J Periodontal Implant Sci.  2014 Apr;44(2):57-64. 10.5051/jpis.2014.44.2.57.

Impact of iron deficiency anemia on chronic periodontitis and superoxide dismutase activity: a cross-sectional study

Affiliations
  • 1Department of Periodontics and Oral Implantology, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India. drshikhatewari@yahoo.com
  • 2Department of Medicine, Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India.
  • 3Department of Biochemistry, Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India.

Abstract

PURPOSE
Both chronic periodontitis (CP) and iron deficiency anemia (IDA) induce oxidative stress in the body and cause an imbalance between reactive oxygen species and antioxidants, such as superoxide dismutase (SOD). This study explored the SOD enzyme activity of saliva and serum in CP patients with and without IDA and analyzed the impact of IDA on CP.
METHODS
A total of 82 patients were divided into four groups: control group (CG, 22), periodontally healthy IDA patients (IDA-PH, 20), CP patients (CP, 20), and IDA patients with CP (IDA-CP, 20). After clinical measurements and samplings, serum and salivary SOD levels were determined using an SOD assay kit.
RESULTS
IDA-CP patients exhibited a higher gingival index, bleeding on probing, probing pocket depth, and percentage (%) of sites with a clinical attachment loss (CAL) of > or =6 mm (P<0.008) than CP patients. The mean salivary and serum SOD levels were significantly lower in the IDA-PH, CP, and IDA-CP patients than in the CG group (P<0.008). A significant positive correlation between salivary and serum SOD activity was observed in IDA (P<0.05). Furthermore, serum and salivary SOD levels were significantly and negatively correlated with all periodontal parameters including the percentage of sites with CAL of 4-5 and > or =6 mm (P<0.05) except the significant correlation between salivary SOD activity and mean CAL and the percentage of sites with CAL of 4-5 mm (P>0.05) in these patients.
CONCLUSIONS
Within the limits of this study, it may be suggested that IDA patients with chronic periodontitis have more periodontal breakdowns than patients with chronic periodontitis. Serum and salivary SOD activity levels were lower in the IDA-PH, CP and IDA-CP groups than in the CG. Iron deficiency anemia influenced the serum SOD activity but did not seem to affect the salivary SOD activity in these patients.

Keyword

Chronic periodontitis; Iron deficiency anemia; Oxidative stress; Superoxide dismutase

MeSH Terms

Anemia, Iron-Deficiency*
Antioxidants
Chronic Periodontitis*
Cross-Sectional Studies*
Hemorrhage
Humans
Iron*
Oxidative Stress
Periodontal Index
Reactive Oxygen Species
Saliva
Superoxide Dismutase*
Superoxides*
Antioxidants
Iron
Reactive Oxygen Species
Superoxide Dismutase
Superoxides

Figure

  • Figure 1 Comparison of salivary superoxide dismutase (SOD), activity (%) between the control group (CG) and the test groups (periodontally healthy iron deficiency anemia patients [IDA-PH], chronic periodontitis patients [CP], iron deficiency anemia patients with chronic periodontitis [IDA-CP]). a)Statistically significant according to the Bonferroni correction (P<0.008), as compared to the control group.

  • Figure 2 Comparison of serum, superoxide dismutase (SOD) activity (%) between the control group (CG) and the test groups (periodontally healthy iron deficiency anemia patients [IDA-PH], chronic periodontitis patients [CP], iron deficiency anemia patients with chronic periodontitis [IDA-CP]). a)Statistically significant according to the Bonferroni correction (P<0.008), as compared to the control group.


Reference

1. Sculley DV, Langley-Evans SC. Salivary antioxidants and periodontal disease status. Proc Nutr Soc. 2002; 61:137–143.
Article
2. Canakci CF, Cicek Y, Canakci V. Reactive oxygen species and human inflammatory periodontal diseases. Biochemistry (Mosc). 2005; 70:619–628.
Article
3. Ozmeric N. Advances in periodontal disease markers. Clin Chim Acta. 2004; 343:1–16.
Article
4. Halliwell B, Gutteridge JM. The antioxidants of human extracellular fluids. Arch Biochem Biophys. 1990; 280:1–8.
Article
5. McCord JM. Human disease, free radicals, and the oxidant/antioxidant balance. Clin Biochem. 1993; 26:351–357.
Article
6. Fridovich I. Superoxide anion radical (O2-.), superoxide dismutases, and related matters. J Biol Chem. 1997; 272:18515–18517.
Article
7. Mapp PI, Grootveld MC, Blake DR. Hypoxia, oxidative stress and rheumatoid arthritis. Br Med Bull. 1995; 51:419–436.
Article
8. Macnee W, Rahman I. Oxidants and antioxidants as therapeutic targets in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1999; 160(5 Pt 2):S58–S65.
Article
9. Elbim C, Pillet S, Prevost MH, Preira A, Girard PM, Rogine N, et al. Redox and activation status of monocytes from human immunodeficiency virus-infected patients: relationship with viral load. J Virol. 1999; 73:4561–4566.
Article
10. Halliwell B. The role of oxygen radicals in human disease, with particular reference to the vascular system. Haemostasis. 1993; 23:Suppl 1. 118–126.
Article
11. Toxqui L, De Piero A, Courtois V, Bastida S, Sanchez-Muniz FJ, Vaquero MP. Iron deficiency and overload. Implications in oxidative stress and cardiovascular health. Nutr Hosp. 2010; 25:350–365.
12. Lainson PA, Brady PP, Fraleigh CM. Anemia, a systemic cause of periodontal disease? J Periodontol. 1968; 39:35–38.
Article
13. Chapple IL, Brock GR, Milward MR, Ling N, Matthews JB. Compromised GCF total antioxidant capacity in periodontitis: cause or effect? J Clin Periodontol. 2007; 34:103–110.
Article
14. Page RC, Eke PI. Case definitions for use in population-based surveillance of periodontitis. J Periodontol. 2007; 78:7 Suppl. 1387–1399.
Article
15. Adamson JW. Iron deficiency and other hypoproliferative anemias. In : Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J, editors. Harrison's principle of internal medicine. Vol 1. New York: McGraw Hill;2012. p. 844–861.
16. Loe H, Silness J. Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scand. 1963; 21:533–551.
Article
17. Silness J, Loe H. Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condtion. Acta Odontol Scand. 1964; 22:121–135.
Article
18. Tamaki N, Tomofuji T, Ekuni D, Yamanaka R, Yamamoto T, Morita M. Short-term effects of non-surgical periodontal treatment on plasma level of reactive oxygen metabolites in patients with chronic periodontitis. J Periodontol. 2009; 80:901–906.
Article
19. Enhos S, Duran I, Erdem S, Buyukbas S. Relationship between iron-deficiency anemia and periodontal status in female patients. J Periodontol. 2009; 80:1750–1755.
Article
20. Kim SC, Kim OS, Kim OJ, Kim YJ, Chung HJ. Antioxidant profile of whole saliva after scaling and root planing in periodontal disease. J Periodontal Implant Sci. 2010; 40:164–171.
Article
21. Baltacioglu E, Akalin FA, Alver A, Balaban F, Unsal M, Karabulut E. Total antioxidant capacity and superoxide dismutase activity levels in serum and gingival crevicular fluid in post-menopausal women with chronic periodontitis. J Clin Periodontol. 2006; 33:385–392.
Article
22. Canakci V, Yildirim A, Canakci CF, Eltas A, Cicek Y, Canakci H. Total antioxidant capacity and antioxidant enzymes in serum, saliva, and gingival crevicular fluid of preeclamptic women with and without periodontal disease. J Periodontol. 2007; 78:1602–1611.
Article
23. Akalin FA, Baltacioglu E, Alver A, Karabulut E. Total antioxidant capacity and superoxide dismutase activity levels in serum and gingival crevicular fluid in pregnant women with chronic periodontitis. J Periodontol. 2009; 80:457–467.
Article
24. Wei D, Zhang XL, Wang YZ, Yang CX, Chen G. Lipid peroxidation levels, total oxidant status and superoxide dismutase in serum, saliva and gingival crevicular fluid in chronic periodontitis patients before and after periodontal therapy. Aust Dent J. 2010; 55:70–78.
Article
25. Guarnieri C, Zucchelli G, Bernardi F, Scheda M, Valentini AF, Calandriello M. Enhanced superoxide production with no change of the antioxidant activity in gingival fluid of patients with chronic adult periodontitis. Free Radic Res Commun. 1991; 15:11–16.
Article
26. Matthews JB, Wright HJ, Roberts A, Cooper PR, Chapple IL. Hyperactivity and reactivity of peripheral blood neutrophils in chronic periodontitis. Clin Exp Immunol. 2007; 147:255–264.
Article
27. Amirkhizi F, Siassi F, Minaie S, Djalali M, Rahimi A, Chamari M. Assessment of lipid peroxidation and activities of erythrocyte cytoprotective enzymes in women with iron deficiency anemia. J Res Med Sci. 2008; 13:248–254.
28. Isler M, Delibas N, Guclu M, Gultekin F, Sutcu R, Bahceci M, et al. Superoxide dismutase and glutathione peroxidase in erythrocytes of patients with iron deficiency anemia: effects of different treatment modalities. Croat Med J. 2002; 43:16–19.
29. Kurtoglu E, Ugur A, Baltaci AK, Undar L. Effect of iron supplementation on oxidative stress and antioxidant status in iron-deficiency anemia. Biol Trace Elem Res. 2003; 96:117–123.
Article
30. Acharya J, Punchard NA, Taylor JA, Thompson RP, Pearson TC. Red cell lipid peroxidation and antioxidant enzymes in iron deficiency. Eur J Haematol. 1991; 47:287–291.
Article
31. Hafez FM, Hassab HM, Mourad ZE, Ascalany HE. Red blood cells superoxide dismutase activity in iron deficiency anemia. Alex J Ped. 1999; 13:439–442.
32. Rifkind JM, Abugo O. Alterations in erythrocyte deformability under hypoxia: implications for impaired oxygen transport. In : Hogan MC, Mathieu-Costello O, Poole DC, Wagner PD, editors. Oxygen transport to tissue. Vol 16. New York: Plenum Press;1994. p. 345–351.
33. Ramamurthy NS, Vernillo AT, Greenwald RA, Lee HM, Sorsa T, Golub LM, et al. Reactive oxygen species activate and tetracyclines inhibit rat osteoblast collagenase. J Bone Miner Res. 1993; 8:1247–1253.
Article
34. Shabani F, McNeil J, Tippett L. The oxidative inactivation of tissue inhibitor of metalloproteinase-1 (TIMP-1) by hypochlorous acid (HOCI) is suppressed by anti-rheumatic drugs. Free Radic Res. 1998; 28:115–123.
Article
35. Chapple IL, Matthews JB. The role of reactive oxygen and antioxidant species in periodontal tissue destruction. Periodontol 2000. 2007; 43:160–232.
Article
36. Arredondo M, Nunez MT. Iron and copper metabolism. Mol Aspects Med. 2005; 26:313–327.
Article
37. Peyssonnaux C, Cejudo-Martin P, Doedens A, Zinkernagel AS, Johnson RS, Nizet V. Cutting edge: Essential role of hypoxia inducible factor-1alpha in development of lipopolysaccharide-induced sepsis. J Immunol. 2007; 178:7516–7519.
Article
38. Ichimura H, Parthasarathi K, Issekutz AC, Bhattacharya J. Pressure-induced leukocyte margination in lung postcapillary venules. Am J Physiol Lung Cell Mol Physiol. 2005; 289:L407–L412.
Article
39. Dallman PR, Yip R, Oski A. Iron deficiency and related nutritional anemias. In : Nathan DG, Oski FA, editors. Hematology of infancy and childhood. 5th ed. Philadelphia: W.B. Saunders;1998. p. 430–476.
Full Text Links
  • JPIS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr