{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:32:02Z","timestamp":1786649522398,"version":"build-2736575974"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Diabetes mellitus is a well-recognized risk factor for periodontitis and there is ample evidence that untreated periodontitis can worsen glycemic control in the diabetic population. However, the effect of untreated periodontitis on glycemic status of nondiabetic population is less explored. The aim of the study is to estimate and correlate glycemic control and inflammatory status with periodontal parameters of nondiabetic subjects with and without generalized periodontitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>\n                      Nondiabetic subjects between 18 and 60 years were divided into two groups: Group 1: periodontally healthy controls (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 50) and Group 2: nondiabetic participants with chronic periodontitis (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 50). Probing pocket depth (PPD), clinical attachment level (CAL), and modified Sulcus Bleeding Index were recorded for all the individuals. Blood samples for the estimation of HbA1c (glycated hemoglobin) and Homeostatic Model Assessment for Insulin Resistance (HOMA IR) and gingival crevicular fluid (GCF) samples for the estimation of tumor necrosis factor alpha (TNF-\u03b1) were collected. The GCF and the serum samples were processed using the ELISA kits.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      There was a statistically significant difference (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.001) between the test and control groups in the values of glycemic indicators; HbA1c (Group A \u2013 5.19% \u00b10.47% and Group B \u2013 5.90% \u00b10.46%), TNF-\u03b1 (Group A \u2013 15.52 \u00b1 7.35 pg\/ml and Group B \u2013 35.25 \u00b1 18.26 pg\/ml), and HOMA IR (Group A \u2013 3.45 \u00b1 2.29; Group B \u2013 5.78 \u00b1 1.82). A lack of correlation was observed between periodontal parameters (PPD and CAL) and glycemic indicators such as HbA1c, TNF \u03b1, and HOMA IR in both the groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>There is a significant difference in the HbA1c, HOMA IR, and TNF \u03b1 between nondiabetic subjects with and without periodontitis indicating that untreated periodontal disease worsens the glycemic control and increases the risk of developing diabetes mellitus in nondiabetic individuals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jisp.jisp_192_23","type":"journal-article","created":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T05:01:00Z","timestamp":1749618060000},"page":"80-84","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Comparative evaluation of tumor necrosis factor-\u03b1 levels in gingival crevicular fluid, HbA1c levels, and homeostatic model assessment for insulin resistance in nondiabetic subjects with and without periodontitis"],"prefix":"10.4103","volume":"29","author":[{"given":"Priyadarshini","family":"Govindarajan","sequence":"first","affiliation":[{"name":"Department of Periodontology, Karpaga Vinayaga Institute of Dental Sciences, Kanchipuram, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saravanakumar","family":"Ravindran","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Indira Gandhi Institute of Dental Sciences, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pratebha","family":"Balu","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Indira Gandhi Institute of Dental Sciences, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jananni","family":"Muthu","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Indira Gandhi Institute of Dental Sciences, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srinivasan","family":"Krishnappan","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Indira Gandhi Institute of Dental Sciences, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elsie Sunitha","family":"Ebenezer","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Indira Gandhi Institute of Dental Sciences, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,6,10]]},"reference":[{"key":"R1-20260422","doi-asserted-by":"crossref","first-page":"95","DOI":"10.4137\/BMI.S38440","article-title":"Significance of HbA1c test in diagnosis and prognosis of diabetic patients","volume":"11","author":"Sherwani","year":"2016","journal-title":"Biomark Insights"},{"key":"R2-20260422","doi-asserted-by":"crossref","first-page":"113","DOI":"10.47102\/annals-acadmedsg.V43N2p113","article-title":"Identification of insulin resistance in subjects with normal glucose tolerance","volume":"43","author":"Lin","year":"2014","journal-title":"Ann Acad Med Singap"},{"key":"R3-20260422","doi-asserted-by":"crossref","first-page":"168","DOI":"10.3109\/00365513.2010.547947","article-title":"The relationship between glycosylated haemoglobin (HbA1c) and measures of insulin resistance across a range of glucose tolerance","volume":"71","author":"Borai","year":"2011","journal-title":"Scand J Clin Lab Invest"},{"key":"R4-20260422","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1507\/endocrj.48.81","article-title":"Clinical significance of the insulin resistance index as assessed by homeostasis model assessment","volume":"48","author":"Ikeda","year":"2001","journal-title":"Endocr J"},{"key":"R5-20260422","doi-asserted-by":"crossref","first-page":"7313","DOI":"10.1016\/S0021-9258(20)89445-9","article-title":"Tumor necrosis factor. 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