The Evaluation of the Salivary Malondyaldehyde, Superoxide Dismutase, Glutathione and Glutathione Peroxidase Levels in Patients with Periodontal Disease and Hyperlipidemia

Öz

The purpose of this study was to evaluate the levels of salivary malondyaldehyde (MDA), superoxide dismutase (SOD), glutathione (GSH) and glutathione peroxidase (GP-x) levels in patients with periodontal disease and hyperlipidemia. Method: One hundred and twenty three subjects with hyperlipidemia aged 30 to 57 and 68 systemically healthy controls (C) aged 31 to 54 were included in the study. Hyperlipidemic groups were divided into two groups as suggested diet (HD) and prescribed statin (HS). All of the groups were divided into three subgroups as healthy (h), gingivitis (g) and periodontitis (p). The clinical periodontal parameters, including plaque index (PI), gingival index (GI), probing pocket (PPD) depth, percentage of bleeding on probing (BOP-%), and clinical attachment level (CAL) were recorded. Serum lipids and salivary MDA, SOD, GSH and GP-x levels were evaluated. Results: MDA is significantly and positively correlated with GI, BOP-% and the ratio of total cholesterol/high density lipoprotein in both hyperlipidemic groups. In the HSh group, salivary SOD level was higher than in the HSp group. Discussion: The salivary MDA and SOD levels are parameters which may play role in the association between periodontal disease and hyperlipidemia. Further longitudinal studies in larger populations with different periodontitis and hyperlipidemia phases are needed to clarify this association. 

Anahtar Kelimeler

• Gingivitis
• periodontitis
• hyperlipidemia
• malondyaldehyde
• antioxidants

Periodontal hastalıklı ve hiperlipidemili bireylerde salya malondialdehit, süperoksit dismutaz, glutatyon ve glutatyon peroksidaz seviyelerinin değerlendirilmesi

Öz

Bu çalışmanın amacı periodontal hastalıklı ve hiperlipidemili bireylerde salya malondialdehit (MDA), süperoksit dismutaz (SOD), glutatyon (GSH) ve glutatyon peroksidaz (GPx) seviyelerinin değerlendirilmesidir. Yöntem: Çalışmaya yaşları 30 ila 57 arasında değişen 123 hiperlipidemili ve yaşları 31 ila 54 arasında değişen 68 sistemik olarak sağlıklı (K) birey alındı. Hiperlipidemik grup diyet önerilen (HD) ve statin önerilen (HS) gruplar olmak üzere iki alt-gruba ayrıldı. Bütün çalışma grupları periodontal sağlıklı (s), gingivitisli (g) ve periodontitili (p) olmak üzere üç gruba ayrıldı. Tüm bireylerin plak indeksi (Pİ), gingival indeks (Gİ), cep derinliği (CD), klinik ataçman seviyesi (KAS) ve sondlamada kanama varlığı yüzdesini (SK-%) içeren ölçümlerden oluşan klinik periodontal parametreleri kaydedildi. Serum lipidleri ve salya MDA, SOD, GSH ve GP-x seviyeleri değerlendirildi. Sonuçlar: Salya MDA ile Gİ, SK-% ve total kolesterol/yüksek densiteli lipoprotein oranı arasındaki pozitif korelasyonlar hiperlipidemili gruplarda anlamlı idi. HSs grubunda salya SOD seviyesi, HSp grubuna göre istatistiksel olarak anlamlı artış gösterdi. Hiperlipidemi ve periodontitis mevcudiyetinde salya MDA seviyesinde artış gözlenirken, statin önerilen hiperlipidemili grupta, periodontal sağlık mevcudiyetinde salya SOD seviyesinde artış saptanmıştır. Tartışma: Salya MDA ve SOD seviyeleri, oksidatif stres ile ilişkili olarak periodontal hastalık ve hiperlipidemi ilişkisinde rol oynayabilen parametreler olabilir. Bu konuda, periodontitis ve hiperlipideminin farklı safhalarına sahip daha geniş popülasyonlarda, uzun dönem ileri çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• Gingivitis
• periodontitis
• hiperlipidemi
• malondialdehit
• antioksidanlar

Kaynakça

1. Akkuş İ. Serbest radikaller ve fizyopatolojik etkileri, Konya: Mimoza Yayınları; 1995:1-57.
2. Gutteridge JM. Lipid peroxidation and antioxidants as biomarkers of tissue damage, Clin Chem 1995; 41(12Pt2)): 1828. Matés Antioxidant implications processes. Front Biosci 1999; 4: D339-345. Day peroxidase mimics, Biochem Pharmacol ; 77(3): 285-296. F. enzymes and their in pathophysiologic
3. BJ. Catalase and glutathione Kinane DF. Causation and pathogenesis of periodontal disease. Periodontol 2000 ; 25: 8–20.
4. Marton IJ, Balla G, Hegedus C, et al. The role of reactive oxygen intermediates in the pathogenesis of chronic apical periodontitis. Oral Microbiol Immunol 1993; 8(4): 254-257.
5. Sobaniec H, Sobaniec-Lotawska ME. Morphological examinations of hard tissues of paradontium and evaluation of selected processes of lipid peroxidation in blood serum of rats in the course of experimental periodontitis. Med Sci Monit 2000; 6(5): 875
6. Sheikhi M, Bouhafs RKL, Hammarström KJ, et al. Lipid peroxidation caused by oxygen stimulated neutrophils as a possible model for the emergence of periodontitis. Oral Dis ; 7(1): 41-46. Chapple IL, Matthews JB. The role of reactive oxygen and antioxidant species in periodontal tissue destruction. Periodontol 2007; 43: 160-232.
7. Ellis SD, Tucci MA, Serio FG, et al. Factors for progression of periodontal diseases. J Oral Pathol Med 1998; 27(3): 101–
8. Akalin FA, Isiksal E, Baltacioğlu E, et al. Superoxide dismutase activity in gingiva in type-2 diabetes mellitus patients with chronic periodontitis. Arch Oral Biol 2008; 53(1): 44–

9. Cutler CW, Shinedling EA, Nunn M, et al. Association hyperlipidemia: cause or effect? J Periodontol ; 70(12): 1429–1434.
10. Morita M, Horiuchi M, Kinoshita Y, et al. Relationship between blood triglyceride levels and periodontal status. Community Dent Health 2004; 21(1): 32-36.
11. Katz J, Chaushu G, Sharabi V. On the association between hypercholesterolemia, cardiovascular disease and severe periodontal disease. J Clin Periodontol 2001; 28(9): 865– al. Association between periodontal pockets and elevated cholesterol and low density lipoprotein cholesterol levels. J Periodontol ; 73(5): 494–500. Fusobacterium- between periodontitis and Katz J, Flugelman MY, Golberg A, et
12. Plazma lipid and blood glucose levels in patients with destructive periodontal disease. J Clin Periodontol 2000; 27(8): 537-541.
13. Metabolic diseases and their possible link to risk indicators of periodontitis. J Periodontol ; 71(6): 898-903. Moeintaghavi A, Haerian-Ardakani A, Talebi-Ardakani M, et al. Hyperlipidemia in patients with periodontitis. J Contemp Dent Pract 2005; 6(3): 78-85. directional relationship between periodontal disease and hyperlipidemia. Eur J Dent 2008; (2):142-146.
14. Fentoğlu O, Oz G, Tasdelen P, et al. Periodontal hyperlipidemia. J Periodontol 2009; 80(2): 273.
15. Fentoğlu O, Sözen T, Oz S, et al. Short- term effects of periodontal therapy as an adjunct to anti-lipemic treatment. Oral Dis ; 16(7): 648-654. periodontal hyperlipidemia. J Contemp Dent Pract 2010; (2): 33-40. pregnancy. I. Prevalenceand Severity. Acta Odontol Scand 1963; 21: 533–551.
16. Silness J, Löe H Periodontal disease in pregnancy. II Correlation between oral hygiene and periodontal condition. Acta Odontol Scand 1964; 22: 121-135. classification system for periodontal diseases and conditions. Ann Periodontol 1999; 4(1): 6.
17. Malondialdehyde determination as index of lipid peroxidation. Methods Enzymol 1990; : 421–431. manual of biochemical methods 12, London: Academic Pres; 1971: 68-70. Pathophysiological periodontitis and systemic disease: Recent concepts involving serum lipids. J Periodontol ; 71(8): 1375-1384. subjects with
18. Awartani F, Atassi F. Evaluation of status in subjects with Löe H, Silness J Periodontal disease in Armitage GC. Development of a Drapper HH, Hadley M. Beutler E, Red cell metabolism. A Iacopino AM, relationships between lipids,lipoproteins, and apolipoproteins with coronary artery disease assessed by coronary arteriography. Ann N Y Acad Sci 1985; 454: 238.
19. Z. Functional-morphologic aspects of changes of mucosal gingiva microcirculatory bed vessels in experimental gingivitis against the background Georgian Med News 2005; 121: 71–74. al. KOAH akut alevlenmesinde oksidatif stres ve üzerine etkisi. Solunum Hastalıkları 2003; 14: 10. al. Oxidative stress and antioxidants in patints with cardiogenic shock complicating acute myocardial infarction. Clin Chim Acta 2004; (1-2): 131-137.
20. Tip 2 diyabetik hastalarda tedavi öncesi ve tedavi sonrası oksidan ve antioksidan durum. Fırat Tıp Dergisi 2005; 10: 117-22.
21. Increased serum malondialdehyde levels in chronic stage of ischemic stroke. Tohoku J Exp Med 2006; 208(1): 33-39.
22. Ramachandran CR. Lipid peroxidation and antioxidant hypercholesterolemia. Orhan Z, Köksal N, Gökırmak M, et tedavinin oksidan-antioksidan denge Senthil S, Veerappen RM, Rao MR, et Halifeoğlu İ, Karataş İ, Çolak R, et al. Bir LS, Demir S, Rota S, et al. Panjamurthy K, Manoharan S, status in patients with crevicular fluid before and after patients Nilsson J, Regnström J, Frostegard J, Stiko A. Lipid oxidation and atherosclerosis. Herz 1992; 17(5):263-269.