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archives of oral biology 56 (2011) 428–436

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journal homepage: http://www.elsevier.com/locate/aob

Relation of salivary antioxidant status and cytokine levels to clinical parameters of oral health in pregnant women with diabetes
´ Anna Surdacka a, Edyta Ciezka a, Maria Piorunska-Stolzmann b, Ewa Wender-Ozegowska c, ˛˙ ˙ d d e Katarzyna Korybalska , EdytaKawka , Elzbieta Kaczmarek , Janusz Witowski d,* ˙
a

Department of Conservative Dentistry and Periodontology, Poznan University of Medical Sciences, Poznan, Poland Department of General Chemistry, Poznan University of Medical Sciences, Poznan, Poland c Department of Obstetrics and Gynecology, Poznan University of Medical Sciences, Poznan, Poland d Department of Pathophysiology, PoznanUniversity of Medical Sciences, Poznan, Poland e Department of Bioinformatics and Computational Biology, Poznan University of Medical Sciences, Poznan, Poland
b

article info
Article history: Accepted 14 November 2010 Keywords: Antioxidants Cytokines Diabetes Pregnancy Saliva

abstract
Objective: Both pregnancy and diabetes are thought to predispose to the impairment of oral health. As salivacontributes to oral homeostasis, we have characterised its properties and flow rate in pregnant women with or without diabetes. Design: Unstimulated whole mixed saliva was collected from 63 women in the first trimester of pregnancy and analysed for the concentration of selected antioxidants, cytokines, and growth factors. Results: Pregnant women with diabetes were found to have markedly increased indexesof caries activity, plaque formation, gingival and periodontal status, as well as increased salivary antioxidant capacity and pro-inflammatory cytokine levels. These changes were more pronounced in patients with long-term disease and systemic diabetic complications, but only partly correlated with the level of blood glycated haemoglobin. Of the cytokines examined, salivary VEGF and HGFconcentrations in diabetic pregnant women correlated in a positive and negative manner, respectively, with the prevalence of caries. Moreover, VEGF levels in this group correlated inversely with the probing depth and clinical attachment levels. All such associations did not occur in healthy individuals. In contrast, the salivary pH and flow rate correlated inversely with several parameters of caries andplaque formation irrespectively of whether the pregnant women were diabetic or not. Conclusions: Diabetes in pregnant women significantly changes saliva properties, which may contribute to accelerated deterioration of the oral status in this population. # 2010 Elsevier Ltd. All rights reserved.

* Corresponding author. Tel.: +48 61 8546575; fax: +48 61 8546574. E-mail address: jwitow@ump.edu.pl (J.Witowski). Abbreviations: API, approximal plaque index; CAL, clinical attachment level; DM, diabetes mellitus; DMF-T, caries prevalence index (decayed, missing, and filled teeth); DMF-S, caries prevalence index (decayed, missing, and filled surfaces); GI, gingival index; G-CSF, granulocyte-colony stimulating factor; GROa, growth related oncogene a; HbAc1, glycated haemoglobin; HGF, hepatocyte growthfactor; IL, interleukin; IL-6sR, interleukin-6 soluble receptor; MCP-1, monocyte chemoattractant protein-1; PL-I, plaque index; PD, probing depth; SBI, sulcus bleeding index; SDF-1, stromal-derived factor-1; sICAM-1, soluble intercellular adhesion molecule-1; SOD, superoxide dismutase; TNFa, tumour necrosis factor a; TNF-R, tumour necrosis factor receptor; VEGF, vascular endothelial cell growthfactor. 0003–9969/$ – see front matter # 2010 Elsevier Ltd. All rights reserved. doi:10.1016/j.archoralbio.2010.11.005

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Introduction

Pregnancy-associated physiological changes are thought to predispose to the impairment of oral health. The most frequent alterations have been reported to occur in the gingiva and saliva and included an...