title: Determining the Effect of Gutkha on Serum Levels of Vitamin B12 and Folic Acid as Compared to Smoking among Chronic Periodontitis Subjects : A Cross-Sectional Study.
abstract: BACKGROUND
  Periodontitis, being a common inflammatory disease has a multifactorial origin , with smoking and gutkha as few of the causative entities. The role of smoking as a risk factor for periodontitis is been well documented in literature. Cigarette smoke also affects vitamin B12 and folic acid mechanisms. Nutritionally derived vitamin B12 occurs mainly as either hydroxycobalamin or deoxyadenosycobalmin. Folic acid is also heat sensitive and water soluble, closely linked to vitamin B12 in its metabolism. However, effect of smokeless tobacco in form of gutkha on serum levels of vitamin B12 and folic acid is yet to be explored.
  
  
  OBJECTIVE
  To estimate and correlate serum vitamin B12 (VB12) and folic acid (FA) levels among periodontally healthy subjects and Chronic Periodontitis (CP) subjects with habit of smoking and gutkha chewing.
  
  
  METHODS
  The study included 111 subjects ranging in age from 18 to 60 y. Participants were divided into four groups: 30 healthy subjects (Group I), 29 subjects with CP (Group II), 25 smokers with CP (Group III) and 27 gutkha chewers with CP (Group IV). Clinical parameters included pocket probing depth (PPD), clinical attachment level (CAL) & gingival index (GI) following which VB12 and FA levels were estimated through UV-spectrophotometry method and data was analysed using Statistical Package for Social Scientists software, Mann-Whitney U-test and Pearson correlation coefficient. p-values less than 0.05 were considered as significant. Results : Pairwise comparison by Mann-Whitney U-test showed an increase in the serum VB12 in Group IV when compared to Group I (p=0.01) and Group II (p=0.01). Although serum FA levels were found to be low in Group III (7.61 ug/ml) & Group IV (8.64 ug/ml), Group III was found to be statistically significant (P=0.046). The clinical parameters GI, PPD and CAL among the four groups of patients were also statistically significant (p < 0.05).
  
  
  CONCLUSIONS
  The study results suggested that among the patients with periodontal disease, serum VB12 levels are directly related while serum FA levels are inversely related to inflammation and tissue destruction in periodontium as occurred in Group IV.
authors: Head of Department, Department of Periodontics, P.M.N.M Dental College and Hospital , Bagalkot, Karnataka, India .
authors: Shivaraj
authors: S
authors: Warad
authors: Professor, Department of Periodontics, P.M.N.M Dental College and Hospital , Bagalkot, Karnataka, India .
authors: Nagaraj B
authors: NB
authors: Kalburgi
authors: Post-Graduate Student, Department of Periodontics, P.M.N.M Dental College and Hospital , Bagalkot, Karnataka, India .
authors: Madhur
authors: M
authors: Manak
authors: Professor, Department of Periodontics, P.M.N.M Dental College and Hospital , Bagalkot, Karnataka, India .
authors: Veena C
authors: VC
authors: Kalburgi
authors: Reader, Department of Periodontics, P.M.N.M Dental College and Hospital , Bagalkot, Karnataka, India .
authors: Arati C
authors: AC
authors: Koregol
authors: Reader, Department of Periodontics, P.M.N.M Dental College and Hospital , Bagalkot, Karnataka, India .
authors: Jyoti
authors: J
authors: Patanashetti
authors: Reader, Department of Periodontics, P.M.N.M Dental College and Hospital , Bagalkot, Karnataka, India .
authors: Subramaniam
authors: S
authors: Rao
authors: Senior Lecturer, Department of Periodontics, P.M.N.M Dental College and Hospital , Bagalkot, Karnataka, India .
authors: M Vijayalaxmi
authors: MV
authors: Kokatnur
keywords: Chronic periodontitis; Folic acid; Gutkha; Smoking; Vitamin B12
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