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Effect of nonsurgical periodontal therapy and smoking status on hematological variables related to anemia of chronic disease in chronic periodontitis patient: a case-control study

  • Show, Sangita (Department of Periodontology, Trinity Dental & Maxillofacial Multispeciality Clinic) ;
  • Bagchi, Somen (Department of Periodontics, Dr. R. Ahmed Dental College and Hospital) ;
  • Dey, Arka Kanti (Department of Oral and Maxillofacial Surgery, Diamond Harbour Government Medical College and Hospital) ;
  • Boyapati, Ramanarayana (Department of Periodontology, Sibar Institute of Dental Sciences) ;
  • Pal, Pritish Chandra (Department of Periodontology, Pacific Dental College and Hospital) ;
  • Tejaswi, Kanikanti Siva (Department of Periodontology, Sibar Institute of Dental Sciences)
  • Received : 2022.01.12
  • Accepted : 2022.03.07
  • Published : 2022.07.31

Abstract

Background: Chronic infectious, inflammatory, or neoplastic disorders are associated with anemia of chronic disease. Chronic inflammatory diseases such as periodontitis may contribute to masked anemia, especially in smokers. This study was aimed at verifying and comparing the efficacy of nonsurgical periodontal therapy (NSPT) for improving anemia among chronic periodontitis patients with and without the habit of smoking. Methods: Thirty systemically healthy individuals with chronic periodontitis were divided into two groups of 15 each, smokers (group A) and nonsmokers (group B). The groups were compared based on hematological parameters such as serum erythropoietin (SE) and serum ferritin (SF) levels at baseline and 3 months after NSPT for anemia evaluation. Results: The baseline SE levels in groups A and B were 11.84 and 15.19 mIU/mL (p=0.031), respectively; the corresponding levels at 3 months after NSPT were 13.00 and 17.74 mIU/mL (p=0.022). The baseline SF levels in groups A and B were 95.49 and 44.86 ng/mL (p=0.018), respectively; the corresponding levels at 3 months after NSPT were 77.06 and 39.05 ng/mL (p=0.009). Group B showed a significant increase and decrease in the SE and SF levels, respectively, at 3 months after NSPT (p=0.035 and p=0.039, respectively), whereas group A showed insignificant changes (p=0.253 and p=0.618, respectively). Conclusion: NSPT led to an improvement in anemia among chronic periodontitis patients. However, the improvement is less in smokers compared to that in nonsmokers. Furthermore, SF and SE levels might serve as effective biomarkers for assessing anemia in smokers and nonsmokers with chronic periodontitis.

Keywords

References

  1. Means RT Jr, Krantz SB. Progress in understanding the pathogenesis of the anemia of chronic disease. Blood 1992;80:1639-47. https://doi.org/10.1182/blood.v80.7.1639.1639
  2. Weiss G. Pathogenesis and treatment of anaemia of chronic disease. Blood Rev 2002;16:87-96. https://doi.org/10.1054/blre.2002.0193
  3. Naik V, Acharya A, Deshmukh VL, Shetty S, Shirhatti R. Generalized, severe, chronic periodontitis is associated with anemia of chronic disease: a pilot study in urban, Indian males. J Investig Clin Dent 2010;1:139-43. https://doi.org/10.1111/j.2041-1626.2010.00028.x
  4. Mullally BH. The influence of tobacco smoking on the onset of periodontitis in young persons. Tob Induc Dis 2004;2:53-65. https://doi.org/10.1186/1617-9625-2-2-53
  5. Aitchison R, Russell N. Smoking: a major cause of polycythaemia. J R Soc Med 1988;81:89-91. https://doi.org/10.1177/014107688808100212
  6. Shirmohamadi A, Chitsazi MT, Faramarzi M, Salari A, Naser Alavi F, Pashazadeh N. Effect of non-surgical periodontal treatment on transferrin serum levels in patients with chronic periodontitis. J Dent Res Dent Clin Dent Prospects 2016;10:169-75. https://doi.org/10.15171/joddd.2016.027
  7. Chow JK, Werner BG, Ruthazer R, Snydman DR. Increased serum iron levels and infectious complications after liver transplantation. Clin Infect Dis 2010;51:e16-23.
  8. Nordenberg D, Yip R, Binkin NJ. The effect of cigarette smoking on hemoglobin levels and anemia screening. JAMA 1990;264:1556-9. https://doi.org/10.1001/jama.1990.03450120068031
  9. Jelkmann W. Proinflammatory cytokines lowering erythropoietin production. J Interferon Cytokine Res 1998;18:555-9. https://doi.org/10.1089/jir.1998.18.555
  10. Singh V, Tanwar AS, Hungund AS, Hungund SA, Nagaraja C. Comparison of serum erythropoietin levels in smokers and nonsmokers with periodontitis: a biochemical study. J Indian Soc Periodontol 2016;20:249-53.
  11. Hutter JW, van der Velden U, Varoufaki A, Huffels RA, Hoek FJ, Loos BG. Lower numbers of erythrocytes and lower levels of hemoglobin in periodontitis patients compared to control subjects. J Clin Periodontol 2001;28:930-6. https://doi.org/10.1034/j.1600-051x.2001.028010930.x
  12. Morley JJ, Kushner I. Serum C-reactive protein levels in disease. Ann N Y Acad Sci 1982;389:406-18. https://doi.org/10.1111/j.1749-6632.1982.tb22153.x
  13. Chakraborty S, Tewari S, Sharma RK, Narula SC. Effect of non-surgical periodontal therapy on serum ferritin levels: an interventional study. J Periodontol 2014;85:688-96. https://doi.org/10.1902/jop.2013.130107
  14. Caton JG, Armitage G, Berglundh T, Chapple I, Jepsen S, Kornman KS, et al. A new classification scheme for periodontal and peri-implant diseases and conditions: introduction and key changes from the 1999 classification. J Clin Periodontol 2018;45 Suppl 20:S1-8. https://doi.org/10.1111/jcpe.12935
  15. National Center for Health Statistics (NCHS); Centers for Disease Control and Prevention. National Health Interview Survey. Glossary terms [Internet]. Hyattsville, MD: NCHS; 2017 [cited 2017 Aug 29]. https://www.cdc.gov/nchs/nhis/data-questionnaires-documentation.htm.
  16. Tanabe N, Ohnishi K, Fukui H, Ohno R. Effect of smoking on the serum concentration of erythropoietin and granulocyte-colony stimulating factor. Intern Med 1997;36:680-4. https://doi.org/10.2169/internalmedicine.36.680
  17. Eisenga MF, Kieneker LM, Touw DJ, Nolte IM, van der Meer P, Huls G, et al. Active smoking and hematocrit and fasting circulating erythropoietin concentrations in the general population. Mayo Clin Proc 2018;93:337-43. https://doi.org/10.1016/j.mayocp.2018.01.005
  18. Miller ME, Garcia JF, Cohen RA, Cronkite EP, Moccia G, Acevedo J. Diurnal levels of immunoreactive erythropoietin in normal subjects and subjects with chronic lung disease. Br J Haematol 1981;49:189-200. https://doi.org/10.1111/j.1365-2141.1981.tb07215.x
  19. Weinberg I, Borohovitz A, Krichevsky S, Perlman R, Ben-Yehuda A, Ben-Yehuda D. Janus Kinase V617F mutation in cigarette smokers. Am J Hematol 2012;87:5-8. https://doi.org/10.1002/ajh.22180
  20. Fredriksson MI, Figueredo CM, Gustafsson A, Bergstrom KG, Asman BE. Effect of periodontitis and smoking on blood leukocytes and acute-phase proteins. J Periodontol 1999;70:1355-60. https://doi.org/10.1902/jop.1999.70.11.1355
  21. Miller ME, Chandra M, Garcia JF. Clinical applications of measurement of serum immunoreactive levels of erythropoietin. Ann N Y Acad Sci 1985;459:375-81. https://doi.org/10.1111/j.1749-6632.1985.tb20847.x
  22. Ghio AJ, Hilborn ED, Stonehuerner JG, Dailey LA, Carter JD, Richards JH, et al. Particulate matter in cigarette smoke alters iron homeostasis to produce a biological effect. Am J Respir Crit Care Med 2008;178:1130-8. https://doi.org/10.1164/rccm.200802-334OC
  23. Erdemir EO, Nalcaci R, Caglayan O. Evaluation of systemic markers related to anemia of chronic disease in the peripheral blood of smokers and non-smokers with chronic periodontitis. Eur J Dent 2008;2:102-9. https://doi.org/10.1055/s-0039-1697363
  24. Prakash S, Dhingra K, Priya S. Similar hematological and biochemical parameters among periodontitis and control group subjects. Eur J Dent 2012;6:287-94. https://doi.org/10.1055/s-0039-1698963