Evaluation of Salivary Alanine Aminotransferase Enzyme level in Smoker Patients with Peptic Ulcer in Relation to Periodontal Condition

Background periodontal diseases are a group of chronic inflammatory disordered which divided into gingivitis and periodontitis while peptic ulcer involve ulceration of the epithelium lining of the stomach or duodenum or both of them. Smoking is a major health problem cause a harmful effect on both periodontium and gastrointestinal organs. Alanine aminotransferase (ALT) is commonly known as liver enzyme, its activity increase in many diseases such as peptic ulcer, hepatitis, chronic periodontitis and others. Aims of the study Evaluate and compare the level of salivary ALT enzyme and the periodontal health status by measuring the clinical periodontal parameters (plaque index (PLI), gingival index (GI), bleeding on probing (BOP), probing pocket depth (PPD), clinical attachment level (CAL) and tooth loss (TL)), at the study groups ( group of smoker patients with peptic ulcer, group of non smoker patients with peptic ulcer, group of non smoker patients and without peptic ulcer (each group subdivided into gingivitis and chronic periodontitis), and control group), and correlate between the level of ALT salivary enzyme with clinical periodontal parameters. Materials and methods Salivary ALT enzyme level and clinical periodontal parameters (PLI, GI, BOP, PPD, CAL, TL) were measured from 140 males, age range (25-40) years old, that divided into study groups which include, group of 40 smoker patients with peptic ulcer, group of 40 non smoker patients with peptic ulcer, and group of 40 non smoker patients and without peptic ulcer, then each of these groups subdivided into (20 had gingivitis and 20 had chronic periodontitis), also the control group which consists of 20 subjects without peptic ulcer and non smoker with clinically healthy periodontium. Results The results showed that the highest median value of plaque index was in patients with gingivitis, peptic ulcer and smoker, while the median values of gingival index and bleeding on probing were highest among patients with gingivitis, peptic ulcer and non -smoker. The highest median values of probing pocket depth, clinical attachment level and tooth loss were recorded in patients with chronic periodontitis, peptic ulcer and smoker. The median value of salivary ALT enzyme (35.05) was found to be highest at patients had chronic periodontitis, peptic ulcer and smoker. All of the clinical periodontal parameters as well as salivary ALT enzyme level revealed highly significant differences in the comparisons among the study groups and subgroups. The correlations between the level of salivary ALT enzyme with clinical periodontal parameters were almost statistically non significant at the study subgroups and control group. Conclusions It can be concluded that there was increase in periodontal tissue destruction and the level of salivary ALT enzyme associated with increase in the severity of periodontal diseases as well as the presence of peptic ulcer and smoking, accordingly, these results can suggest that salivary ALT enzyme is considered as a good biochemical marker of tissue destruction and measuring the level of this enzyme is consider as easy, time saving and non-invasive method of screening and early diagnosis of chronic periodontitis and to evaluate the effect of peptic ulcer and smoking on periodontal health status.