Evaluation of serum alkaline phosphatase and serum creatinine level in chronic periodontitis patients before and after non-surgical periodontal therapy

Aarti L. Jinjala; Nilam A Brahmbhatt; Kirti S. Dulani; Mit Pandya

doi:10.18203/2394-6040.ijcmph20253694

Authors

Aarti L. Jinjala Department of Periodontology, Government Dental College and Hospital, Ahmedabad, Gujarat, India
Nilam A Brahmbhatt Department of Periodontology, Government Dental College and Hospital, Ahmedabad, Gujarat, India
Kirti S. Dulani Department of Periodontology, Government Dental College and Hospital, Ahmedabad, Gujarat, India
Mit Pandya Department of Periodontology, Government Dental College and Hospital, Ahmedabad, Gujarat, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20253694

Keywords:

Chronic periodontitis, Biomarkers, Non-surgical periodontal therapy, Serum alkaline phosphatase, Serum creatinine

Abstract

Background: This study aimed to quantitatively evaluate and compare serum alkaline phosphatase (ALP) and serum creatinine (SCr) levels in chronic periodontitis patients before and after non-surgical periodontal therapy (NSPT), and compare these levels with periodontally healthy individuals.

Methods: Eighty participants, aged 30-50 years, were recruited: 40 with chronic generalized periodontitis (study group) and 40 periodontally healthy individuals (control group). Clinical parameters including simplified oral hygiene index (OHI-S), gingival index (GI), probing depth (PD), and clinical attachment level (CAL) were measured at baseline for both groups. Blood samples were collected from both groups at baseline for ALP and SCr estimation. The both groups received phase I therapy. On day 30 post-NSPT, clinical parameters and blood samples were re-evaluated for the study group. The results were statistically analysed using paired t test and one way ANOVA.

Results: At baseline, the chronic periodontitis group exhibited significantly higher serum ALP levels compared to the healthy control group. Following NSPT, a significant decrease in serum ALP levels (<0.001) was observed in the chronic periodontitis group, accompanied by significant improvements clinical parameters. SCr levels were found to be significantly higher in the periodontitis group at baseline compared to healthy controls. However, no statistically significant (≈0.53) change was observed in SCr levels in the periodontitis group following NSPT.

Conclusions: These results indicate that serum ALP may serve as a responsive biomarker of disease activity and therapeutic response in chronic periodontitis, while SCr though elevated at baseline does not respond to short term NSPT.

Metrics

Metrics Loading ...

References

Kinane DF, Stathopoulou PG, Papapanou PN. Periodontitis: nature’s prototype of a smoldering disease. Eur J Oral Sci. 2006;114:380-5.

Giannobile WV. Host-response therapeutics for periodontal diseases. J Periodontol. 2012;83:434-46.

Singh P, Suresh DK, Chandra R. Evaluation of serum alkaline phosphatase in chronic periodontitis patients. J Indian Soc Periodontol. 2014;18:575-8.

Vivekananda MR, Faizuddin M, Das SK. Periodontal status in patients with chronic kidney disease: a comparative study. J Contemp Dent Pract. 2010;11:24-31.

D’Aiuto F, Parkar M, Andreou G, Suvan J, Brett PM, Ready D, et al. Periodontal therapy: a novel non-drug-induced experimental model to study human inflammation. J Periodontal Res. 2004;39:294-9. DOI: https://doi.org/10.1111/j.1600-0765.2004.00741.x

Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39:175-91. DOI: https://doi.org/10.3758/BF03193146

Faul F, Erdfelder E, Lang AG, Buchner A. Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods. 2009;41:1149-60. DOI: https://doi.org/10.3758/BRM.41.4.1149

Lang NP, Bartold PM. Periodontal health. J Periodontol. 2018;89(Suppl 1):S9-16. DOI: https://doi.org/10.1002/JPER.16-0517

Biomarkers Definitions Working Group. Biomarkers and surrogate endpoints: Preferred definitions and conceptual framework. Clin Pharmacol Ther. 2001;69:89-95. DOI: https://doi.org/10.1067/mcp.2001.113989

Kumar PR, Faizuddin M. Role of alkaline phosphatase in periodontitis. J Indian Soc Periodontol. 2011;15:227-31. DOI: https://doi.org/10.4103/0972-124X.92566

Dabra S, Singh P. Evaluating the levels of salivary alkaline and acid phosphatase activities as biochemical markers for periodontal disease: a case series. Dent Res J. 2012;9:41-5. DOI: https://doi.org/10.4103/1735-3327.92942

Malhotra R, Grover V, Kapoor A, Kapur R. Alkaline phosphatase as a periodontal disease marker. Indian J Dent Res. 2010;21:531-6. DOI: https://doi.org/10.4103/0970-9290.74209

Gibert P, Tramini P, Sieso V, Piva MT. Alkaline phosphatase isozyme activity in serum from patients with chronic periodontitis. J Periodontal Res. 2003;38:362-5. DOI: https://doi.org/10.1034/j.1600-0765.2003.00388.x

Harita N, Hayashi T, Sato KK, Nakamura Y, Endo G, Kambe H, et al. Lower serum creatinine is a new risk factor of type 2 diabetes: the Kansai health care study. Diabetes Care. 2009; 32:424-6. DOI: https://doi.org/10.2337/dc08-1265

Hjelmesæth J, Røislien J, Nordstrand N, Hofsø D, Hager H, Hartmann A. Low serum creatinine is associated with type 2 diabetes in morbidly obese women and men: a cross-sectional study. BMC Endocr Disord. 2010;10:6. DOI: https://doi.org/10.1186/1472-6823-10-6

Hattatoglu-Sönmez E, Ozcakar L, Gokce-Kutsal Y, Karaagaoglu E, Demiralp B, Nazliel-Erverdi H. No alteration in bone mineral density in patients with periodontitis. J Periodontol. 2008;87:79-83. DOI: https://doi.org/10.1177/154405910808700114

Kshirsagar AV, Moss KL, Elter JR, Beck JD, Offenbacher S, Falk RJ. Periodontal disease is associated with renal insufficiency in the Atherosclerosis Risk in Communities (ARIC) study. Am J Kidney Dis. 2005;45:650-7. DOI: https://doi.org/10.1053/j.ajkd.2004.12.009

Caúla AL, Lira-Junior R, Tinoco EM, Fischer RG. Serum creatinine and alkaline phosphatase levels are associated with severe chronic periodontitis. J Periodont Res. 2015;50:793-7. DOI: https://doi.org/10.1111/jre.12266

Page RC, Eke PI. Case definitions for use in population-based surveillance of periodontitis. J Periodontol. 2007;78:S1387-99. DOI: https://doi.org/10.1902/jop.2007.060264

Shimazaki Y, Kushiyama M, Murakami M, Yamashita Y. Relationship between normal serum creatinine concentration and periodontal disease in Japanese middle-aged males. J Periodontol. 2013;84:94-9. DOI: https://doi.org/10.1902/jop.2012.110528

Vrinda SM, Sadasivan A, Koshi E, Unnikrishnan B, Chandradas ND, Saraswathi IR. Effect of nonsurgical periodontal therapy on C-reactive protein and iron indices in hemodialysis patients. J Indian Soc Periodontol. 2021;25:485-90. DOI: https://doi.org/10.4103/jisp.jisp_32_20

Beddhu S, Ma X, Baird B, Cheung AK, Greene T. Serum alkaline phosphatase and mortality in African Americans with chronic kidney disease. Clin J Am Soc Nephrol. 2009;4:1805-10. DOI: https://doi.org/10.2215/CJN.01560309

Regidor DL, Kovesdy CP, Mehrotra R, Rambod M, Jing J, McAllister CJ, et al. Serum alkaline phosphatase predicts mortality among maintenance hemodialysis patients. J Am Soc Nephrol. 2008;19:2193-203. DOI: https://doi.org/10.1681/ASN.2008010014

Wannamethee SG, Sattar N, Papacosta O, Lennon L, Whincup PH. Alkaline phosphatase, serum phosphate, and incident cardiovascular disease and total mortality in older men. Arterioscler Thromb Vasc Biol. 2013;33:1070-6. DOI: https://doi.org/10.1161/ATVBAHA.112.300826