Abstract
Sialic acid (SA), a family of acetylated derivatives of neuraminic acid, an acute phase reactant by itself. It usually occurs as a terminal component at the non-reducing end of carbohydrate chains of glycoproteins and glycolipids. SA participates in multiple physiological functions, such as cell-to-cell interactions, cell migration and proliferation. Diabetes mellitus (DM) is a chronic metabolic disorder characterized by rise in blood glucose level. Periodontitis is a chronic inflammatory disease of the periodontal tissue, leading to destruction of bone surrounding the tooth and ultimately tooth loss. There is a two way relationship between diabetes mellitus and periodontitis. Periodontitis is the sixth complication of diabetes along with retinopathy, nephropathy, neuropathy, macrovascular disease, and altered wound healing. Inflammatory mediators like interleukin-6 and tumor necrosis factor-alpha produced during periodontal inflammation can interfere with the actions of insulin receptors and worsen the glycemic control of diabetic patients. Periodontitis is a major cause of tooth loss, affecting over 300 million people and bacteria associated with periodontitis are also linked with systemic problems like endocarditis, atherosclerosis. Recent work has highlighted a major role for the host sugar sialic acid in the biofilm physiology and host-pathogen interactions of T. forsithya, a key periodontal pathogen. There exists a need for a biomarker, for early detection of disease evolution and more robust therapy efficacy measurements. Serum sialic acids were estimated in Indian population by diphenylamine method and Thiobarbituric acid method. The average values were 68 ± 2.6 mg percent by DPA method and 56 ± 5 mg percent by TBA (thiobarbituric acid assay) method. Age and sex showed no influence on serum sialic acid level. Objectives of the present study was to compare (TSSA) level in healthy subjects, subjects with (CMP) with and without (NIDDM) and its effect on non-surgical periodontal therapy. In the present study, the participants were divided into three groups: Group A, B and C. Group A consists of systemically healthy subjects, Group B consists of subjects with (CMP) while Group C consists of subjects with (CMP) with (NIDDM) and results of this study indicated that, at baseline, there were significant differences between Group A, B and Group C with respect to all the clinical parameters, including (GI), (OHI-S), (PPD), (CAL), (TSSA) and (HbA1c) levels. Thus (TSSA) level could be considered as novel biomarker in the progression of periodontal disease and diabetic status. Periodontitis could be considered as a potential, modifiable, and independent risk factor for the development of diabetes. Early detection of elevated (TSSA) level may help in interpreting the progression of periodontitis, risk of development of diabetes mellitus in future and also to prevent complications.
Highlights
Periodontitis is a chronic inflammatory disease affecting the periodontium and resulting in progressive attachment and alveolar bone loss [1]
After obtaining the written informed consent and the ethical committee approval, the selected subjects were divided into three groups; Group A [Systemically healthy subjects without periodontitis, having Oral Hygiene Index – Simplified (OHI-S) score 0.8 to 1, Gingival Index (GI) score 0.1 to 1, with Probing pocket depth (PPD) not >3 mm and with no Clinical Attachment Loss (CAL)], Group B [Systemically healthy subjects with chronic moderate periodontitis (CMP) as defined by CAL 3–4 mm, having OHI-S score 1.3 to 3, GI score 1.1 to 2, with PPD ≥3 to ≤5 mm, CAL ≥3 to ≤4 mm in 5 or more teeth were selected]
Comparison of TSSA levels in systemically healthy subjects, subjects with CMP with and without Non-insulin dependent diabetes mellitus (NIDDM), and the effect of non-surgical periodontal therapy on TSSA levels in these groups and its influence on diabetic status were assessed in this study
Summary
Periodontitis is a chronic inflammatory disease affecting the periodontium and resulting in progressive attachment and alveolar bone loss [1]. Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. It is characterized by a cascade of events like activation of acute phase proteins, release of proinflammatory cytokines. In 2010, it was estimated that 285 million people had been diagnosed with diabetes mellitus worldwide, with a prevalence of 6.4%. This is predicted to reach up to 439 million, a prevalence of 7.7%, by 2030 [2]. Elevated level of serum SA has been seen in malignancy, diabetic mellitus, and coronary artery disease [7]
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