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On the one hand, periodontitis can influence the development and state of chronic systemic inflammation, through the aberrant increase in proinflammatory cytokines, such as IL-1, IL-6 and TNF-, affecting endothelial function, and substantially contributing to the development of insulin resistance, causing a homeostatic imbalance in blood glucose regulation ( Figure 1 TNF- plays a crucial role in regulating the expression of endocan, a soluble proteoglycan that is highly produced by vascular endothelium during endothelial activation and inflammatory processes (Sarrazin et al., 2006)
Some of these factors include the cellular composition and vascular nature of the tissue(s) in question
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![Structures of (a) GLP-1, (b) GIP and (c) tirzepatide [19, 88, 90]](https://www.researchgate.net/publication/370926483/figure/fig4/AS:11431281185432337@1693619320519/Structures-of-a-GLP-1-b-GIP-and-c-tirzepatide-19-88-90-Amino-acids-are.png)
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