Unlocking the diagnostic value of GCF: Sclerostin as a biomarker in Periodontitis and Diabetes Mellitus – A Cross‐sectional observational study

Abstract

Background: Sclerostin, a critical regulator of bone metabolism, has emerged as a potential

biomarker in the pathogenesis of periodontal disease. Its elevated expression in individuals with

type 2 diabetes mellitus (T2DM) underscores the need to explore local versus systemic detection

methods for better diagnostic accuracy. Aim: This cross‐sectional study aimed to assess and compare

sclerostin levels in gingival crevicular fluid (GCF), saliva, and serum among chronic periodontitis

patients with and without T2DM, to determine the most sensitive medium for early diagnosis. Materials

and Methods: Thirty‐six individuals aged 30–60 years were enrolled and stratified into three

groups: healthy (Group 1), chronic periodontitis (Group 2), and chronic periodontitis with T2DM

(Group 3). Clinical periodontal parameters were recorded, followed by collection of GCF, saliva, and

serum samples. Sclerostin concentrations were quantified using ELISA, and statistical analyses were

performed using ANOVA and Pearson’s correlation. Results: Significantly higher sclerostin levels

were observed in GCF compared to saliva and serum across all groups. Group 3 exhibited the highest

mean GCF sclerostin levels (40.19 ± 5.87 ng/mL), followed by Group 2 (29.11 ± 4.36 ng/mL)

and Group 1 (25.75 ± 4.92 ng/mL), with p < 0.001. GCF demonstrated greater diagnostic specificity

in identifying disease progression, particularly in diabetic patients. Conclusion: GCF serves as a superior

medium for detecting sclerostin, reflecting site‐specific periodontal pathology and offering

valuable clinical utility for early intervention in periodontitis, especially among high‐risk diabetic individuals.