PURPOSE: The purpose of this observational study was to measure the prevalence of the presence of the anterior loop and to estimate sex and ethnicity-related variations in anterior loop length in the Malaysian population.
MATERIAL AND METHODS: A total of 100 cone beam computed tomography (CBCT) Digital Imaging and Communications in Medicine (DICOM) files were selected from a pool of 810 ongoing or completed patients in 3 different ethnic groups: Malay (33), Indian (33), and Chinese (34). The DICOM data were imported into commercial software. The IAN was traced with software along with the anterior loop and part of the incisive nerve. The vertical length of the nerve was estimated from the canal to the opening of the mental foramen from the cross-sectional view and translated to the panoramic view. Measurement was made from this point to the most anterior point of the anterior loop by following the trajectory of the nerve and was repeated on the opposite side. A 2-way mixed analysis of variance (ANOVA) test was carried out to evaluate the sex- and ethnicity-related variations (α=.05).
RESULTS: The anterior loop was present in 94% of the 100 participants. Overall anterior loop length (AnLL) ranged between 0.73 and 7.99 mm with a mean length of 3.69 ±1.75 mm on the left side and 3.85 ±1.73 mm on the right side. Among all participants, no statistically significant differences were found between the left and right sides of the mandible (P=.379). Overall, no significant main effect of ethnicity (P=.869) or sex (P=.576) was found on AnLL measurements. Also, with multiple comparisons, no significant effect was found between each pair of ethnic groups. Men in all 3 ethnic groups had greater AnLL than women.
CONCLUSIONS: The anterior loop was present in 94% of the 100 participants among the 3 major ethnic groups of Malaysia. Overall AnLL ranged between 0.73 and 7.99 mm and mean lengths of 3.69 ±1.75 mm on the left side and 3.85 ±1.73 mm on the right side, with no significant ethnicity- or sex-related variations.
Methods: A total of 150 CKD patients and 64 non-CKD patients were enrolled. The type 2 diabetic patients in the recruited study participants were categorised based on their glycaemic control; poor glycaemic control (GC) with haemoglobin A1c (HbA1c) > 7% and good GC with HbA1c ≤ 7%. The levels or activities of GPx, SOD and sRAGE in plasma were measured. These biochemical parameters were analysed using Mann-WhitneyUtest and two-way analysis of variance (ANOVA).
Results: The activities of GPx and SOD as well as plasma level of sRAGE were not significantly different among the CKD patients with varying glycaemic control status. Irrespective of diabetes status and glycaemic control status, CKD patients also exhibited lower plasma SOD activities compared with non-CKD patients. Among the non-CKD patients, SOD activities were significantly higher in diabetic patients with good GC than diabetic patients with poor GC. Two-way ANOVA revealed that both CKD status and glycaemic control had an interaction effect on SOD activities in diabetic subjects with and without CKD. Follow-up analysis showed that SOD activities were significantly higher in non-CKD patients with good GC. There were no overall significant differences in GPx activities among the study participants. Furthermore, plasma sRAGE levels were higher in diabetic patients with CKD than those without CKD, regardless of glycaemic control status. There were no interaction effects between CKD status and glycaemic control status on GPx and sRAGE. Instead, CKD status showed significant main effects on these parameters, indicating significant differences between diabetic subjects with CKD and diabetic subjects without CKD.
Conclusion: Glycaemic control did not quantitatively alter GPx, SOD and sRAGE in diabetic CKD patients. Despite the advantages of good glycaemic control, a well-controlled diabetes in CKD did not modulate the activities of enzymatic antioxidants and sRAGE levels, therefore may not be the primary mechanism to handle oxidative stress.