Salivary and Serum Aspartate Aminotransferases and Alanine Aminotransferases in Insulin-Dependent Diabetes Mellitus and Normal Children: A Comparative Study

Adjunctive systemic antibiotic effect on periodontal state, salivary enzyme activity, and glycemia imbalance in type-2 diabetics after non-surgical periodontal management

AIM

The current study aimed at analyzing the effect of non-surgical periodontal treatment accompanied by systemic antibiotics on salivary enzyme activities, periodontal parameters, and glycemic control in type-2 diabetic (T2D) patients with chronic periodontitis.

METHODS

The study included 125 type-2 diabetic patients with chronic periodontitis who had good glycemic control (T2Dc), 125 type-2 diabetics who had bad glycemic control (T2Dpc). The 125 T2Dpc were divided randomly into two groups. The first one enrolled 63 T2Dpc and received a non-surgical periodontal treatment (T2Dpc + NST). The second group enrolled 62 T2Dpc and received the non-surgical treatment accompanied by systemic antibiotics (T2Dpc+NST+A). HbA1c, periodontal indices, and salivary enzyme activities were assessed for all groups. The Glycated hemoglobin (HbA1c) was assessed. The Salivary alkaline phosphatase (ALP), aspartate aminotransferase (AST), alanine aminotransaminase (ALT), lactate dehydrogenase (LDH), and creatine kinase (CK) activities were measured.

RESULTS

The T2Dpc were characterized by the highest probing depth (PPD) and clinical attachment loss (CAL) periodontal scores, as well as ALP, AST, and ALT enzymatic activities. However, BOP did not differ significantly between T2Dc and T2Dpc. Whereas the rest of clinical parameters PI, GI, and OHI-S did not significantly differ between groups. The Pearson's analysis revealed three correlations between ALP-PPD, ALP-CAL, and ALP-BOP (bleeding on probing) in both T2Dc and T2Dpc (P < 0.05). Interestingly, a significant decrease in periodontal indices, salivary enzyme activities, and HbA1c was recorded in T2Dpc+NST+A group.

CONCLUSION

The increase in ALP, AST, and ALT activities reflects the impact of uncontrolled T2D on periodontal tissue alteration. The ALP activity increase was associated with the severity of periodontal status in diabetic patients. In comparison to non-surgical treatment alone, the adjunct use of systemic antibiotics improves periodontal state, enzyme activity, and glycemic control.

Salivary Aspartate Aminotransferase, Alanine Aminotransferase and IgA as biomarkers for Type I Diabetes Mellitus: A Systematic Review

Introduction:

Type I diabetes mellitus (T1DM) is an autoimmune disorder characterized by absolute insulin deficiency, which is caused by progressive destruction of the β-islet cells of the pancreas. Aminotransferases participate in the interconversion of amino acids and oxalic acids by transfer of amino groups. Organ damage leads to leakage of transaminases into the blood. IgA is the only immunoglobulin that is found in saliva and forms the first line of defense. Alteration in the levels of secretory IgA often indicates a local or systemic disease. The aim of this systematic review is to evaluate the role of salivary aspartate aminotransferase (AST), alanine aminotransferase (ALT), and IgA as biomarkers for T1DM patients.

Materials and Methods:

An electronic literature search was conducted by two independent reviewers using PubMed, Medline and Google scholar without any date filter. The inclusion criteria included case control and cross-sectional studies. Publications in languages other than English, review articles, letters to the editor, and studies done on animal models were excluded from the review. The difference in the levels of salivary AST, ALT, or IgA in T1DM patients and in healthy individuals were compared. Risk of bias assessment was done using the ROBINS-I tool.

Results:

A total of eight relevant articles were assessed, out of which three studies showed elevated salivary AST and ALT levels and five studies showed elevated salivary IgA levels in patients with T1DM.

Conclusion:

Our review reflected that salivary AST, ALT, and IgA were elevated in T1DM patients, and they can be used for monitoring these patients. Further studies are needed to establish the diagnostic accuracy of these parameters for clinical application.

Toxicological and pharmacological assessment of a multiherbal phytopharmaceutical on Triton X-1339-induced hyperlipidemia and allied biochemical dysfunctions

This study investigated the safety and therapeutic effect of a multiherbal tea (MHT) on Triton X-1339-induced hyperlipidemia and associated biochemical and tissue dysfunctions. An infusion of the MHT was assessed for phytoconstituents, proximate and mineral composition, and antioxidant activity. Wistar rats administered 200 mg/kg Triton X-1399 were post-treated with MHT for 14 days followed by biochemical estimations in serum, heart, liver, and kidney of animals. Hematological and histopathological evaluations of the blood, and liver, respectively, were also performed. Different phytochemicals were detected in MHT, toxic metals were absent and antioxidant activity was appreciable. Disturbances in glucose level and redox homeostasis, alterations in liver, kidney, and heart function markers, and imbalances in hematological parameters precipitated by triton toxicity were mitigated by posttreatment with MHT. Multiherbal tea also ameliorated triton-induced hepatic histoarchitectural abnormalities. These results suggest that MHT is apparently an effective antilipemic tea with minimal or no side effects. PRACTICAL APPLICATIONS: Hyperlipidemia is one of the core risk factors for arteriosclerosis and a major contributor to other adverse health conditions. The prevalence of hyperlipidemia has increased drastically in the last few decades. Plant and plant products have been extensively used in the management of dyslipidemia and many plant-based antilipemic products with poorly defined toxicity and pharmacological profiles abound in the market. The results of this study demonstrated the protective effects of a MHT against triton-induced hyperlipidemia, atherogenic tendency, and dysfunction of key organs in rats and lent credence to its therapeutic relevance in the management of hyperlipidemia and related diseases.