Alteration of Haemoglobin Value in Relation to Age, Sex and Dental Diseases- A Retrospective Correlation Study

 

Shreya. S¹, Dr. M.P. Brundha²

¹BDS-III year, Saveetha Dental College, Chennai

²Dept. Of General Medicine, Saveetha Dental College, Chennai

 

ABSTRACT:

AIM: To study the haemoglobin value in a dental Institution based population and to correlate the alterations in the value among people of various age group, sex and dental diseases.

MATERIALS AND METHODS: A total of 130 haemoglobin values were collected from the out patient population of Saveetha Dental College, Chennai, India for a period of 3months and analysed for the alterations in the value among people of various age group, sex and dental diseases.

BACKGROUND: With increasing age, people tend to develop more systemic diseases and oral health problems. Patients visiting dental clinics may have systemic medical condition and are on medication or without medication. Many of these systemic conditions have manifestations in the oral cavity, among which haemoglobin alterations serves to be the common condition affecting people of all age irrespective of male or female.

REASON: The alterations in the haemoglobin value is considered to be significant in any dental practice. There is little information regarding the relative frequency of these alterations and it's correlation with the age, sex and dental diseases among the Indian population.

 

 

 

INTRODUCTION:

Haemoglobin is the oxygen-carrying pigment and predominant protein in the red blood cells. Each hemoglobin molecule is made up of four heme groups surrounding a globin group(1). Heme contains iron and gives a red color to the molecule. Globin consists of two linked pairs of polypeptide chains(2). When red blood cells die, the hemoglobin within them is released and broken up: the iron in hemoglobin is salvaged, transported by a protein and used again in the production of new red blood cells, thus maintaining homeostasis(3). The amount of hemoglobin in whole blood is expressed in grams per decilitre (g/dl).

 

The normal Hb level for males is 14 to 18 g/dl; that for females is 12 to 16 g/dl(4). When the hemoglobin level is low, the patient has anaemia. An erythrocytosis is the consequence of too many red cells; this results in hemoglobin levels above normal.

 

When the patient does have symptoms from an abnormality in the hemoglobin level, the symptoms are often a nonspecific weakness or fatigue(5). The only finding on physical examination may be pallor; additional changes in the nail beds (such as spooning), glossitis (red tongue), or hepatosplenomegaly (enlarged liver or spleen) may give a clue to the etiology of the anemia(6). Symptoms are usually related to the level of hemoglobin, its abruptness of onset and its duration. So, it is essential to understand the significance of haemoglobin.

 

METHODOLOGY:

A total of 130 haemoglobin values were collected from the archives collected from the out patient population of Saveetha Dental College, Chennai, India for a period of 3months and analysed for the alterations in the value among people of various age group, sex and dental diseases. The study is then statistically analysed to correlate the obtained retrospective values of haemoglobin with the age, sex and dental diseases and thereby understand the significance of haemoglobin for a healthy living.

 

DATA ANALYSIS:

Age group	Total count	No of male	Average haemoglobin value	No of female	Average hemoglobin value	Mean hemoglobin value
15-25	13	8	12.8	5	11.8	12.3
26-35	43	25	12.2	18	11.2	11.7
36-45	28	12	11.8	16	10.6	11.2
46-55	22	9	11.2	13	9.4	10.3
56-65	18	12	10.6	6	8.2	9.4
66-75	6	3	10.4	3	7.6	9

 

 

Diagnosis	Male	Female	Total
Normal	28	19	47
Anemia	41	42	83

 

Dental disorders	Male	Female	Total
Generalized chronic gingivitis	41	36	77
Generalized chronic periodontitis	20	15	35
Localized chronic periodontitis	10	8	18

 

Dental disorders among people with anemia	Age in decades						Total
	15-25	26-35	36-45	46-55	56-65	66-75
Generalized chronic gingivitis	12	15	6	10	5	3	51
Generalized chronic periodontitis	-	9	6	4	3	-	22
Localized chronic periodontitis	-	-	5	3	2	-	10

 

 

STATISTICAL ANALYSIS:

1)       To correlate age and haemoglobin value

AGE GROUP	COUNT	MEAN HAEMOGLOBIN VALUE	TOTAL
15-45 years	84	11.7	95.7
46-75 years	46	9.5	55.5
Total	130	21.2	151.2

N= 130

(AiBj)e= (Ai* Bj)/ N

(84)e= (130 *95.7) / 130 =95.7

(46)e= (130*55.5) / 130 = 55.5

(11.7)e= (21.2 *95.7) / 130 =15.6

(9.5)e= (21.2 *55.5) / 130 = 9.05

 

OBSERVED (O)	EXPECTED(E)	(O-E) (O-E)	(O-E) (O-E)/N
84	95.7	136.89	1.053
46	55.5	90.25	0.693
11.7	15.6	15.21	0.117
9.5	9.05	0.25	0.001
		Total	1.864

 

 

2)       To correlate gender and haemoglobin value

GENDER	COUNT	AVERAGE HAEMOGLOBIN VALUE	TOTAL
MALE	69	11.6	80.6
FEMALE	61	10	71
TOTAL	130	21.6	151.6

N= 130

(AiBj)e= (Ai* Bj)/ N

(69)e= (130 *80.6) / 130 =80.6

(61)e= (130*71) / 130 = 71

(11.6)e= (21.6*80.6) / 130 = 13.4

(10)e= (21.6 *71) / 130 = 11.8

 

OBSERVED (O)	EXPECTED (E)	(O-E) (O-E)	(O-E) (O-E)/N
69	80.6	134.5	1.034
61	71	100.0	0.815
11.6	13.4	3.24	0.024
10	11.8	3.24	0.024
		Total	1.897

 

3)       To correlate dental diseases and haemoglobin value

DENTAL DISEASES	MALE COUNT	FEMALE COUNT	AVERAGE HAEMO-GLOBIN VALUE	TOTAL
Generalised chronic gingivitis	41	36	11.8	88.8
Generalised chronic periodontitis	20	15	11.2	46.2
Localised Chronic periodontitis	10	8	10.9	28.9
TOTAL	71	59	33.9	163.9

N= 83 (Among people with anaemia)

(AiBj)e= (Ai* Bj)/ N

(41)e= (71 *88.8) / 83=75.96

(20)e= (71*46.2) / 83= 39.5

(10)e= (71 *28.9) / 83 = 24.5

(36)e= (59 *88.8) / 83= 63.1

(15)e= (59 *46.2) / 83 =32.8

(8)e= (59*28.9) / 83= 20.5

(11.8)e= (33.9 *88.8) / 83 = 36.2

(11.2)e= (33.9*46.2) / 83 = 18.8

(10.9)e= (33.9*28.9) / 83= 11.8

 

RESULTS:

From Tables for (r-1) and (c-1) degrees of freedom,

Where, r = No. of Rows

c =No. of columns

Similarly, H0 indicates that there is no significant relation between age, sex and dental diseases

H1 indicates that there is significant relation between age, sex and dental diseases

 

(2-1)(2-1) = 1 d.f.

χ2tab= 3.84(At 0.05)

since, χ2cal>χ2tab

H1 is accepted

There is a significant relation betweenhaemoglobin value and its alterations among age, sex and dental diseases

 

DISCUSSION:

From the study conducted on the alteration of haemoglobin in relation to age, sex and dental diseases, it is been revealed that there exist a significant relationship between age, sex and dental diseases. A vast differences are found in the collected values which are even proved by statistical analysis. Among the 130 total sample count obtained, men count was 69 and female count was 61, among which there were 28 male with normal haemoglobin value and 41 males who were anaemic and on considering females, there were 19 females with normal haemoglobin value and 42 females presented with anaemia. This shows that anaemia is a common factor among both male and female but the female predilection was more when compared to age.

 

Considering the age group, people of age group 15-75 are included in the study, which suggests that as the age of the people increases, the haemoglobin value decreases. This proves that age and haemoglobin value is inversely proportionate to each other. As the age increases people are much prone to anaemia and related systemic disorders, which are due to increasing factor of smoking, alcoholism, stress, improper food intake which are pathological and other physiological factors including menopause, narrowing of bone marrow space resulting in reduced red blood cell count resulting in anaemia. Among dental disease, generalised chronic gingivitis, generalised chronic periodontitis and localised chronic periodontitis are commonly seen among people. All these possess a slight male prediction and found to prevail more in males which can be attributed to the increased smoking, alcohol consumption and other adverse habits leading to reduced haemoglobin count, while on the other hand, in females, the main reason is due to excessive menstrual bleeding which induces anaemia.

 

CONCLUSION:

The results obtained from the study includes,

1)       There exists a significant relationship between age, sex and dental diseases

2)       As the age increases, haemoglobin value decreases by 0.2% per decade, independent of other factors thereby causing anaemia

3)       Considering gender, female predilection is more than that of male

4)       Considering the dental diseases, males are found to be much prone to dental diseases such as generalised chronic gingivitis, generalised chronic periodontitis and localised chronic periodontitis

 

REFERENCES:

1.        Nissenson AR, Goodnough LT, RW. D.Anemia: not just an innocent bystander. Arch intern med 2003; 163(12):1400-4.

2.        Clevenger B, Prevalence of Anaemia. 2015; 70 suppl 1:20–8, e 6–8.

3.        Auerbach m. intravenous iron in the perioperative setting. am j hematol. 2014; 89(9):933.

4.        Dharmarajan TS, Avula S, Jayakrishnan l, Jospeh P, talamati j, ep. kmn. mild anemia increases the risk of falls in hospitalized older adults. 2005; 53(s94).

5.        Munsoor Mohammed Munsoor, mohammed omer gibreel, mubarak el saeed el :haemoglobin and age relation. 2008; 45(6)

6.        Karsani. Nutritional anemia amongpatients referred to hematology laboratories in port sudan city. clinical medicine journal, 2015; 1(2):38-42.

 

 

 

Accepted on 06.04.2017           © RJPT All right reserved