Vascular Endothelial Growth Factor and Microvessel Density in Periodontitis Patients With and Without Diabetes

Background: Periodontal disease is one of the major problems encountered in patients with diabetes mellitus (DM), and vascular changes may contribute to periodontitis. Our aim was to investigate vascular endothelial growth factor (VEGF) expression and microvessel density (MVD) in patients with periodontitis with and without DM. Methods: Immunohistochemical detection of VEGF and MVD analysis, evaluated by CD34+ endothelial cell counts, were performed in 66 gingival samples from patients with generalized, severe, chronic periodontitis who were divided into three groups: 22 participants without systemic diseases (controls), 22 participants with type 1 DM (T1DM), and 22 participants with type 2 DM (T2DM). Results: In patients with T1DM or T2DM, positive VEGF cells were found to be significantly increased in the epithelium compared to controls. In patients with T1DM, endothelial VEGF expression and MVD were significantly greater than in patients with T2DM and controls. Conclusions: In patients with diabetes, VEGF overexpression plays a primary role in promoting the extravasation of inflammatory cells, suggesting a useful antiangiogenic strategy for periodontitis treatment. The decreased endothelial VEGF expression and MVD found in patients with T2DM may be caused by insulin resistance and endothelial dysfunction, which are often present in patients with T2DM. J Periodontol 2009,80:1783-1789.