sdj-10156

Differences in Periodontal Parameters, Serum Vitamin D, Calcium, Phosphorus, Alkaline Phosphatase and C-Reactive Protein Between Perimenopausal and Postmenopausal Women with Periodontitis

Parez S. khalid*, Chenar A. Mohammad*

* Periodontics Department, College of Dentistry, Hawler Medical University, Erbil, Iraq.

Submitted: June 23, 2022, Accepted: August 10, 2022, Published: December 1, 2022.

DOI: https://doi.org/10.17656/sdj.10156

Objective: The study aimed to evaluate and compare the differences in periodontal and biochemical parameters between perimenopausal and postmenopausal women with periodontitis. 

Methods: A cross-sectional study was conducted on 100 women with chronic periodontitis, aged 40-60 years, divided into 50 perimenopausal and 50 postmenopausal groups. Periodontal parameters (plaque index PI, gingival index GI, gingival bleeding index GBI, simplified debris index DI-S, simplified calculus index CI-S, simplified oral hygiene index OHI-S, clinical attachment loss CAL, and pocket depth PD) and blood samples were collected to estimate vitamin D, calcium Ca, phosphorous P, alkaline phosphatase ALP and C-reactive protein CRP.     

Results: The mean values of clinical periodontal parameters were significantly higher in the postmenopausal group as compared to the perimenopausal group (P<0.05), except for CI-S (P>0.05). For the biochemical parameters, the mean serum level of AlP, Ca, and P were within the normal reference ranges, with non-significant differences reported between both groups regarding ALP and P (P>0.05). While serum Vit.D level was more significantly reduced in the postmenopausal group (P<0.05), and CRP levels were increased in both groups, but with non-significant differences (P>0.05).   

Conclusions: Postmenopause could more significantly affect the progression & severity of periodontal disease and vitamin D deficiency than peri menopause due to reducing circulating estrogen level.                                                                                     

Keywords: Calcium, Perimenopause, Periodontitis, Postmenopause, Vitamin D.         

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References:

1. Amar S, Chung KM. Influence of hormonal variation on the periodontium in women. Periodontol 2000. 1994;6(1):79-87.

2. Meurman JH, Tarkkila L and Tiitnen A. The menopause and oral health. Maturitas. 2009;63(1):56-62.

3. Markou E, Eleana B, Lazaros T, Antonios K. The influence of sex steroid hormones on gingiva of women. Open Dent J. 2009;5(3):114-9.

4. Deepa D, Gain G. Assessment of periodontal health status in postmenopausal women visiting dental hospital from in and around Meerut city: Cross-sectional observational study. J Midlife Health. 2016;7(4):175-179.

5. Prasanna JS, Sumadhura C, Karunakar P. A Comparative Analysis of pre- and postmenopausal females with periodontitis and its response to a noninvasive clinical approach. J Menopausal Med. 2017;23(3):202-09.

6. Wulandari P, Masulili SLC, Kusdhany LS, Tadjoedin FM, Puspitadewi SR, Baziad A. Differences in periodontal severity between perimenopausal and postmenopausal women with chronic periodontitis. Pesqui Bras Odontopediatria Clín Integr. 2019;19:e5091:1-9.

7. Mohan RPS, Gupta A, Kamarthi N, Malik S, Goel S, Gupta S. Incidence of oral lichen planus in perimenopausal women: a cross-sectional study in western uttar pradesh population. J Midlife Health. 2017;8(2):70-4.

8. Khammissa RA G, Fourie J, Motswaledi MH, Ballyram R, Lemmer J, Feller L. The biological activities of vitamin d and its receptor in relation to calcium and bone homeostasis, cancer, immune and cardiovascular systems, skin biology, and oral health. Bio Med Res Int. 2018;2018:9276380:1-9.

9. Li, X., Zhang, D., Bryden, W.L., Li, X., Zhang, D., Bryden, W.L., 2017. Calcium and phosphorus metabolism and Nutrition of poultry: are current diets formulated in excess? Anim. Prod. Sci. 2017;57(11):2304-10.

10. Ramesh A, Bhandary R, Thomas B, Souza SRD, Kumari. Alkaline phosphatase – a diagnostic marker of periodontitis in postmenopausal women – a biochemical study. NUJHS. 2013;3(4):071-3.

11. Malutan, AM, Dan M, Nicolae, C., Carmen, M., 2014. Proinflammatory and anti- inflammatory cytokine changes related to menopause. Prz Menopauzalny. 2014;13(3):162-8.

12. 1999 International workshop for a classification of periodontal diseases and conditions. papers. oak brook, illinois, october 30-november 2, 1999. Ann Periodontol. 1999;4(1):1-112.

13. Kim MJ, Cho J, Ahn Y, Yim G, Park HY. Association between physical activity and menopausal symptoms in perimenopausal women. BMC Womens Health. 2014;14(1):1-8.

14. Silness J, Löe, H. Periodontal disease in pregnancy.II.Correlation between oral hygiene and periodontal condition. Acta Odontol Scand. 1964;22(1):121-35.

15. Löe, H, Silness J. Periodontal disease in pregnancy.I.Prevalence and severity. Acta Odontol Scand.1963;21(1):533-51.

16. Ainamo J, Bay I. Problems and proposals for recording gingivitis and plaque. Int Dent J. 1975;25(4):229-35.

17. Greene JC, Vermillion JR. The simplified oral hygiene index. J Am Dent Assoc.1964;68(1):7-13.

18. Lindhe J, Lang NP, Karring T. Clinical periodontology and implant dentistry. 2008. Blackwell Munksgaard, Oxford; Ames, Iowa.

19. Hakimi S, Mirghofurvand M, Seiiedin SA. Comparative study of climacteric symptoms in perimenopausal and postmenopausal women in Tabriz, Islamic Republic of Iran. East Mediterr Health J. 2010;16(11):1165-9.

20. Rashad JM, Mohammed SJ, Kalf SA. Salivary calcium and phosphate in relation to oral health among postmenopausal women in Baghdad governorate. Mustansiria Dent J. 2016;13(1):92-7.

21. Wölfl C, Schweppenhäuser D, Gühring T, Takur C, Höner B, Kneser U, et al. Correction:Characteristics of bone turnover in the long bone metaphysis fractured patients with normal or low Bone Mineral Density (BMD). PloS One. 2022;17(6):e0270079:1-6.

22. Cáceres M, Oyarzun A, Smith PC. Defective wound-healing in aging gingival tissue. J Dent Res. 2014:93(7):691-7.

23. Pallos D, Ceshin A, Victor G, Bulhões R and Quirino M. Menopause: a risk factor for periodontal disease? Rev Bras Ginecol Obstet. 2006;28(5):292-7.

24. Alves RC, Félix SA, Rodriguez-Archilla A, Oliveira P, Brito J, dos Santos JM. Relationship between menopause and periodontal disease: a Vol 9(2) Khalid and Mohammad 46 cross-sectional study in a Portuguese population. Int J Clin Exp Med. 2015;8(7):11412-9.

25. Azodo CC, Umoh AO. Association between periodontal status, oral hygiene status and tooth wear among adult male population in Benin City, Nigeria. Ann Med Health Sci Res. 2013;3(2):149- 54.

26. Harlow SD, Gass M, Hall JE, Lobo R, Maki P, Rebar RW, et al. Executive summary of the stages of reproductive aging workshop + 10: addressing the unfinished agenda of staging reproductive aging. J Clin Endocrinol Metab. 2012;97(4):1159- 68.

27. Kumari A, Kumari V. The study of vitamin D deficiency in peri and postmenopausal women of Jamshedpur, Jharkhand. Int J Contemp Med Res. 2018;5(12):4-6.

28. Shukar-ud-din S, Tabassum R, Nusrat U, Rabia S. Prevalence of Vitamin D Inadequacy in peri and postmenopausal women presented at Dow University hospital, Ojha Campus. A cross sectional study. Internet J Nutr Wellness. 2013;12(1):1-6.

29. Mishra S, Manju M, Toora B, Mohan S, Venkatesh P. Comparison of bone mineral density and serum minerals in pre and postmenopausal women. Int. J. Clin. Trials. 2015;22(2):85-90.

30. Kumari P, Rao R, Dhiman B. Comparison of serum mineral levels in perimenopausal women with surgical menopausal women: Analytical cross sectional study. Int. J. Clin. Obstet. Gynaecol. 2020;4(4):324-6.

31. Lombardi G, Ziemann E, Banfi G, Corbetta S. Physical activity-dependent regulation of parathyroid hormone and calcium-phosphorous metabolism. Int J Mol Sci. 2020;21(15):5388:1-50.

32. Hejazi J, Davoodi A, Khosravi M, Sedaghat M, Abedi V, Hosseinverdi S, et al. Nutrition and osteoporosis prevention and treatment. Biomed Res Ther. 2020;7(4):3709-20.

33. Gil‐Montoya JA, Garrido‐Martínez, M, Barrios‐ Rodríguez R, Ramos‐García P, Lenouvel D, Montes‐Castillo C, et al. Association between low bone mineral density and periodontitis in generally healthy perimenopausal women. J Periodontol. 2021;92(1):95-103.

34. Kalita N, Choudhury BD. A cross sectional study evaluating the association of serum calcium, serum magnesium, and body mass index in premenopausal and postmenopausal women. Int J Res Med Sci. 2017;5(5):1953-8.

35. Bhattarai T, Bhattacharya K, Chaudhuri P, Sengupta P. Correlation of common biochemical markers for bone turnover, serum calcium, and alkaline phosphatase in postmenopausal women. Malays J Med Sci. 2014;21(1):58-61.

36. Usoro CAO, Onyeukwu CU, Nsonwu AC. Biochemical bone turnover markers in postmenopausal women in Calabar municipality. Asian J Biochem. 2007;2(2):130-5.

37. Koek WNH, Campos-Obando N, Eerden BCJ van der, Rijke YB de, Ikram MA, Uitterlinden AG, et al. Age-dependent sex differences in calcium and phosphate homeostasis. Endocr Connect. 2021;10(3):273-82.

38. Fazlini, MF, Suriah, AR, Zaitun Y, Kandiah M, Chee WSS, Chan YM. et al. Calcium supplementation amongst postmenopausal women: effect on serum calcium, phosphorus and magnesium level. Int Food Res J. 2013;20(1):477- 80.

39. Maggio, M., Ceda, G.P., Lauretani, F., Bandinelli, S., Corsi, A.M., Giallauria, F., et al. SHBG, Sex hormones, and inflammatory markers in older women. J Clin Endocrinol. Metab. 2011;96(4):1053-9.

40. Gaskins AJ, Wilchesky M, Mumford SL, Whitcomb BW, Browne RW, Wactawski-Wende J, et al. Endogenous reproductive hormones and C- reactive protein across the menstrual cycle: the BioCycle Study. Am J Epidemiol. 2012;175(5):423-31.

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