Comparative Evaluation of Serum Homocysteine in Patients with Oral Submucous Fibrosis and Healthy Controls

Oral submucous fibrosis (OSMF) is a potentially malignant, persistent, and progressive condition that is closely linked with the use of areca nut. As the prevalence and malignant potential of OSMF continue to rise, it is urgently necessary to develop some reliable biomarkers of progression and prognostication.

The study was a case-control study based on 60 individuals: 30 individuals who had OSMF and 30 age and sex-appropriate healthy persons as controls. Histopathological grading and clinical staging were carried out according to the standardized criteria. Measurements of serum homocysteine were performed by the competitive chemiluminescent immunoassay. Statistical analysis of data was calculated based on SPSS version 20.0; contrasts were done by t-tests, F-tests, and one-way ANOVA.

Serum level of homocysteine in the OSMF patients was higher compared to that of the controls, with a mean of 37.02 (4.84 mmol/L; P < 0.01) in the OSMF group and 22.55 (2.52 mmol/L) in the controls. There was a significant elevation of homocysteine with the increasing clinical stages and grading of histopathological stages of OSMF.

Among OSMF patients, the clinical and histopathological severity of this disease is positively related to increased serum homocysteine. As part of prognostic biomarkers, homocysteine could be used in the early detection and management of progression of OSMF at a minimal cost and with minor invasiveness.