ADVANCED GLYCATION END PRODUCTS AND THIOBARBITURIC ACID REACTIVE SUBSTANCE IN GINGIVAL TISSUES OF DIABETIC AND NON-DIABETIC PATIENTS WITH CHRONIC PERIODONTITIS

Background: Production of advanced glycation end products (AGEs) is directly linked to the level and duration of hyperglycemia in diabetic patients. Oxidative stress plays a major role in the pathogenesis of diabetes mellitus. Free radicals are formed in diabetes by glucose oxidation, nonenzymatic glycation of proteins and subsequent oxidative degradation of glycated proteins. Thiobarbituric acid reactive substance (TBARs) is a factor evidence in the presence of oxidative stress as a potential mechanism underlying periodontal disease associated with diabetes.
Methods: 11 subjects (mean age 38.9 years, 6M, 5F) with chronic periodontitis associated with diabetes (5 Type I, 6 Type II) and 16 subjects (mean age 36.7 years, 7M, 6F) with chronic periodontitis as a matched control group participated in this study. Clinical attachment loss and bleeding on probing were determined in all subjects during clinical examination. FBS and HbA1c were measured in all subjects. Sections of gingival tissue of all patients were removed during periodontal surgery.AGEs and TBARS were measured in all removed gingival tissues. The statistical analysis was carried out using T-test, Mann-Whitney U-test and Spearman correlation coefficient.
Results: FBS in diabetic and non-diabetic patients was 155.0 ± 82.0 and 87.4±10.6 mg/dL respectively and the difference between the two groups was statistically significant (p= 0.03 ). There was also a significant difference in HbA1c between the two studied groups (5±0.04 and 9.1±1.03%) in diabetic and non-diabetic subjects respectively, (p= 0.000). A higher level of TBARs was observed in diabetic patients compared to non-diabetics (1.13±0.3 vs 0.05±0.01 mole/lit ; p= 0.001). Clinical attachment loss also was higher in diabetic patients (p= 0.008).
Conclusion: From the results of this study it can be concluded that oxidative stress plays a major role in the development of periodontitis in diabetic patients.

Keywords
Diabetes, Periodontitis, Advanced glycation end products (AGE), Thiobarbituric acid reactive substance (TBARS).