Serum alkaline phosphatase: A potential marker in the progression of periodontal disease in cirrhosis patients

Objective: As a consequence of their liver dysfunction, cirrhotic patients have elevated levels of serum alkaline phosphatase (ALP). Increased ALP activity is seen in periodontal tissues during the progression of periodontitis. The present study was carried out to compare ALP levels in cirrhosis patients with and without periodontitis and to correlate ALP levels with the severity of periodontitis. Method and Materials: Both the test and control groups consisted of 30 liver cirrhosis patients with or without periodontitis. The parameters recorded were modified OHI-S Index, Gingival Index (GI), and clinical attachment level (CAL). All patients underwent standardized panoramic radiographs to assess alveolar bone height. The total serum ALP was determined with the kinetic method (R.A 50). Results: Alveolar bone loss (ABL) was 1.62 ± 0.32 mm in the test group and 0.28 ± 0.04 mm in the control group. Mean clinical attachment level (CAL) for the test group was greater than the control group: 2.34 ± 0.67 mm and 0.43 ± 0.14 mm, respectively. The mean serum alkaline phosphatase level in the test group was higher (39.94 ± 3.34) than the control group (29.42 ± 6.11) and the differences was statistically significant (P > .05). When comparison was made between age group (20 to 40 years and 41 to 60 years), the older age group liver cirrhosis patients exhibited significantly higher values for bone loss, clinical attachment level, and serum ALP level. Conclusion: There is strong positive correlation between periodontal breakdown and serum alkaline phosphatase level in liver cirrhosis patients. Keywords: liver cirrhosis, periodontitis, serum alkaline phosphatase