Association of adipocyte fatty acid‑binding protein and tumor necrosis factor alpha with periodontal health and disease: A cross‑sectional investigation

Abstract

Background: Adipocyte fatty acid binding protein (A‑FABP) is a novel biomarker of inflammation
for various chronic systemic diseases. Since periodontitis is a chronic inflammatory disease, this
study explores the association of A‑FABP with periodontal disease parameters and tumor necrosis
factor‑alpha (TNF‑α) levels in gingival crevicular fluid in periodontal health and disease.
Materials and Methods: This original research article describes a cross‑sectional study
conducted at the Department of Periodontics, M. R. Ambedkar Dental College and Hospital,
Bangalore, India. This cross‑sectional investigation was conducted on sixty subjects which were
divided into three groups of twenty subjects each – healthy, gingivitis, and chronic periodontitis.
Clinical parameters – plaque index, bleeding index, probing depth, and clinical attachment loss were
recorded. Gingival crevicular fluid samples were analyzed for A‑FABP and TNF‑α levels using ELISA.
One‑way analysis of variance was used to find the significance of study parameters on a continuous
scale between three groups. Pearson’s correlation has been used to find the relationship between
Gingival crevicular fluid concentration of markers and periodontal parameters. Multiple linear
regression analysis was applied to the study. The statistical significance was considered at P < 0.05.
Results: Mean concentration of A‑FABP (6.43 ± 2.51) and TNF‑α (3454.82 ± 1566.44) was highest
in the periodontitis group, and the difference among the groups was statistically significant (P < 0.05).
A positive correlation was observed between clinical attachment loss and the two markers
among all groups. The correlation between A‑FABP and TNF‑α in periodontitis groups was
positive and statistically significant (P < 0.05). Multiple linear regression model was statistically
significant (P < 0.05) indicating that there is a significant relationship between the set of predictors
and the clinical attachment loss.
Conclusion: A‑FABP and TNF‑α levels in GCF were significantly elevated in the presence of
inflammation. A‑FABP has a probable stimulatory effect on TNF‑α; however, its role needs to be
explored. A‑FABP could serve as a novel inflammatory biomarker of periodontitis and the scope of
using A‑FABP inhibition as a treatment modality could be investigated with interventional studies.
Key Words: Adipocytes, chronic periodontitis, fatty acid‑binding proteins, gingival crevicular
fluid, tumor necrosis factor‑alpha