Estimation of macrophage migration inhibitory factor in gingival crevicular fluid of obese and non-obese patients with periodontitis using ELISA: a case control study.

OBJECTIVES

Periodontitis is a chronic inflammatory disease exacerbated by systemic factors such as obesity. Macrophage migration inhibitory factor (MIF) is a potent proinflammatory cytokine involved in tissue destruction. This study aimed to compare gingival crevicular fluid (GCF) MIF levels in obese and non-obese patients with periodontitis and evaluate how obesity influences the inflammatory response following nonsurgical therapy.

METHOD AND MATERIALS: Seventy-six participants (39 men, 37 women; mean age 50 years) were enrolled using a computer-generated stratified allocation sequence to ensure balanced cohorts. Participants were divided into two groups: Group A (non-obese, body mass index [BMI] 25 kg/m2) and Group B (obese, BMI ≥ 25 kg/m2). Clinical parameters, including Plaque Index (PI), modified Gingival Index (mGI), probing pocket depth (PPD), and clinical attachment level (CAL), were recorded at baseline, 1 month, and 3 months. GCF MIF levels were quantified using ELISA at baseline and 3 months. Data were analyzed using two-way mixed ANOVA to determine the impact of obesity on the pattern of healing over time.

RESULTS

Baseline demographics (age and sex) were comparable between groups (P > .05). Nonsurgical therapy significantly reduced MIF levels and improved all clinical parameters in both groups (P .001). However, the degree of improvement was significantly lower in the obese group for GCF MIF, PPD, and CAL (P .001). At 3 months, MIF levels remained significantly higher in obese subjects (14.59 ± 2.26) compared to non-obese subjects (11.64 ± 1.72). While both groups maintained similar oral hygiene (PI) throughout the study (P = .593), the non-obese group achieved a significantly more pronounced resolution of clinical inflammation and attachment gain.

CONCLUSION

Obesity acts as a biologic modifier that limits the resolution of inflammation and clinical healing in periodontitis. The sustained elevation of GCF MIF in obese patients, despite effective plaque control, suggests a state of 'metabolic inflammatory priming.' These findings highlight the need for risk-stratified, personalized periodontal management for patients with obesity.