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Relationship Between Crevicular Aspartate Aminotransferase Levels and Periodontal Disease Progression
Author(s) -
Oringer Richard J.,
Howell T. Howard,
Nevins Marc L.,
Reasner David S.,
Davis Gordon H.,
Sekler Julio,
Fiorellini Joseph P.
Publication year - 2001
Publication title -
journal of periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.036
H-Index - 156
eISSN - 1943-3670
pISSN - 0022-3492
DOI - 10.1902/jop.2001.72.1.17
Subject(s) - medicine , gastroenterology , bleeding on probing , periodontal disease , periodontitis , clinical attachment loss , odds ratio
Background: Aspartate aminotransferase (AST), an enzyme released from necrotic cells, has been identified in gingival crevicular fluid (GCF), and elevated levels are associated with periodontal tissue destruction. The aim of this study was to examine the relationship between elevated GCF levels of AST and periodontal disease progression. Methods: Over a 12‐month period, 8 to 10 interproximal sites in 41 periodontitis subjects (PS) and 15 healthy subjects (HS) were monitored. Clinical measurements included relative attachment level (RAL), probing depth, and bleeding on probing (BOP). Semiquantitative levels of GCF AST (<800 µIU, ≥800 µIU, and ≥1,200 µIU) were determined using a chairside assay. At the 6‐and 12‐month visits, scaling and root planing and prophylaxis were performed in the PS and HS, respectively. Sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV) were calculated for 2 diagnostic criteria (AST ≥800 µIU, AST ≥1,200 µIU) utilizing 4 thresholds of disease progression as determined by 2 methods (absolute change in relative attachment level and cumulative sum [CUSUM]). Results: The percentage of sites exhibiting AST ≥800 µIU, AST ≥1,200 µIU, and BOP in the PS was significantly ( P <0.02) lower at 6 and 12 months compared to baseline. The use of crevicular AST activity to monitor periodontal disease progression was associated with many false‐positive results. Overall, low specificities, PPV, and odds ratios were demonstrated by the assay when using 2 diagnostic criteria and 4 thresholds of disease progression. The high NPV suggest that a negative AST test result was indicative of a periodontally stable site. Conclusions: These results demonstrate that elevated levels of AST were present at sites that did not subsequently exhibit disease progression. The high prevalence of AST‐positive sites due to gingival inflammation diminished the test's ability to discriminate between progressive and stable, but inflamed, sites. J Periodontol 2001;72:17‐24.