Gamma Glutamyl Transferase- A Link between Oxidative Stress and Periodontitis in Smokeless Tobacco Users and Non Users with Chronic Periodontitis

Abstract

Introduction: Long-term usage of tobacco related products are the potential generators of free radicals which alter the cellular antioxidant defense system. Changing the balance towards an increase in the pro-oxidants over the capacity of the antioxidants is defined as oxidative stress (OS), which leads to oxidative damage. Gamma-glutamyl transpeptidase/transferase (GGT), a liver function marker plays a key role in regulating cellular levels of the antioxidant molecule glutathione, hence is a critical enzyme in maintaining cellular redox homeostasis. Aim: To investigate and compare the level of GGT in smokeless tobacco users (STU) and non tobacco users (NTU) with chronic periodontitis (CP). Materials and Methods: The study comprises of 50 subjects with the age group 20-64 years categorized as smokeless STU with CP (n=25) and non tobacco users NTU with CP (n=25). 2 ml of blood from antecubital vein and 2 ml of unstimulated saliva was obtained and evaluated for GGT. Clinical parameters such as Plaque index (PI), Gingival Index (GI), Pocket probing depth (PD), Clinical attachment levels (CAL) were recorded. The statistical analysis was carried out using Chi-square test / Fisher’s exact probability test for the inter-group comparison of categorical variable. The statistical significance of inter-group difference in the continuous variables is tested using independent sample t test after confirming the underlying normality assumption. Results: Within the reference range, level of GGT was significantly higher in STU with CP than NTU with CP. Conclusion: Estimation of GGT levels being an easy, reliable and inexpensive test, can become an emerging tool for the diagnostic assessment of periodontal disease for early detection of OS suggesting its high scope to be recognized as a biomarker for OS damage and thereby establishing both oral and systemic health.