title: Nuclear morphometric and morphological analysis of exfoliated buccal and tongue dorsum cells in type-1 diabetic patients.
abstract: BACKGROUND
  Diabetes mellitus type 1 that results from immunologically mediated damage to the β-cells in the pancreas. Diabetes mellitus is characterized by recurrent or persistent hyperglycemia. Hyperglycemia can be associated with salivary gland dysfunction and alterations in the oral epithelial cells.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the qualitative and quantitative changes in buccal and tongue dorsum epithelial cells using an exfoliative cytology method in type 1 diabetic patients.
  
  
  METHODS
  We performed light microscopic analysis of the buccal and tongue dorsum smears in thirty type 1 diabetic patients and thirty healthy individuals. The oral smears were stained using Papanicolaou method for cytological examination and nuclear morphometric analysis. In each case, the mean nuclear area, perimeter, length, breadth, and roundness factor were evaluated in each smear using the image analysis software (Q Win, Leica™).
  
  
  RESULTS
  The nuclear area, length, breadth, and perimeters were significantly higher in the diabetic group from tongue dorsum smear than that of the control group (P < 0.05). In the cytological examination, karyorrhexis-karyolysis-karyopyknosis, binucleation, nuclear membrane irregularity, cytoplasmic polymorphism, perinuclear halo were observed in oral smears with type 1 diabetic patients. Binucleation (P = 0.002) and nuclear membrane irregularity (P = 0.024) were significantly more common in buccal smears of diabetic group. Furthermore, the sensitivity of buccal mucosa was significantly higher in the diabetic group (P = 0.006).
  
  
  CONCLUSIONS
  The light microscopic and nuclear morphometric study indicates that type 1 diabetes can produce morphological and nuclear morphometric changes in the oral mucosa that are noticeable with exfoliative cytology.
authors.affiliation: Department of Medical Biology, School of Medicine, Bulent Ecevit University, Zonguldak, Turkey.
authors.forename: Zehra Safi
authors.initials: ZS
authors.lastname: Oz
authors.affiliation: Department of Pathology, School of Medicine, Bulent Ecevit University, Zonguldak, Turkey.
authors.forename: Sibel
authors.initials: S
authors.lastname: Bektas
authors.affiliation: Department of Pediatrics, Sammas Vehbi Ekecik Women Health and Children Hospital, Aksaray, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Battal
authors.affiliation: Department of Endocrinology, School of Medicine, Ondokuz Mayıs University, Samsun, Turkey.
authors.forename: Hulusi
authors.initials: H
authors.lastname: Atmaca
authors.affiliation: Department of Pediatrics, School of Medicine, Sakarya University, Sakarya, Turkey.
authors.forename: Bahri
authors.initials: B
authors.lastname: Ermis
keywords: Nuclear morphometry; Papanicolaou stain; diabetes mellitus; exfoliative cytology; type 1 diabetes