Cervicular fluid asparatate aminotransferase AST levels innon-insulin dependent diabetes mellitus

ABSTRACT

This study was carried out on 30 subjects their age ranged from 35-45 years. They were divided into three groups Group I consisted of 10 non insulin dependent diabetes mellitus patients [NIDDM] with periodontitis, selected from the Outpatient Clinic of Diabetes, the duration of the disease not less than 5 years. Group II consisted of 10 having adult periodontitis according to Page et al., [1983] 118 selected from the Oral Medicine and Periodontology Dept., faculty of Dentistry, Alexandria University. Group III consisted of 10 matched age and sex healthy subjects, with clinically normal gingiva, GI < 1 [Loe and Silness, 1963][19], served as controls. All three groups were screened clinically and biophysically exclude other systemic diseases Clinical dental examination was performed to all subjects enrolled in the study including Gingival index [GI] [Loe and Sliness, 1963][9]. Plaque index [PI] [Silness and Loe 1964][20]. Probing pocket depth using William's probe. Probing attachment level [Ramfjord 1974][21] Determination of Aspartate Aminotransferase [AST] Level in the Gingi- Val Crevicular Fluid The site to be sampled was dried supragingival calculs was removed. After isolation a filter paper strip was inserted into the crevice and left for one minute. The filter strip was then placed in a vial containing 100 ul-Tris-Hcl pH 8.0 and AST assessment was performed according to the standardized method of Bergmeyer, et al., [1978][22]. The results of the present study revealed a relationship between diabetes and the severe periodontal disease. The mechanisms by which increased susceptibility to periodontitis in diabetes is not entirely clear. However, this is in partly due to the susceptibility of NIDDM patients to periodontal disease breakdown, due to increased salivary glucose that may arise besides abnormal PMN function including depressed chemotaxis phagocytosis and PMN-bacterial interaction. The biochemical analysis in this study showed significant statistical increased GCF AST level in both NIDDM patients and adult periodontitis as compared to controls Additionally, a significant increase was detected on comparing group I and group II. This shows that AST enzyme activity is associated with the extent of gingival inflammation and tissue destruction. The high levels of AST in GCF of diabetic patients in the present study possibly arise from local tissue destruction, this supports the concept that elevated GCF levels indicate concurrent or impending disease activity. Commonly used clinical parameters as plaque and gingival indices are correlated to each to other but are poor diagnostic indicators of periodontal deterioration. Furthermore plaque and gingival indices pocket depth and attachment measurements do not reveal concurrent or further disease activity Clinical enzymology is used nowadays to aid in the diagnosis of inflammatory destruction, so it could be concluded that AST activity may be more useful for the assessment of inflammatory periodontal disease Therefore, paired with clinical data crevicular fluid AST activity could provide valuable data about the periodontyal condition and likelihood disease activity. A significant relationship between AST level and the clinical parameters recorded has been demonstrated It could be concluded that AST enzyme level is one of the promising markers of tissue destruction. Biochemical enzyme analysis without clinical examination cannot be useful for the assessment of inflammatory disease Finally, GCF AST level can be used as a diagnostic adjunct for periodontal condition, to verify clinical methods to evaluate the combination of information gathered for initiation of periodontal therapy