BIOCHEMICAL INDICES OF ORAL FLUID AS MARKERS FOR THE FEATURES OF THE STRUCTURAL AND FUNCTIONAL STATE OF THE STOMATOGNATIC SYSTEM IN PERSONS WHO WERE BORN WITH MACROSOMIA
Authors: Garmash O.V. 
Published: June 2020

Two hundred sixty eight people in the Kharkiv and surrounding Provinces' population have been examined: one hundred sixty eight persons were born with macrosomia, and fifty persons were born with weight and height parameters that correspond to the norm. The macrosomic-at-birth persons were divided into groups, with allowance for the features of their intrauterine development.

The levels of total calcium, inorganic phosphorus, and alkaline phosphatase activity were determined in an unstimulated oral fluid.

In the macrosomic-at-birth persons, who did not show the symptoms of overweight at the time of birth (Subgroups 1 and 2), the high levels of calcium, phosphorus, and alkaline phosphatase have been revealed in the oral fluid over younger age periods, which may be a consequence of intrauterine hyperthyroidism. The high calcium levels may also be due to the exposure to the elevated concentrations of growth hormone, which stimulated bone growth, and which shifted the peak of jaw growth to a younger age. This is an explanation for the high prevalence of dentoalveolar abnormalities in children.

In such individuals, a significant increase in the activity of alkaline phosphatase and in the levels of phosphorus and calcium in the oral fluid is observed to occur with age, which is associated with the formation of dystrophic and inflammatory disorders of periodontal tissues with a predominance of the inflammatory component (periodontitis).

In the 4–11-year-old macrosomic-at-birth persons born with the signs of overweight (Subgroups 3 and 4), a decrease in the activity of alkaline phosphatase and in the levels of phosphorus and calcium in the oral fluid has been revealed, which provides evidence for a low level of bone mineralization in such individuals, obviously due to an intrauterine decrease in thyroid activity. This explains the formation of a higher percentage of dentoalveolar abnormalities and agrees well with the information about the high intensity of deciduous and permanent teeth caries.

In such individuals, the level of calcium in the oral fluid significantly increased in older age periods, which is consistent with information on the formation of dystrophic and inflammatory disorders of periodontal tissues in most of these individuals with a predominance of dystrophic component (periodontosis). Due to the modulation of the activity of the corresponding enzymes, an increase in the level of calcium is associated with hypercortisolemia and with the effect of cortisol on bone remodeling processes, and it is a consequence of the progression of metabolic inflammation.

Conclusions. Changes in the indices of phosphorus-calcium metabolism and in the activity of alkaline phosphatase in the oral fluid can be used as markers for the development of disorders of the stomatognathic system, for various variants of the course of dystrophic-inflammatory diseases of periodontal tissues, and for caries in individuals who were born with macrosomia, taking into account their various anthropometric parameters at birth.