Research Article

Interaction between vitamin D insufficiency and periodontitis, GCF vitamin D and LL-37 levels in well-controlled diabetes patients with periodontitis

Volume: 60 Number: 1 September 9, 2026

Interaction between vitamin D insufficiency and periodontitis, GCF vitamin D and LL-37 levels in well-controlled diabetes patients with periodontitis

Abstract

Purpose

To determine whether low serum vitamin D levels are inversely correlated with clinical parameters and positively correlated with gingival crevicular fluid (GCF) 25(OH)D₃, 1,25(OH)₂D₃, LL-37 and tumor necrosis factor-α (TNF-α) levels in periodontitis patients with well-controlled type-2 diabetes (T2DM).

Materials and Methods

Twenty-six well-controlled T2DM patients with periodontitis and Vitamin D insufficiency (Vit.D-IS group), and 15 well-controlled T2DM patients with periodontitis and Vitamin D sufficiency (Vit.D-S group) were included. Papilla bleeding index, bleeding on probing (BOP), supragingival plaque, clinical attachment level (CAL) and probing depth (PD) were evaluated. GCF total amounts of 25(OH)D, 1,25(OH)₂D₃, LL-37 and TNF-α were analyzed by ELISA. Serum 25(OH)D₃ levels were determined using liquid chromatography tandem-mass spectrometry.

Results

Whole mouth CAL and BOP scores were higher in the Vit.D-IS group than those of Vit.D-S group (P=0.038, P=0.048, respectively). Whole mouth PD and plaque values were comparable in both groups. Differences were not detected in GCF 25(OH)D₃, 1,25(OH)₂D₃, LL- 37 and TNF-α levels between Vit.D-IS and Vit.D-S groups. Serum 25(OH)D₃ levels were adversely associated with CAL and BOP scores (P=0.018, P=0.049, respectively). Also, GCF 1,25(OH)₂D₃ total amounts were positively related with GCF LL-37 total amounts (P=0.0001).

Conclusion

Serum 25(OH)D₃ insufficiency was related to periodontal inflammation and destruction in periodontitis patients with well-controlled T2DM. However, GCF 25(OH)D₃, 1,25(OH)₂D₃, TNF-α and LL-37 total amounts were not correlated with serum vitamin D levels. We have opinion that obtaining and maintenance of periodontal health should be included in the diabetic treatment

Keywords

Supporting Institution

Ege University Research Foundation

Project Number

2013-Diş-028

Ethical Statement

The present study was approved by the Ethical Committee of Ege University School of Medicine (#13-5.1/12).

Thanks

We thank Ege University Research Foundation for supporting the study (Grant number:2013-Diş-028).

References

  1. Bikle Daniel D. Vitamin D and Bone. Current Osteoporosis Reports. 2012; 10(2): 151-159 [CrossRef ] google scholar
  2. Cheng J B, Motola D L, Mangelsdorf D J, Russell D W. De-orphanization of cytochrome P450 2R1: a microsomal vitamin D 25-hydroxilase. J Biol Chem. 2003; 278: 38084-38093 [CrossRef ] google scholar
  3. Holick Michael F. Vitamin D Deficiency. New England Journal of Medicine. 2007; 357(3): 266-281 [CrossRef ] google scholar
  4. Adams JS, Chen H, Chun R, Ren S, Wu S, Gacad M, Nguyen L, Ride J, Liu P, Modlin R, Hewison M. Substrate and enzyme trafficking as a means of regulating 1, 25- dihydroxyvitamin D synthesis and action: the human innate immune response. J Bone Miner Res. 2007; 22(Suppl 2): 20-24 [CrossRef ] google scholar
  5. Hidayat R, Setiati S, Soewondo P. The association between vitamin D deficiency and type 2 diabetes mellitus in elderly patients. Acta Med Indones. 2010; 42(3): 123-129 google scholar
  6. Graves D T, Cochran D. The contribution of interleukin-1 and tumor necrosis factor to periodontal tissue destruction. J Periodontol. 2003; 74(3): 391-401 [CrossRef ] google scholar
  7. Türkoğlu Oya, Emingil Gülnur, Kütükçüler Necil, Atilla Gül. Gingival crevicular fluid levels of cathelicidin LL-37 and interleukin-18 in patients with chronic periodontitis. J Periodontol. 2009; 80(6): 969-976 [CrossRef ] google scholar
  8. Giulietti Annapaula, van Etten Evelyne, Overbergh Lut, Stoffels Katinka, Bouillon Roger, Mathieu Chantal. Monocytes from type 2 diabetic patients have a pro-inflammatory profile. 1, 25-Dihydroxyvitamin D(3) works as anti-inflammatory. Diabetes Res Clin Pract. 2007; 77(1): 47-57 [CrossRef ] google scholar

Details

Primary Language

English

Subjects

Periodontics

Journal Section

Research Article

Publication Date

September 9, 2026

Submission Date

September 16, 2025

Acceptance Date

December 28, 2025

Published in Issue

Year 2026 Volume: 60 Number: 1

APA
Eren, G., Turkoglu, O., Çetinkalp, Ş., Atmaca, H., & Atilla, G. (2026). Interaction between vitamin D insufficiency and periodontitis, GCF vitamin D and LL-37 levels in well-controlled diabetes patients with periodontitis. European Oral Research, 60(1), 298-304. https://doi.org/10.26650/eor.20261785247
AMA
1.Eren G, Turkoglu O, Çetinkalp Ş, Atmaca H, Atilla G. Interaction between vitamin D insufficiency and periodontitis, GCF vitamin D and LL-37 levels in well-controlled diabetes patients with periodontitis. EOR. 2026;60(1):298-304. doi:10.26650/eor.20261785247
Chicago
Eren, Gülnihal, Oya Turkoglu, Şevki Çetinkalp, Harika Atmaca, and Gül Atilla. 2026. “Interaction Between Vitamin D Insufficiency and Periodontitis, GCF Vitamin D and LL-37 Levels in Well-Controlled Diabetes Patients With Periodontitis”. European Oral Research 60 (1): 298-304. https://doi.org/10.26650/eor.20261785247.
EndNote
Eren G, Turkoglu O, Çetinkalp Ş, Atmaca H, Atilla G (September 1, 2026) Interaction between vitamin D insufficiency and periodontitis, GCF vitamin D and LL-37 levels in well-controlled diabetes patients with periodontitis. European Oral Research 60 1 298–304.
IEEE
[1]G. Eren, O. Turkoglu, Ş. Çetinkalp, H. Atmaca, and G. Atilla, “Interaction between vitamin D insufficiency and periodontitis, GCF vitamin D and LL-37 levels in well-controlled diabetes patients with periodontitis”, EOR, vol. 60, no. 1, pp. 298–304, Sept. 2026, doi: 10.26650/eor.20261785247.
ISNAD
Eren, Gülnihal - Turkoglu, Oya - Çetinkalp, Şevki - Atmaca, Harika - Atilla, Gül. “Interaction Between Vitamin D Insufficiency and Periodontitis, GCF Vitamin D and LL-37 Levels in Well-Controlled Diabetes Patients With Periodontitis”. European Oral Research 60/1 (September 1, 2026): 298-304. https://doi.org/10.26650/eor.20261785247.
JAMA
1.Eren G, Turkoglu O, Çetinkalp Ş, Atmaca H, Atilla G. Interaction between vitamin D insufficiency and periodontitis, GCF vitamin D and LL-37 levels in well-controlled diabetes patients with periodontitis. EOR. 2026;60:298–304.
MLA
Eren, Gülnihal, et al. “Interaction Between Vitamin D Insufficiency and Periodontitis, GCF Vitamin D and LL-37 Levels in Well-Controlled Diabetes Patients With Periodontitis”. European Oral Research, vol. 60, no. 1, Sept. 2026, pp. 298-04, doi:10.26650/eor.20261785247.
Vancouver
1.Gülnihal Eren, Oya Turkoglu, Şevki Çetinkalp, Harika Atmaca, Gül Atilla. Interaction between vitamin D insufficiency and periodontitis, GCF vitamin D and LL-37 levels in well-controlled diabetes patients with periodontitis. EOR. 2026 Sep. 1;60(1):298-304. doi:10.26650/eor.20261785247