Association of Vitamin D, IL-6, TNF-α, CRP and Periodontal Health Status in the Eastern Black Sea Region

Association of Vitamin D, IL-6, TNF-α, CRP and Periodontal Health Status in the Eastern Black Sea Region

Objective: It is well established that vitamin D deficiency may increase risk of periodontitis, and that supplementation with vitamin D can contribute to maintain periodontal health. Since the Eastern Black Sea Region receives little sunlight due to its location, individuals living in this region don’t produce enough vitamin D and these individuals generally have vitamin D deficiency. The goal of this study was to analyze that association of vitamin D and periodontal health status in a study population of the Eastern Black Sea Region. Methods: In this study, which was planned as a case control study, it was planned to reach a total of 72 samples, with at least 24 samples in each group in the sample calculation. As a result of data collection, 29 individuals with periodontitis, 28 individuals with gingivitis and 25 periodontally healthy individuals, a total of 82 individuals were included in the study. Cytokines in inflamed periodontal tissues have a marked effect on host modulation and onset and progression of periodontal disease. Venous blood samples were collected from the individuals. Periodontal clinical parameters were measured. Serum levels of 1.25(OH)2D3, 25(OH)D, C-reactive protein (CRP), tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6) were assessed. Results: Periodontally healthy group had statistically significantly lower periodontal clinical parameter values compared to gingivitis and periodontitis group (p<0.05). The serum 1.25(OH)2D3 level was lower in the periodontitis group compared to the periodontally healthy group and gingivitis group (p<0.05). But there was no statistically significant difference in the periodontitis 10.20 (3.70-29.50) ng/mL, gingivitis 11.35 (5.60-29.50) ng/mL and periodontally healthy groups 9.10 (2.90-55.40) ng/mL in terms of serum 25(OH)D levels (p>0.05). Conclusion: The outcomes of this study support the idea that lower serum 1.25(OH)2D3 level has a negative effect on periodontal health status. Our data suggest that vitamin D supplementation to people living in the Eastern Black Sea Region would be beneficial in reducing the risk of developing periodontal disease. Further studies are needed on this subject.


  • Cochran DL. Inflammation and bone loss in periodontal disease. J Periodontol. 2008;79:1569-1576.
  • Teles FR, Teles RP, Martin L, Socransky SS, Haffajee AD. Relationship among IL-6, TNF-α, adipokines, vitamin D and chronic periodontitis. J Periodontol. 2012;83(9):1183-1191.
  • Podzimek S, Mysak J, Janatova T, Duskova J. C-reactive protein in peripheral blood of patients with chronic and aggressive periodontitis, gingivitis, and gingival recessions. Mediators Inflamm. 2015;2015:564858.
  • Nakajima T, Honda T, Domon H, Okui T, Kajita K, Ito H, et al. Periodontitis‐associated up‐regulation of systemic inflammatory mediator level may increase the risk of coronary heart disease. J Periodontal Res. 2010;45(1):116-122.
  • Bretz WA, Weyant RJ, Corby PM, Ren D, Weissfeld L, Kritchevsky SB, et al. Systemic inflammatory markers, periodontal diseases, and periodontal infections in an elderly population. J Am Geriatr Soc. 2005;53(9):1532-1537.
  • Loos BG. Systemic markers of inflammation in periodontitis. J Periodontol. 2005;76(11 Suppl):2106-2115.
  • Passoja A, Puijola I, Knuuttila M, Niemelä O, Karttunen R, Raunio T, et al. Serum levels of interleukin‐10 and tumour necrosis factor‐α in chronic periodontitis. J Clin Periodontol. 2010;37(10):881-887.
  • Marcaccini AM, Meschiari CA, Sorgi CA, Saraiva MCP, de Souza AM, Faccioli LH, et al. Circulating interleukin-6 and high-sensitivity C-reactive protein decrease after periodontal therapy in otherwise healthy subjects. J Periodontol. 2009;80(4):594-602.
  • Antonoglou G, Knuuttila M, Niemelä O, Raunio T, Karttunen R, Vainio O, et al. Low serum level of 1,25(OH)2D is associated with chronic periodontitis. J Periodontal Res. 2015;50(2):274-280.
  • Anand N, Chandrasekaran S, Rajput NS. Vitamin D and periodontal health: current concepts. J Indian Soc Periodontol. 2013;17:302-308.
  • Hossein-nezhad A, Holick MF. Vitamin D for health: a global perspective. Mayo Clin Proc. 2013;88(7):720-755.
  • Holick MF. Vitamin D: evolutionary, physiological and health perspectives. Curr Drug Targets. 2011;12(1):4-18.
  • Wacker M, Holick MF. Vitamin D- Effects on skeletal and extraskeletal health and the need for supplementation. Nutrients. 2013;5: 111-148.
  • Dietrich T, Joshipura KJ, Dawson-Hughes B, Bischoff-Ferrari HA. Association between serum concentrations of 25-hydroxyvitamin D3 and periodontal disease in the US population. A J Clin Nutr. 2004;80:108-113.
  • Antonoglou G, Knuuttila M, Niemelä O, Hiltunen L, Raunio T, Karttunen R, et al. Serum 1,25(OH)D level increases after elimination of periodontal inflammation in T1DM subjects. J Clin Endocrinol Metab. 2013;98(10):3999-4005.
  • Rafique S, Hingorjo MR, Mumtaz M, Qureshi MA. The relationship of 1,25-dihydroxyvitamin D and Vitamin D binding protein in periodontitis. Pak J Med Sci. 2019;35(3):847-851.
  • Bhargava A, Rastogi P, Lal N, Singhal R, Khatoon S, Mahdi AA. Relationship between VITAMIN D and chronic periodontitis. J Oral Biol Craniofac Res. 2019;9(2):177–179.
  • Alzahrani AAH, Alharbi RA, Alzahrani MSA, Sindi MA, Shamlan G, Alzahrani FA, et al. Association between periodontitis and vitamin D status: A case-control study. Saudi J Biol Sci. 2021;28(7):4016-4021.
  • Pradhan S, Agrawal S. serum vitamin D in patients with chronic periodontitis and healthy periodontium. J Nepal Health Res Counc. 2020;18(49): 610-614.
  • Isola G, Alibrandi A, Rapisarda E, Matarese G, Williams RC, Leonardi R. Association of vitamin D in patients with periodontitis: A cross-sectional study. J Periodont Res. 2020;55(5):602-612.
  • Dietrich T, Nunn M, Dawson-Hughes B, Bischoff-Ferrari HA. Association between serum concentrations of 25-hydroxyvitamin D and gingival inflammation. Am J Clin Nutr. 2005;82(3):575-580.
  • Hiremath VP, Rao CB, Naik V, Prasad KV. Anti-inflammatory effect of vitamin D on gingivitis: a dose-response randomised control trial. Oral Health Prev Dent. 2013;11(1):61-69.
  • Garcia MN, Hildebolt CF, Miley DD, Dixon DA, Couture RA, Spearie CLA, et al. One-year effects of vitamin D and calcium supplementation on chronic periodontitis. J Periodontol. 2011;82(1):25-32.
  • Alshouibi E, Kaye E, Cabral HJ, Leone CW, Garcia RI. Vitamin D and periodontal health in older men. J Dent Res. 2013;92(8):689-693.
  • Vieth R. Why the minimum desirable serum 25-hydroxyvitamin D level should be 75 nmol/L (30 ng/mL). Best Pract Res Clin Endocrinol Metab 2011;25:681–691
  • Millen AE, Hovey KM, LaMonte MJ, Swanson M, Andrews CA, Kluczynski MA, et al. Plasma 25‐hydroxyvitamin D concentrations and periodontal disease in postmenopausal women. J Periodontol. 2013;84(9):1243-1256.
  • Bhalla AK, Amento EP, Serog B, Glimcher LH. 1,25-Dihydroxyvitamin D3 inhibits antigen-induced T cell activation. J Immunol. 1984;133(4):1748-1754.
  • Mathieu C, Adorini L. The coming of age of 1, 25-dihydroxyvitamin D3 analogs as imunomodulatory agents. Trends Mol Med. 2002;8(4):174-179.
  • Goyal L, Bey A, Gupta ND, Sharma VK. Comparative evaluation of serum C-reactive protein levels in chronic and aggressive periodontitis patients and association with periodontal disease severity. Contemp Clin Dent. 2014;5(4):484-488.
  • Linden GJ, McClean K, Young I, Evans A, Kee F. Persistently raised C‐reactive protein levels are associated with advanced periodontal disease. J Clin Periodontol. 2008;35(9):741-747.
  • Eickholz P, Siegelin Y, Scharf S, Schacher B, Oremek GM, Sauer-Eppel H, et al. Non‐surgical periodontal therapy decreases serum elastase levels in aggressive but not in chronic periodontitis. J Clin Periodontol. 2013;40(4):327-333.
  • Jayaprakash D, Aghanashini S, Vijayendra RR, Chatterjee A, Rosh RM, Bharwani A. Effect of periodontal therapy on C-reactive protein levels in gingival crevicular fluid of patients with gingivitis and chronic periodontitis: a clinical and biochemical study. J Indian Soc Periodontol. 2014;18:456-460.
  • Pradeep A, Manjunath R, Kathariya R. Progressive periodontal disease has a simultaneous incremental elevation of gingival crevicular fluid and serum CRP levels. J Investig Clin Dent. 2010;1(2):133-138.
  • Andrukhov O, Andrukhova O, Hulan U, Tang Y, Bantleon HP, Rausch-Fan X. Both 25-hydroxyvitamin-D3 and 1,25-dihydroxyvitamin-D3 reduces inflammatory response in human periodontal ligament cells. PLoS One. 2014;9:e90301.
  • Yousefimanesh H, Maryam R, Mahmoud J, Mehri GB, Mohsen T. Evaluation of salivary tumor necrosis factor-alpha in patients with the chronic periodontitis: a case-control study. J Indian Soc Periodontol. 2013;17(6):737-740.


Vancouver Yemenoğlu H. , Zihni Korkmaz M. , Arpa M. Association of Vitamin D, IL-6, TNF-α, CRP and Periodontal Health Status in the Eastern Black Sea Region. Middle Black Sea Journal of Health Science. 2023; 9(3): 498-510.
Middle Black Sea Journal of Health Science
  • Yayın Aralığı: Yılda Yılda 3 Sayı
  • Yayıncı: Ordu Üniversitesi


Sayıdaki Diğer Makaleler

Investigation of Postgraduate Theses on Using of Web-Based Education in Nursing Education

Hüsne YÜCESOY, Nülüfer ERBİL

Evaluation of infections associated with central venous catheters in ICU


Machine Learning Approach for Thyroid Cancer Diagnosis Using Clinical Data


Endometrioma cerrahisinde kistektomi over rezervini olumsuz etkiler: Kistektomi öncesi ve sonrası serum FSH, AMH ve AFC'nin karşılaştırılması


Analysis of 55 Adult Cases Surgically Treated for Pontocerebellar Angle Tumors

İbtahim BAŞAR, Sinan BAHADIR, Murat YÜCEL, Tevfik YILMAZ

Rapid Antigen Tests for COVID-19: Are Their Specificity, Sensivity and Accuracy Sufficient?

Hulya SİNAN, Emel UZUNOĞLU, Mediha UĞUR, Esin AVCİ, Cihangir AKDEMİR, Şahin DİREKEL

Determination of Factors Affecting Severity of Helicobacter pylori for Gastric Biopsy Samples by CART Decision Tree Algorithm

Türkan Mutlu YAR, Ülkü KARAMAN, Yeliz KAŞKO ARICI

What Impact does a Pandemic have on Emergency Department Visits? COVID-19 Pandemic and Coronaphobia

Muhammet Fatih BEŞER, Engin İLHAN, Perihan ŞİMŞEK, Metin YADIGAROGLU, Abdul Samet ŞAHİN, Emre KOÇ, Esra ÜÇÜNCÜ, Özlem BÜLBÜL, Demet SAĞLAM AYKUT, Özgür ARAZ, Murat TOPBAŞ, Abdulkadir GÜNDÜZ

Determining University Students' Anxiety and Problem Solving Skills in the COVID-19 Pandemic Process


Assessment of the Relationship between Vitamin D Deficiency and the Development of Hyperemesis Gravidarum