Nuclear Abnormalities and Cytomorphometric Characteristics of Buccal Epithelial Cells Across Glycemic Categories and Periodontitis Stages: A Cross-Sectional Study

This study compared nuclear abnormalities and cytomorphometric characteristics of exfoliated buccal epithelial cells across clinical groups defined by glycemic status and periodontal stage. A total of 156 participants were allocated into seven groups based on glycemic status and periodontal condition: four groups with type 2 diabetes stratified by HbA1c level (<7% or ≥7%) and periodontitis stage (Stage I–II or Stage III–IV), two periodontitis groups without diabetes (Stage I–II or Stage III–IV), and a periodontally healthy reference group without diabetes. Exfoliated buccal cells were assessed for micronuclei, binucleated cells, perinuclear halos, inflammatory cell presence, nuclear area (NA), cytoplasmic area (CA), and nuclear-to-cytoplasmic (N/C) ratio. Data were analyzed using multivariable regression models adjusted for age group and sex. Significant adjusted differences were observed across the seven clinical groups for micronuclei, binucleated cells, inflammatory cell presence, NA, CA, and the N/C ratio. The highest micronucleus and binucleated cell counts were generally observed in the HbA1c ≥ 7% groups (p < 0.001). NA and the N/C ratio were higher in groups with diabetes than in groups without diabetes, with the highest values observed in the HbA1c ≥ 7% groups. Diabetes duration showed no consistent association with cytogenetic or morphometric parameters. Within the clinical groups examined, differences in buccal epithelial nuclear abnormalities and cytomorphometric measures were generally more consistent across glycemic categories than between periodontal stages within the same glycemic category.