop.1967.38.6_part2.610","volume":"38","author":"H Loe","year":"1967","unstructured":"Loe, H. The Gingival Index, the Plaque Index and the Retention Index systems. J. Periodontol. 38(Suppl), 610\u2013616 (1967).","journal-title":"J. Periodontol."},{"key":"76067_CR26","doi-asserted-by":"crossref","first-page":"7","DOI":"10.14219\/jada.archive.1964.0034","volume":"68","author":"JC Greene","year":"1964","unstructured":"Greene, J. C. & Vermillion, J. R. The simplified oral Hygiene Index. J. Am. Dent. Assoc. 68, 7\u201313 (1964).","journal-title":"J. Am. Dent. Assoc."},{"key":"76067_CR27","doi-asserted-by":"crossref","unstructured":"Bessa Rebelo, M. A. & Correa de Queiroz, A. Gingival indices: state of art. In Gingival Diseases - Their Aetiology, Prevention and Treatment (ed Dr. Panagakos, F.) (InTech, 2011).","DOI":"10.5772\/26236"},{"key":"76067_CR28","doi-asserted-by":"publisher","unstructured":"American Academy of Periodontology Task Force Report on the update to the 1999 classification of periodontal diseases and conditions. J. Periodontol. 86(7), 835\u2013838. https:\/\/doi.org\/10.1902\/jop.2015.157001 (2015).","DOI":"10.1902\/jop.2015.157001"},{"key":"76067_CR29","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1902\/annals.1999.4.1.1","volume":"4","author":"GC Armitage","year":"1999","unstructured":"Armitage, G. C. Development of a classification system for periodontal diseases and conditions. Ann. Periodontol. 4, 1\u20136 (1999).","journal-title":"Ann. Periodontol."},{"key":"76067_CR30","doi-asserted-by":"crossref","first-page":"39","DOI":"10.4158\/EP.1.1.39","volume":"1","author":"E Canalis","year":"1995","unstructured":"Canalis, E. Growth hormone, skeletal growth factors and osteoporosis. Endocr. Pract. 1, 39\u201343 (1995).","journal-title":"Endocr. Pract."},{"key":"76067_CR31","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1007\/s10195-006-0143-8","volume":"7","author":"LL Morselli","year":"2006","unstructured":"Morselli, L. L. et al. Bone and joint alterations in acromegaly. J. Orthop. Traumatol. 7, 169\u2013175 (2006).","journal-title":"J. Orthop. Traumatol."},{"key":"76067_CR32","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1111\/j.1600-0765.2004.00714.x","volume":"39","author":"PM Duarte","year":"2004","unstructured":"Duarte, P. M. et al. Effect of an estrogen-deficient state and its therapy on bone loss resulting from an experimental periodontitis in rats. J. Periodontal. Res. 39, 107\u2013110 (2004).","journal-title":"J. Periodontal. Res."},{"key":"76067_CR33","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1111\/j.1834-7819.2005.tb00352.x","volume":"50","author":"GN Guncu","year":"2005","unstructured":"Guncu, G. N., Tozum, T. F. & Caglayan, F. Effects of endogenous sex hormones on the periodontium\u2014Review of literature. Aust. Dent. J. 50, 138\u2013145 (2005).","journal-title":"Aust. Dent. J."},{"key":"76067_CR34","first-page":"183","volume":"27","author":"M Bolanowski","year":"2006","unstructured":"Bolanowski, M., Daroszewski, J., Zatonska, K. & Arkowska, A. Circulating cytokines in relation to bone mineral density changes in patients with acromegaly. Neuro Endocrinol. Lett. 27, 183\u2013188 (2006).","journal-title":"Neuro Endocrinol. Lett."},{"key":"76067_CR35","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1530\/EJE-11-1009","volume":"166","author":"M Andreassen","year":"2012","unstructured":"Andreassen, M., Frystyk, J., Faber, J. & Kristensen, L. O. GH activity and markers of inflammation: A crossover study in healthy volunteers treated with GH and a GH receptor antagonist. Eur. J. Endocrinol. 166, 811\u2013819 (2012).","journal-title":"Eur. J. Endocrinol."},{"key":"76067_CR36","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1006\/cyto.1998.0336","volume":"10","author":"M Parkar","year":"1998","unstructured":"Parkar, M., Tabona, P., Newman, H. & Olsen, I. IL-6 expression by oral fibroblasts is regulated by androgen. Cytokine 10, 613\u2013619 (1998).","journal-title":"Cytokine"},{"key":"76067_CR37","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1210\/jc.2009-0422","volume":"95","author":"T Ueland","year":"2010","unstructured":"Ueland, T. et al. Associations between body composition, circulating interleukin-1 receptor antagonist, osteocalcin, and insulin metabolism in active acromegaly. J. Clin. Endocrinol. Metab. 95, 361\u2013368 (2010).","journal-title":"J. Clin. Endocrinol. Metab."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-020-76067-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-020-76067-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-020-76067-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,6]],"date-time":"2022-12-06T17:43:51Z","timestamp":1670348631000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-020-76067-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,5]]},"references-count":37,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020,12]]}},"alternative-id":["76067"],"URL":"https:\/\/doi.org\/10.1038\/s41598-020-76067-5","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,5]]},"assertion":[{"value":"12 April 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 October 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 November 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"19170"}}