Markers of cytotoxicity and oxidative DNA damage in Diabesity: A new age illness

Abstract

Background: The oral mucous membrane is particularly sensitive to certain types of systemic disorders such as anemia, vitamin deficiencies, infectious diseases, hormonal disturbances and can be objectively reproduced through definite measurements using cytomorphometry.

Objectives: The objective of the study is to evaluate the quantitative and qualitative changes in cytological buccal smears of obese individuals with type II diabetes (Group 1 = 20), obese individuals without type II diabetes (Group 2 = 20), individuals with type II diabetes without obesity (Group 3 = 20) by comparing with controls (individuals without obesity and without type II diabetes) (Group 4 = 20).

Materials and methods: Buccal mucosal cells were scraped from study participants and were subjected to morphometric analysis (Magnus Pro software). Clinical history, hemoglobin A1c, heights and weights of participants were measured and consequently, their body mass index was calculated. Quantitative parameters (nuclear area, cytoplasmic area, nucleo-cytoplasmic ratio) and qualitative parameters (micronuclei [MN], nuclear budding, nuclear disintegration, apoptosis, necrosis) were assessed among the groups. The data were statistically interpreted using SPSS software version 20.0.

Results: There is an increase in nuclear diameter and nuclear: cytoplasmic ratio of Groups 1 and 3 relative to Group 2. The qualitative assessment revealed MN and nuclear disintegration in Group 1 and 3 individuals. In addition, other qualitative changes such as nuclear budding and apoptotic bodies were evident in patients with type II diabetes.

Conclusion: The aforementioned qualitative and quantitative parameters facilitate early diagnosis and identification of individuals at risk of developing new age systemic illnesses such as diabetes and obesity.

Keywords: Cytomorphometry; diabetes mellitus; obesity.

Figure 1

Cytosmears depicting various cytoplasmic and nuclear disintegrating features such as vacuolization, budding and micronuclei formation

Figure 2

Morphometric measurements of nuclear and cellular area in buccal cytosmears

Figure 3

(a) Distribution of HbA1c, WHR and BMI in study cases, (b) Correlation of HbA1c with nuclear budding, nuclear disintegration and apoptotic bodies, (c) Correlation of WHR with nuclear budding, nuclear disintegration and apoptotic bodies, (d) Correlation of BMI with nuclear budding, nuclear disintegration and apoptotic bodies. WHR: Waist-to-hip ratio, BMI: Body mass index, HbA1c: Glycated hemoglobin

Figure 4

(a) Positive correlation coefficient between N/C ratio and HbA1c, (b) Positive correlation coefficient between N/C ratio and WHR, (c) Positive correlation coefficient between N/C ratio and BMI. WHR: Waist-to-hip ratio, BMI: Body mass index, HbA1c: Glycated hemoglobin

Figure 5

Comparison of correlation coefficients and P values of NA, CA and N/C ratio in various study groups. (a) NA: Nuclear area, (b) CA: Cytoplasmic area

Figure 6

Synchronous pathophysiology of diabetes and obesity in bringing cytomorphometric changes