A Comparative Evaluation of Salivary Alkaline Phosphatase Level in Pre-Menopausal And Post-Menopausal Women With And Without Periodontitis. A Biochemical Study.
awadhiya et al; alkaline phosphatase as a biomarker
Keywords:
Alkaline phosphatase; Menopause; Saliva; Chronic periodontitis
Abstract
Introduction- Alkaline phosphatase is an intracellular destruction enzyme in the periodontium, and it takes part in the normal turnover of the periodontal ligament, alveolar bone, and root cementum formation and maintenance.
Aim- The aim of this case control study was to evaluate the enzyme Alkaline Phosphatase (ALP) level in saliva of post menopausal women with and without chronic periodontitis.
Materials and Methods- This study includes 48 samples of pre and post menopausal females. All the subjects were selected from the Department of Periodontology, Peoples College of Dental Science and Research Centre, Bhopal. The study participants were divided into 4 groups, Group A: 12 pre- menopausal women without periodontitis with systemically healthy, Group B : 12 post-menopausal women without periodontitis with systemically healthy, Group C: 12 pre- menopausal women with periodontitis and systemically healthy, Group D: 12 post- menopausal women with periodontitis and systemically healthy. Clinical parameters assessed were Plaque Index (PI), Gingival Index (GI), Clinical Attachment Level (CAL) and Probing Pocket Depth (PPD). Unstimulated salivary samples were obtained in which the ALP concentration was measured using p-Nitrophenylphosphate, and 2-amino-2-methyl-1-propanol reagents in Beckman and Coulter, AU 480 auto analyser. Mann-Whitney U test was used to find statistical difference with respect to all clinical parameters such as PI, GI, CAL, PPD and salivary ALP levels.
Result – The result of the present study showed considerably higher salivary ALP levels in post menopausal women with chronic periodontitis compared to other groups.
Conclusion -The present study suggest that the presence of ALP levels is not simply a reflection of the local inflammatory state in females but their estrogen levels may possibly influence bone destruction in periodontitis.
References
1. Ramesh A, BhandaryR ,Thomas B, D' souza S & Kumari S. Alkaline
phosphatase – a diagnostic marker of periodontitis in
postmenopausal women – A biochemical study. NUJHS 2013; 3
(4):71-7
2. Ozmeric N. Advances in periodontal disease markers. Clin Chim
Acta. 2004;343,1-16.
3. I Ishikawa, G. Cimasoni. Alkaline phosphotase in human gingival
fluid and its relation to periodontitis. Arch Oral Biol. 1970;15;1402- 4
4. Bhattarai T, Bhattacharya K, Chaudhuri P, Sengupta P. Correlation
of common biochemical markers for bone turnover, serum calcium,
and alkaline phosphatase in post-menopausal women. Malays J Med
Sci. 2014;21:58-61.
5. . Acharya D, Gautam S, Neupane N, Kaphle HP, Singh JK. Health
Problems of Women above Forty Years of Age in Rupandehi
District of Nepal. International Journal of Health Sciences and
Research (IJHSR). 2013;3(3):29-36.
6. Nelson H, Haney E, Humphrey L. Management of menopauserelated
symptoms (Agency of Healthcare Research and Quality, Rockville, MD) Evidence report. Technology Assessment.
2005(120).
7. Ishikawa K, Nagai T, Sakamoto K, Ohara K, Eguro T, Ito H, et al.
High bone turnover elevates the risk of denosumab-induced
hypocalcemia in women with postmenopausal osteoporosis.
Therapeutics and Clinical Risk Management. 2016;12:1831.
8. Zappa U. Histology of the periodontal lesion: Implications for
diagnosis. Periodontol 2000. 1995;7:22- 38.
9. Malamud D, Tabak LA, editors. Saliva as a Diagnostic Fluid: Ann
NY Acad Sci. 1992. Malamud D, Tabak LA, eds. Saliva as a
Diagnostic Fluid; No. 694.
10. Ng PY, Donley M, Hausmann E, Hutson AD, Rossomando EF,
Scannapieco FA. Candidate salivary biomarkers associated with
alveolar bone loss: Cross sectional and in-vitro studies. Immunol
Med Microbiol. 2007;49:252-60.
11. Mariotti, J.A. Estrogen and extra-cellular matrix influence human
gingival fibroblast proliferation and production. Journal of
Periodontology 2005; 76:1391-1397.
12. Johnson, R.B., Gilbert, J.A., Cooper, R.C., et al. Effect of estrogen
deficiency on skeletal and alveolar bone density in sheep. Journal of
Periodontology 2002;73:383-391. 13. Matsuura T, Tokutomi K, Sasaki M, Katafuchi M, Mizumachi E,
Sato H. Distinct characteristics of mandibular bone collagen relative
to long bone collagen: Relevance to clinical dentistry. Bio Med
Research International 2014;2014:769414.
14. Pacifini R. Is there a causal role of IL-1 in postmenopausal bone
loss? Calcif Tissue Int. 1992;50:295-99.
15. Tezal M, Wactawski-Wende J, Grossi SG, Ho AW, Dunford R,
Genco RJ. The relationship between bone mineral density and
periodontitis in post-menopausal women. J Periodontol.
2000;71:1492-98.
16. Desai S, Shinde H, Mudda J, Patil V. Levels of alkaline phosphatase
(ALP) in saliva of patients with chronic periodontitis; A clinical and
biochemical study. Internet J Dent Sci. 2009;8:1–9.
17. Soben peter (2017). Essentials of public health dentistry. (6th
edition)
18. Prof. Jose Luis Millan (2006). Mammalian Alkaline Phosphatases:
From Biology to Applications in Medicine and Biotechnology
19. Agrawal N, Singhvi A, Upadhyay M, Kaur N, Yadav OP, Khan M.
Estimation of Serum Alkaline Phosphatase in Chronic Periodontitis
in Smokers and Non-Smokers with Healthy Individuals: A Pilot
Study. Int J Dent Med Res 2014;1(4):30-34 20. Sajjanar DS, Sajjanar SL. Study of serum alkaline phosphatase,
calcium and urinary hydroxyproline as bone biomarkers in
postmenopausal women. Int J Basic Appl Med Sci. 2014;4(1):223
21. AlRowis R, AlMoharib HS, AlMubarak A, Bhaskardoss J,
Preethanath RS, Anil S. Oral fluid-based biomarkers in periodontal
disease - part 2. Gingival crevicular fluid. J Int Oral Health. 2014
Sep;6(5):126-35. PMID: 25395809; PMCID: PMC4229821.
22. B., Santhosh & Shenoy, Prajnya & Talwar, Avaneendra & Thomas,
Biju & Sharath, K.S. & K., Shamila. (2014). Evaluation of salivary
enzymes in post menopausal women with and without periodontitis.
Journal of Health and Allied Sciences NU. 04. 088-091. 10.1055/s-
0040-1703840.
23. Mona Adam A. ELmalik, Emtithal A.Alraheem Taher,
NassrEldinM.A.Shrif, Husham O.Elzein, Amna O.M.Elzein.
Comparison of the Serum Levels of Calcium, Phosphorus Alkaline
Phosphatase Activity, and Plasma Parathyroid Hormone Betweenpre and Postmenopausal women in Khartoum-State. Journal of Dental and Medical Sciences 2016;15(11):118-121.
24. Puneeth HK, Veda Priya, Bhavana S B, Ananthaneni Anuradha,
Vijay Srinivas, Mohammad Asif kiresur. Salivary Alkaline
Phosphatase and Calcium – Diagnostic Marker for Bone Resorption in Post-Menopausal Women. Saudi Journal of Oral and Dental
Research, 2016; 1(3):102-107
25. Hegde, Shashikanth; Jayaprakash, Hridya; Ks, Rajesh; Maiya, Arun;
Kumari, Suchetha. A Comparative Evaluation of Salivary Alkaline
Phosphatase Among Premenopausal and Postmenopausal Women
with Chronic Periodontitis. Indian Journal of Stomatology
2016;7(3):66-69
26. Khadka, Bikram & Timalsina, Binod & Gupta, Suprita & Acharya,
Dilaram & Lecturer, & Professor, Assistant. (2017). Serum Calcium
and Alkaline Phosphatase Level among Pre-Menopausal and Post-
Menopausal Women in Rupandehi District of Nepal: A Co-Relational
Study. 1367.
27. Shetty, Shishir & Al-Bayati, Sura & Said, Mohamed & Eid, Hossam.
(2017). Salivary alkaline phosphatase and oral health: A review. I tal
Ian J ournal of D ental M eDIcIn.
28. Rua Hashim Yousuf and Dr. Tarig Mohmed Fadl Elmula.
Evaluation of serum alkaline phosphatase and calcium in premenopausal and postmenopausal sudanese women. European Journal of Biomedical and Pharmaceutical sciences;2017:4(6)
29. Al-Hindawi, Sahar & Luaibi, Noori & Al-Ghurabi, Batool. Estimation
of Alkaline Phosphatase level in the Serum and Saliva of Hypothyroid
Patients with and without Periodontitis. Research Journal of Pharmacy
and Technology; 2018:11. 1-4. 10.5958/0974-360X.2018.00551.6.
30. Sophia K, Suresh S, Sudhakar U, Jayakumar P, Mathew D.
Comparative Analysis of Salivary Alkaline Phosphatase in Post
menopausal Women with and without Periodontitis. J Clin Diagn
Res.2017;11(1):ZC122-ZC124. doi:10.7860/ JCDR/2017
/24654.9309
31. Kuldip Singh, Amandeep Kaur, Khushpreet Kaur, Maninder Kaur.
Correlation between postmenopausal period and certain hepatic
enzymes in women of tertiary hospitals of Punjab. International
Journal of Medical and Health Research 2017;3(6):109-112.
32. Dr. Mamta Malik, Ravinder S Saini, Dr. Sanjeev Laller, Dr.
Kanwalpreet Kaur, Dr. Pooja Sheokand and Dr. Nisha Dahiya 2018.
Salivary alkaline phosphatase estimation in chronic periodontitis in
smokers and non smokers: A Biochemical study, International
Journal of Current Research, 10, (07), 71825-71827.
33. Bairwa BK, Sagar M, Gupta RC, Gupta M. A comparative study of
salivary and serum calcium and alkaline phosphatase in patients with
osteoporosis. Int J Res Med Sci 2019;7:2412-6.
34. Koppolu, Pradeep & Sirisha, Sunkara & Mishra, Ashank &
Deshpande, Kopparesh & Swapna, Lingam & Alotaibi, Dalal &
Alwahibi, Mohammed & Penela, Soumya. (2020). Alkaline phosphatase and acid phosphatase levels in saliva and serum of patients with healthy periodontium, gingivitis, and periodontitis before and after scaling with root planing: A clinico-biochemical study. Saudi Journal of Biological Sciences. 28.10.1016/j.sjbs.2020.10.016.
35. Keerthana Baskar, Sreedevi Dharman, Evaluation of Calcium and
Alkaline Phosphatase in the Salivary Samples of Premenopausal and
Postmenopausal Women. Journal of Pharmaceutical Research
International; 2020:32(19): 157-163
phosphatase – a diagnostic marker of periodontitis in
postmenopausal women – A biochemical study. NUJHS 2013; 3
(4):71-7
2. Ozmeric N. Advances in periodontal disease markers. Clin Chim
Acta. 2004;343,1-16.
3. I Ishikawa, G. Cimasoni. Alkaline phosphotase in human gingival
fluid and its relation to periodontitis. Arch Oral Biol. 1970;15;1402- 4
4. Bhattarai T, Bhattacharya K, Chaudhuri P, Sengupta P. Correlation
of common biochemical markers for bone turnover, serum calcium,
and alkaline phosphatase in post-menopausal women. Malays J Med
Sci. 2014;21:58-61.
5. . Acharya D, Gautam S, Neupane N, Kaphle HP, Singh JK. Health
Problems of Women above Forty Years of Age in Rupandehi
District of Nepal. International Journal of Health Sciences and
Research (IJHSR). 2013;3(3):29-36.
6. Nelson H, Haney E, Humphrey L. Management of menopauserelated
symptoms (Agency of Healthcare Research and Quality, Rockville, MD) Evidence report. Technology Assessment.
2005(120).
7. Ishikawa K, Nagai T, Sakamoto K, Ohara K, Eguro T, Ito H, et al.
High bone turnover elevates the risk of denosumab-induced
hypocalcemia in women with postmenopausal osteoporosis.
Therapeutics and Clinical Risk Management. 2016;12:1831.
8. Zappa U. Histology of the periodontal lesion: Implications for
diagnosis. Periodontol 2000. 1995;7:22- 38.
9. Malamud D, Tabak LA, editors. Saliva as a Diagnostic Fluid: Ann
NY Acad Sci. 1992. Malamud D, Tabak LA, eds. Saliva as a
Diagnostic Fluid; No. 694.
10. Ng PY, Donley M, Hausmann E, Hutson AD, Rossomando EF,
Scannapieco FA. Candidate salivary biomarkers associated with
alveolar bone loss: Cross sectional and in-vitro studies. Immunol
Med Microbiol. 2007;49:252-60.
11. Mariotti, J.A. Estrogen and extra-cellular matrix influence human
gingival fibroblast proliferation and production. Journal of
Periodontology 2005; 76:1391-1397.
12. Johnson, R.B., Gilbert, J.A., Cooper, R.C., et al. Effect of estrogen
deficiency on skeletal and alveolar bone density in sheep. Journal of
Periodontology 2002;73:383-391. 13. Matsuura T, Tokutomi K, Sasaki M, Katafuchi M, Mizumachi E,
Sato H. Distinct characteristics of mandibular bone collagen relative
to long bone collagen: Relevance to clinical dentistry. Bio Med
Research International 2014;2014:769414.
14. Pacifini R. Is there a causal role of IL-1 in postmenopausal bone
loss? Calcif Tissue Int. 1992;50:295-99.
15. Tezal M, Wactawski-Wende J, Grossi SG, Ho AW, Dunford R,
Genco RJ. The relationship between bone mineral density and
periodontitis in post-menopausal women. J Periodontol.
2000;71:1492-98.
16. Desai S, Shinde H, Mudda J, Patil V. Levels of alkaline phosphatase
(ALP) in saliva of patients with chronic periodontitis; A clinical and
biochemical study. Internet J Dent Sci. 2009;8:1–9.
17. Soben peter (2017). Essentials of public health dentistry. (6th
edition)
18. Prof. Jose Luis Millan (2006). Mammalian Alkaline Phosphatases:
From Biology to Applications in Medicine and Biotechnology
19. Agrawal N, Singhvi A, Upadhyay M, Kaur N, Yadav OP, Khan M.
Estimation of Serum Alkaline Phosphatase in Chronic Periodontitis
in Smokers and Non-Smokers with Healthy Individuals: A Pilot
Study. Int J Dent Med Res 2014;1(4):30-34 20. Sajjanar DS, Sajjanar SL. Study of serum alkaline phosphatase,
calcium and urinary hydroxyproline as bone biomarkers in
postmenopausal women. Int J Basic Appl Med Sci. 2014;4(1):223
21. AlRowis R, AlMoharib HS, AlMubarak A, Bhaskardoss J,
Preethanath RS, Anil S. Oral fluid-based biomarkers in periodontal
disease - part 2. Gingival crevicular fluid. J Int Oral Health. 2014
Sep;6(5):126-35. PMID: 25395809; PMCID: PMC4229821.
22. B., Santhosh & Shenoy, Prajnya & Talwar, Avaneendra & Thomas,
Biju & Sharath, K.S. & K., Shamila. (2014). Evaluation of salivary
enzymes in post menopausal women with and without periodontitis.
Journal of Health and Allied Sciences NU. 04. 088-091. 10.1055/s-
0040-1703840.
23. Mona Adam A. ELmalik, Emtithal A.Alraheem Taher,
NassrEldinM.A.Shrif, Husham O.Elzein, Amna O.M.Elzein.
Comparison of the Serum Levels of Calcium, Phosphorus Alkaline
Phosphatase Activity, and Plasma Parathyroid Hormone Betweenpre and Postmenopausal women in Khartoum-State. Journal of Dental and Medical Sciences 2016;15(11):118-121.
24. Puneeth HK, Veda Priya, Bhavana S B, Ananthaneni Anuradha,
Vijay Srinivas, Mohammad Asif kiresur. Salivary Alkaline
Phosphatase and Calcium – Diagnostic Marker for Bone Resorption in Post-Menopausal Women. Saudi Journal of Oral and Dental
Research, 2016; 1(3):102-107
25. Hegde, Shashikanth; Jayaprakash, Hridya; Ks, Rajesh; Maiya, Arun;
Kumari, Suchetha. A Comparative Evaluation of Salivary Alkaline
Phosphatase Among Premenopausal and Postmenopausal Women
with Chronic Periodontitis. Indian Journal of Stomatology
2016;7(3):66-69
26. Khadka, Bikram & Timalsina, Binod & Gupta, Suprita & Acharya,
Dilaram & Lecturer, & Professor, Assistant. (2017). Serum Calcium
and Alkaline Phosphatase Level among Pre-Menopausal and Post-
Menopausal Women in Rupandehi District of Nepal: A Co-Relational
Study. 1367.
27. Shetty, Shishir & Al-Bayati, Sura & Said, Mohamed & Eid, Hossam.
(2017). Salivary alkaline phosphatase and oral health: A review. I tal
Ian J ournal of D ental M eDIcIn.
28. Rua Hashim Yousuf and Dr. Tarig Mohmed Fadl Elmula.
Evaluation of serum alkaline phosphatase and calcium in premenopausal and postmenopausal sudanese women. European Journal of Biomedical and Pharmaceutical sciences;2017:4(6)
29. Al-Hindawi, Sahar & Luaibi, Noori & Al-Ghurabi, Batool. Estimation
of Alkaline Phosphatase level in the Serum and Saliva of Hypothyroid
Patients with and without Periodontitis. Research Journal of Pharmacy
and Technology; 2018:11. 1-4. 10.5958/0974-360X.2018.00551.6.
30. Sophia K, Suresh S, Sudhakar U, Jayakumar P, Mathew D.
Comparative Analysis of Salivary Alkaline Phosphatase in Post
menopausal Women with and without Periodontitis. J Clin Diagn
Res.2017;11(1):ZC122-ZC124. doi:10.7860/ JCDR/2017
/24654.9309
31. Kuldip Singh, Amandeep Kaur, Khushpreet Kaur, Maninder Kaur.
Correlation between postmenopausal period and certain hepatic
enzymes in women of tertiary hospitals of Punjab. International
Journal of Medical and Health Research 2017;3(6):109-112.
32. Dr. Mamta Malik, Ravinder S Saini, Dr. Sanjeev Laller, Dr.
Kanwalpreet Kaur, Dr. Pooja Sheokand and Dr. Nisha Dahiya 2018.
Salivary alkaline phosphatase estimation in chronic periodontitis in
smokers and non smokers: A Biochemical study, International
Journal of Current Research, 10, (07), 71825-71827.
33. Bairwa BK, Sagar M, Gupta RC, Gupta M. A comparative study of
salivary and serum calcium and alkaline phosphatase in patients with
osteoporosis. Int J Res Med Sci 2019;7:2412-6.
34. Koppolu, Pradeep & Sirisha, Sunkara & Mishra, Ashank &
Deshpande, Kopparesh & Swapna, Lingam & Alotaibi, Dalal &
Alwahibi, Mohammed & Penela, Soumya. (2020). Alkaline phosphatase and acid phosphatase levels in saliva and serum of patients with healthy periodontium, gingivitis, and periodontitis before and after scaling with root planing: A clinico-biochemical study. Saudi Journal of Biological Sciences. 28.10.1016/j.sjbs.2020.10.016.
35. Keerthana Baskar, Sreedevi Dharman, Evaluation of Calcium and
Alkaline Phosphatase in the Salivary Samples of Premenopausal and
Postmenopausal Women. Journal of Pharmaceutical Research
International; 2020:32(19): 157-163
Published
2021-06-14
How to Cite
Dr GD awadhiya, D. N. A., & Kalburgi, V. (2021). A Comparative Evaluation of Salivary Alkaline Phosphatase Level in Pre-Menopausal And Post-Menopausal Women With And Without Periodontitis. A Biochemical Study. UNIVERSITY JOURNAL OF DENTAL SCIENCES, 7(2). https://doi.org/10.21276//ujds.2021.7.2.8
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Original Research Paper
