Cytomorphometric Analysis of Exfoliated Buccal Mucosal Cells and DNA Repair Proficiency in Peripheral Lymphocytes in Type 1 Diabetes Mellitus

The aim of this study was to analyze the cytomorphometric changes in the buccal mucosal smears and to correlate the cytomorphometric findings and glycosylated hemoglobin (HbA1c) in type 1 diabetic (T1D) patients. In addition, DNA repair proficiency in peripheral lymphocytes of T1D patients was evaluated. Smears from the clinically normal buccal mucosa of 46 healthy subjects as controls and randomly selected 45 T1D patients, were stained using the Papanicolaou method, and the mean values (μm(2)) of nuclear area (NA), cytoplasmic area (CA), and cytoplasmic: nucleus ratio (CNR) were obtained for each patient. DNA damage in diabetics and control subjects was tested on peripheral blood samples using an in vitro mutagen sensitivity assay. Statistical analysis included Student’s t-test, one-way ANOVA, and Pearson’s correlation test to correlate cytomorphometric changes with HbA1c levels in both T1D and healthy control groups. The mean NA and CA values were higher in T1D while the mean CNR was found to be higher in the healthy control group. Statistical significance between the two groups was found only for the mean NA (P < 0.001) and mean CNR values (P < 0.001). A significant correlation was seen between HbA1c and CNR in both the T1D group (P = 0.015) and the healthy control group (P = 0.02). Significant differences were noted between the T1D and control subjects with regard to the frequency of damaged cells and DNA repair proficiency (P < 0.05). Significant cytomorphometric alterations were detected in the buccal mucosal cells of diabetic patients, which may aid in the early detection of diabetes or predict the risk for future disease complications among T1D patients.