title: Smoking affects diagnostic salivary periodontal disease biomarker levels in adolescents.
abstract: BACKGROUND
  The effects of smoking on periodontal biomarkers in adolescents are unknown. This study investigates matrix metalloproteinase (MMP)-8 and polymorphonuclear leukocyte elastase levels in saliva together with periodontal health indices accounting for body mass index and smoking in a birth cohort from Finland.
  
  
  METHODS
  The oral health of boys (n = 258) and girls (n = 243) aged 15 to 16 years was examined clinically. Health habits were assessed by questionnaire. Saliva samples were collected and analyzed by immunofluorometric and peptide assays for MMP-8 levels and polymorphonuclear leukocyte elastase activities, and investigated statistically with the background factors.
  
  
  RESULTS
  Median MMP-8 values of male smokers were 112.03 microg/l compared to 176.89 microg/l of non-smokers (P = 0.05). For female smokers corresponding values were 170.88 microg/l versus 177.92 microg/l in non-smokers (not statistically significant). Elastase values in male smokers were 5.88 x 10(-3) Delta OD(405)/h versus 11.0 x 10(-3) Delta OD(405)/h in non-smokers (P = 0.02), and in female smokers 9.16 x 10(-3) Delta OD(405)/h versus 10.88 x 10(-3) Delta OD(405)/h in non-smokers (P = 0.72). The effect was strengthened by high pack-years of smoking (MMP-8, P = 0.04; elastase, P = 0.01). Both biomarkers increased with gingival bleeding. However, statistically significant associations were observed with bleeding on probing and MMP-8 (P = 0.04); MMP-8 was suggestively associated with probing depth (P = 0.09) in non-smoking boys. In smokers with calculus, MMP-8 increased after adjusting with body mass index (P = 0.03). No corresponding differences were seen in girls.
  
  
  CONCLUSIONS
  Smoking significantly decreased both biomarkers studied. Compared to girls, boys seem to have enhanced susceptibility for periodontitis as reflected in salivary MMP-8 values.
authors.affiliation: Kotka Health Centre and Network of Academic Health Centres, Kotka, Finland.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Heikkinen
authors.forename: Timo
authors.initials: T
authors.lastname: Sorsa
authors.forename: Janne
authors.initials: J
authors.lastname: Pitkäniemi
authors.forename: Taina
authors.initials: T
authors.lastname: Tervahartiala
authors.forename: Kirsti
authors.initials: K
authors.lastname: Kari
authors.forename: Ulla
authors.initials: U
authors.lastname: Broms
authors.forename: Markku
authors.initials: M
authors.lastname: Koskenvuo
authors.forename: Jukka H
authors.initials: JH
authors.lastname: Meurman
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000378:metabolism; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D019272:Leukocyte Elastase / Q000378:metabolism*; D008297:Male; D020784:Matrix Metalloproteinase 8 / Q000378:metabolism*; D010510:Periodontal Diseases / Q000201:enzymology*; D012044:Regression Analysis; D012463:Saliva / Q000201:enzymology*; D012737:Sex Factors; D012907:Smoking / Q000378:metabolism*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires
chemical_list: D015415:Biomarkers; D019272:Leukocyte Elastase; D020784:Matrix Metalloproteinase 8