Salivary and serum oxidative stress biomarkers and advanced glycation end products in periodontitis patients with or without diabetes: A cross-sectional study

Altingoz S. M. , KURGAN Ş., ÖNDER C., SERDAR M. A. , ÜNLÜTÜRK U., Uyanik M., ...More

Journal of Periodontology, vol.92, no.9, pp.1274-1285, 2021 (Journal Indexed in SCI Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 92 Issue: 9
  • Publication Date: 2021
  • Doi Number: 10.1002/jper.20-0406
  • Title of Journal : Journal of Periodontology
  • Page Numbers: pp.1274-1285
  • Keywords: 4&#8208, hydroxy&#8208, 2&#8208, nonenal, 8&#8208, hydroxy&#8208, 2&#8208, deoxyguanosine, diabetes mellitus, oxidative stress, periodontitis, type 2, GINGIVAL CREVICULAR FLUID, C-REACTIVE PROTEIN, LIPID-PEROXIDATION LEVELS, TOTAL OXIDANT STATUS, ASSOCIATION, DISEASE, MARKERS, THERAPY, RISK, 8-HYDROXY-2'-DEOXYGUANOSINE

Abstract

© 2020 American Academy of PeriodontologyBackground: Non-invasive methods for periodontitis diagnosis would be a clinically important tool. This cross-sectional study aimed to investigate the association between oxidative stress, glycation, and inflammation markers and periodontal clinical parameters in periodontitis and periodontally healthy patients with type 2 diabetes and corresponding systemically healthy controls. Methods: Sixty-seven periodontally healthy (DM-H, n = 32) and periodontitis (DM-P, n = 35) patients with type 2 diabetes, and 54 systemically healthy periodontitis (H-P, n = 26) and periodontally healthy (H-H, n = 28) controls were included. Clinical periodontal parameters, body mass index, fasting glucose, hemoglobin A1c (HbA1c), along with saliva and serum 8-hydroxy-2′-deoxyguanosine (8-OHdG), malondialdehyde (MDA), 4-hydroxy-2-nonenal (4-HNE), advanced glycation end products (AGE), AGE receptor (RAGE) and high sensitivity C-reactive protein (hsCRP) levels were recorded and analyzed. Results: Salivary 8-OHdG levels were significantly higher in periodontitis compared to periodontally healthy patients, regardless of systemic status (P < 0.001). Salivary MDA levels were significantly higher in all disease groups compared to H-H group (P ≤ 0.004). Serum AGE levels were significantly higher in diabetic groups than systemically healthy groups (P < 0.001) and in H-P compared to H-H (P < 0.001). Bleeding on probing (BOP) and clinical attachment level (CAL) strongly correlated with salivary 8-OHdG and serum hsCRP (P < 0.001). In systemically healthy patients, salivary 8-OHdG was the most accurate marker to differentiate periodontitis from controls (AUC = 0.84). In diabetics salivary 4-HNE and RAGE were the most accurate (AUC = 0.85 for both). Conclusion: Salivary 8-OHdG alone or in combination with 4-HNE, AGE and RAGE for diabetics, and salivary 8-OHdG alone or in combination with MDA and hsCRP for systemically healthy persons, could potentially serve as non-invasive screening marker(s) of periodontitis.