Detection of Cytomorphological Changes in Buccal Mucosal Cells of Type 2 Diabetic Patients Using Oral Exfoliative Cytology

Abstract

Abstract

Background:  Diabetes mellitus is an extremely common endocrine metabolic disorder that results in chronic hyperglycemia. It has effects on various tissues of the body. Due to this increased blood glucose levels considerable cellular changes occur in oral cavity as well. This field has attracted little research. The aim of the study was to analyze the changes in morphology and cytomorphometric measurements in the buccal mucosal cells of type 2 diabetic patients.

Objectives:  The Objective of this study was to detect the cytological and morphological alterations of oral epithelial cells, in type 2 diabetic patients and healthy control subjects in exfoliated cytology smears, to com-pare the cytoplasmic diameter, nuclear diameter, and nucleus: cytoplasm ratio in type 2 diabetics and heal-thy control subjects and to analyze the above mentioned cellular alterations in patients with controlled and uncontrolled diabetes.

Methods:  Cross-sectional analysis was performed in three groups on the bases of HbA1c levels. Group 1 was uncontrolled diabetics with HbA1C ≥ 7.0%, Gro-up 2 was well controlled diabetics with HbA1c ≤ 7.0% and Group 3 was Control healthy having HbA1C ≤ 5. 6%. Smears from normal buccal mucosa were obtai-ned from each subject and stained with Papanicolaou method. An eyepiece micrometer was used to take mean values of ND, CyD, and N: C ratio. Fifty (50) clearly defined cells were measured in each case in a step wise manner, to evade quantifying cells once more. Comparison of Nuclear Diameter (ND), Cytoplasmic Diameter (CY D) and ratio of two Diameters (N: C) among three groups was performed by using ANOVA. TUKEY’S test for post –hoc analysis was used where required.

Results:  The variability in diameter of nucleus among all three sample groups showed significant p-value < 0.001.Whereas the measurement for cytoplasmic diameter between three groups was not significant (p-value 0.178). The ratio of nuclear diameter to cytoplasmic diameter calculated was significant (p-value < 0.001). Hence it proved from the results that considerably exaggerated ND and N: C ratios were seen as the glycemic control (HbA1C) is poorer.

Conclusion:  The results suggested that nuclear size of buccal mucosal cells increased in type 2 diabetic pati-ents while no change was observed in cytoplasmic dimensions.