ASSOCIATION BETWEEN SERUM RESISTIN LEVEL AND PERIODONTAL CONDITION CHANGE
AMONG ELDERLY PEOPLE
26
individual having a serum resistin level <5.3 ng/mL, and
48 participants were in a high resistin group (HR), or who
had serum resistin from 5.3 ng/mL. This categorization
was according to a previous study [9].
Table 1 shows the characteristic of the participants
at baseline. Based on general data, 44.7 % (59 out of
132) of participants were smokers. With respect to
the drinking habit, one participant who was in the
HR group refused to answer the questionnaire so we
excluded this participant in the analysis of the drinking
habit and we found that 64.1 % (84 out of 131) of
participants drank alcohol. There was no difference
regarding the number of drinkers or smokers between
the groups. The distribution of serum resistin ranged
from 1.2 to 17.9 ng/mL with an average of 5.38 ± 3.24
ng/mL. The average BMI of participants in the present
study were in the normal weight range based on the
WHO classification for Asians [25]. Six participants (5 in
LR and 1 in HR group, data not shown) were classified
as obese (BMI ≥ 27.5). With respect to the adipokine/
cytokines data at baseline, there were no differences
between the groups in all these parameters (Table 1).
Intergroup comparisons of periodontal parameters are
shown in Table 2. At baseline, the HR group had sites
with PD≥4 mm, and sites with PD≥4 mm concomitant
BOP 1.58. This was 2 times higher than those of the LR
group, respectively.
There were statistically significant differences at p =
0.026 and 0.016, respectively. Interestingly, after 4 years
all these parameters were improved in all participants.
Alteration of above parameters were markedly detected
in the HR group for both sites with PD ≥ 4 mm and sites
with PD ≥ 4 mm concomitant BOP which were reduced
by 54.2% and 92.5% after 4 years, respectively while in
the LR group, these parameters decreased only by 28.3%
and 87.2%, respectively from baseline. No significant
difference was found between groups regarding PD ≥
6 mm, and PD ≥ 6 mm concomitant BOP. The average
number of tooth loss was only 1.1 teeth (5.0% loss from
baseline) in the LR group, and 1.62 teeth (7.8% loss from
baseline) in the HR group.
Multiple linear regression analyses (Table 3 and 4) were
performed using alteration in the number of sites with
PD≥4 mm, and these sites concomitant BOP during
4 years as a dependent variable, and all adipokines/
cytokines level at baseline as well as the number
of tooth loss in 4 years as independent variables. It
was found that serum resistin levels had a significant
contribution effect on the improvement of sites with PD
≥ 4 mm (correlation coefficient = -0.49; p = 0.080), and
also inflammation shown by the reduction of sites with
PD ≥ 4 mm concomitant BOP (correlation coefficient
= -0.41, p = 0.009). The other cytokines and adipokine,
however, appeared to have no such relationship.
Additionally, the number of teeth lost during the 4-year
period also had a significantly positive effect on the
reduction of sites with PD ≥ 4 mm and sites with PD ≥
4 mm concomitant BOP (correlation coefficient = -2.48;
p = 0.000 and correlation coefficient = -0.78; p = 0.001,
respectively).
Most of participants received periodontal treatment
during the study period. Table 5 shows the numbers
of participants who received scaling and scaling with
root planning which were 109 (82.6%) and 56 (42.4%)
Table 2. Comparison of periodontal conditions between low (LR) and
high (HR) serum resistin
Resistin
Characteristics
LR (<5.3 ng/
mL) N = 84
HR (≥5.3 ng/
mL) N = 48
p value
Periodontal conditions (Baseline)
Sites with PD ≥
4 mm 9.91 ± 11.98 15.62 ± 17.02 0.026
Sites with PD ≥
6 mm 1.69 ± 3.11 2.75 ± 5.17 0.144
Sites with PD ≥ 4
mm concomitant
BOP 2.82 ± 4.84 5.75 ± 8.97 0.016
Sites with PD ≥ 6
mm concomitant
BOP 0.60 ± 1.69 1.02 ± 2.07 0.216
Number of
present teeth 20.36 ± 5.67 20.83 ± 6.25 0.664
Periodontal conditions (4 years follow-up)
Sites with PD ≥
4 mm 7.11 ± 12.08 7.16 ± 8.10 0.980
Sites with PD ≥
6 mm 0.89 ± 0.30 0.87 ± 1.23 0.969
Sites with PD ≥ 4
mm concomitant
BOP 0.36 ± 0.48 0.43 ± 0.50 0.442
Sites with PD ≥ 6
mm concomitant
BOP 0.21 ± 0.85 0.22 ± 0.55 0.913
Number of
present teeth 19.09 ± 6.56 19.02 ± 6.68 0.950
Periodontal conditions (alteration)
Sites with PD ≥
4 mm -2.79 ± 11.02 -8.45 ± 12.44 0.000
Sites with PD ≥
6 mm -0.79 ± 4.06 -1.87 ± 4.72 0.170
Sites with PD ≥ 4
mm concomitant
BOP -1.15 ± 4.98 -4.27 ± 7.34 0.004
Sites with PD ≥ 6
mm concomitant
BOP -0.39 ± 1.86 -0.79 ± 1.97 0.250
Number of
present teeth 1.10 ± 2.17 1.62 ± 2.60 0.224
Data expressed as mean ± standard deviation
HbA1c = glycated hemoglobin, PD = probing pocket depth, BOP = bleeding on
probing
t test was used to analysed
individuals, respectively. When we compared the
groups, there were no statistically significant differences
between groups in participants who received scaling
or those who received scaling with root planning (p =
0.862 and p = 0.894, respectively).
4. Discussion
To our knowledge, this is the first longitudinal
observational study to compare the potential of low
and high serum resistin level at baseline to predict
the periodontal condition alteration of community-
dwelling elderly in a 4-year period. The primary
outcome variable was the association between
the baseline serum resistin level and the alteration
Stoma Edu J. 2018;5(1): 24-30
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