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Roy L, Mondal S, Bhattacharyya N, Ghosh R, Banerjee A, Singh S, Chattopadhyay A, Ahmed SA, Jassas RS, Al-Rooqi MM, Moussa Z, Althagafi II, Bhattacharya D, Bhattacharya K, Mallick AK, Pal SK. A spectroscopy based prototype for the noninvasive detection of diabetes from human saliva using nanohybrids acting as nanozyme. Sci Rep 2023; 13:17306. [PMID: 37828100 PMCID: PMC10570348 DOI: 10.1038/s41598-023-44011-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 10/03/2023] [Indexed: 10/14/2023] Open
Abstract
The recent prediction of diabetes to be a global pandemic invites a detection strategy preferably non-invasive, and bloodless to manage the disease and the associated complications. Here, we have synthesized chitosan polymer functionalized, organic-inorganic bio-compatible nano-hybrids of Mn3O4 nanoparticles, and characterized it by utilizing several optical methodologies for the structural characterization which shows the Michaelis Menten (MM) kinetics for glucose and alpha-amylase protein (well-known diabetes biomarkers). We have also studied the potentiality for the detection of alpha-amylase in human salivary secretion which is reported to be strongly correlated with uncontrolled hyperglycemia. Finally, we have developed a prototype for the measurement of glucose (LOD of 0.38 mg/dL, LOQ of 1.15 mg/dL) and HbA1c (LOD of 0.15% and LOQ of 0.45%) utilizing the basic knowledge in the study for the detection of uncontrolled hyperglycemia at the point-of-care. With the limited number of clinical trials, we have explored the potential of our work in combating the diabetic pandemic across the globe in near future.
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Affiliation(s)
- Lopamudra Roy
- Department of Applied Optics and Photonics, University of Calcutta, JD-2, Sector-III, Salt Lake, Kolkata, West Bengal, 700 106, India
| | - Susmita Mondal
- Department of Chemical and Biological Sciences, S. N. Bose National Centre for Basic Sciences, Kolkata, 700106, India
| | - Neha Bhattacharyya
- Department of Radio Physics and Electronics, University of Calcutta, Kolkata, 700009, India
| | - Ria Ghosh
- Department of Chemical and Biological Sciences, S. N. Bose National Centre for Basic Sciences, Kolkata, 700106, India
| | - Amrita Banerjee
- Department of Physics, Jadavpur University, 188, Raja Subodh Chandra Mallick Rd, Poddar Nagar, Jadavpur, Kolkata, West Bengal, 700032, India
| | - Soumendra Singh
- Department of Chemical and Biological Sciences, S. N. Bose National Centre for Basic Sciences, Kolkata, 700106, India
- Neo Care Inc, 27, Parker St, Dartmouth, NS, B2Y 2W1, Canada
- Electrical and Computer Engineering Department, Dalhousie University, 6299 South St, Halifax, NS, B3H 4R2, Canada
| | - Arpita Chattopadhyay
- Department of Basic Science and Humanities, Techno International New Town Block, DG 1/1, Action Area 1 New Town, Rajarhat, Kolkata, 700156, India
- Department of Physics, Sister Nivedita University, DG 1/2 New Town, Action Area 1, Kolkata, 700156, India
| | - Saleh A Ahmed
- Chemistry Department, Faculty of Applied Science, Umm Al-Qura University, 21955, Makkah, Saudi Arabia.
- Chemistry Department, Faculty of Science, Assiut University, Assiut, 71516, Egypt.
| | - Rabab S Jassas
- Department of Chemistry, Jamoum University College, Umm Al-Qura University, 21955, Makkah, Saudi Arabia
| | - Munirah M Al-Rooqi
- Chemistry Department, Faculty of Applied Science, Umm Al-Qura University, 21955, Makkah, Saudi Arabia
| | - Ziad Moussa
- Department of Chemistry, College of Science, United Arab Emirates University, P.O. Box 15551, Al Ain, Abu Dhabi, United Arab Emirates
| | - Ismail I Althagafi
- Chemistry Department, Faculty of Applied Science, Umm Al-Qura University, 21955, Makkah, Saudi Arabia
| | - Debasish Bhattacharya
- Department of Gynecology & Obstetrics, Nil Ratan Sircar Medical College & Hospital, 138, AJC Bose Road, Sealdah, Raja Bazar, Kolkata, 700014, India
| | - Kallol Bhattacharya
- Department of Applied Optics and Photonics, University of Calcutta, JD-2, Sector-III, Salt Lake, Kolkata, West Bengal, 700 106, India
| | - Asim Kumar Mallick
- Department of Pediatrics, Nil Ratan Sircar Medical College and Hospital, Kolkata, 700014, India
| | - Samir Kumar Pal
- Department of Chemical and Biological Sciences, S. N. Bose National Centre for Basic Sciences, Kolkata, 700106, India.
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Dhanarathna S, Jeddy N, Sabarinath B, Protyusha GB. Estimation and comparison of salivary flow rate and its composition in diabetic patients and nondiabetic patients: A pilot study. J Oral Maxillofac Pathol 2021; 25:232-238. [PMID: 34703115 PMCID: PMC8491333 DOI: 10.4103/0973-029x.325120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 05/18/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Diabetes mellitus (DM) is a chronic metabolic disorder characterized by hyperglycemia irregularities in the metabolism of carbohydrates, lipids and protein. It is often associated with the development of microvascular and macrovascular complications and neuropathies. The health of oral tissues is known to be related to the quality and quantity of saliva both of which may be altered in diabetes. Aim: The aim of the present study was to determine the salivary flow rate, electrolytes and total proteins in saliva of Type II diabetic patients. Materials and Methods: A total number of 120 participants were included in this study, in which 80 patients were suffering from Type II DM (which included both controlled and uncontrolled diabetes) and 40 nondiabetic persons (controls). The study population included both the genders, with an age range of 40–70 years. The study population was divided into three groups. Results: The values of total protein, sodium, potassium and salivary flow rate among controls, controlled diabetes and uncontrolled diabetes were collected, formulated and multiple comparisons between the groups using the analysis of variance and post hoc Tukey honestly significant difference analysis were done in version 16.0 of SPSS software. Conclusion: Studies with larger sample size are warranted to know the exact pathophysiology of controlled and uncontrolled Type II DM in terms of salivary flow rate, salivary electrolytes and total protein.
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Affiliation(s)
- S Dhanarathna
- Oral Pathologist, Thai Moogambigai Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Nadeem Jeddy
- Department of Oral Pathology and Microbiology, Thai Moogambigai Dental College and Hospital, Chennai, Tamil Nadu, India
| | - B Sabarinath
- Department of Oral Pathology and Microbiology, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
| | - G B Protyusha
- Department of Oral Pathology and Microbiology, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
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Bhattarai KR, Lee SW, Kim SH, Kim HR, Chae HJ. Ixeris dentata extract regulates salivary secretion through the activation of aquaporin-5 and prevents diabetes-induced xerostomia. J Exp Pharmacol 2017; 9:81-91. [PMID: 28814903 PMCID: PMC5546769 DOI: 10.2147/jep.s141807] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The aim of this study was to investigate the effects of Ixeris dentata (IXD) extract to improve the salivation rate in dry mouth induced by diabetes. Both control and diabetic rats were treated with a sublingual spray of either water or IXD extract to determine the effects of IXD on salivation. During the study, we observed that IXD extract treatment increased the salivary flow rate in diabetic rats. The expression of α-amylase was increased significantly in both saliva and glandular tissue lysates of IXD-treated diabetic rats. Aquaporin-5 protein expression was abnormally low in the salivary glands of diabetic rats, which increased hyposalivation and led to salivary dysfunction. However, a single oral spray of IXD extract drastically increased the expression of aquaporin-5 in salivary gland acinar and ductal cells in diabetic rats. Moreover, IXD extract induced expression of Na+/H+ exchangers in the salivary gland, which suggests that Na+/H+ exchangers modulate salivary secretions and aid in the fluid-secretion mechanism. Furthermore, transient treatment with IXD extract increased the intracellular calcium in human salivary gland cells. Taken together, these results suggest the potential value of an IXD extract for the treatment of diabetes-induced hyposalivation and xerostomia.
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Affiliation(s)
- Kashi Raj Bhattarai
- Department of Pharmacology and Institute of New Drug Development, School of Medicine, Chonbuk National University, Jeonju
| | - Sang-Won Lee
- Department of Herb Crop Resources, National Institute of Horticultural and Herbal Science, Rural Development Administration, Eumseong-gun
| | - Seung Hyun Kim
- College of Pharmacy, Yonsei Institute of Pharmaceutical Science, Yonsei University, Incheon
| | - Hyung-Ryong Kim
- Graduate School, Daegu Gyeongbuk Institute of Science and Technology, Daegu, Republic of Korea
| | - Han-Jung Chae
- Department of Pharmacology and Institute of New Drug Development, School of Medicine, Chonbuk National University, Jeonju
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Ladgotra A, Verma P, Raj SS. Estimation of Salivary and Serum Biomarkers in Diabetic and Non Diabetic Patients - A Comparative Study. J Clin Diagn Res 2016; 10:ZC56-61. [PMID: 27504412 DOI: 10.7860/jcdr/2016/19135.7995] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 04/21/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Blood is the gold standard body fluid for diagnosis of Diabetes Mellitus (DM) but saliva offers an alternative to serum as a biological fluid for diagnostic purposes because it contains serum constituents. AIM The study was conducted to estimate and compare serum and salivary glucose, amylase, proteins, calcium and phosphorus levels in DM and healthy subjects and to evaluate whether saliva can be used as a diagnostic fluid in DM patients. MATERIALS AND METHODS Study consisted of 120 subjects from OPD of Surendera Dental College, Sriganganagar, Rajasthan, India. The study groups were divided into Group I-60 DM patients (Type I & II) and Group II-60 healthy subjects. The saliva and serum samples were collected from each subject and levels of different biochemical parameters were estimated. RESULTS Mean serum level of glucose (211.50 ± 43.82), amylase (79.86 ± 16.23), total proteins (6.65 ± 0.84), calcium (7.17 ± 0.91) and phosphorus (3.68±0.65) as observed in Group I while in Group II, glucose (88.81±11.29), amylase (77.67±14.88), total proteins (6.35±0.76), calcium (7.52±0.97) and phosphorus (3.96 ± 0.91) were noted. Mean salivary level of glucose (14.10±6.99), amylase (1671.42±569.86), total proteins (1.33±1.11), calcium (10.06±2.76) and phosphorus (13.75±4.45) as observed in Group I while in Group II, glucose (5.87± 2.42), amylase (1397.59 ±415.97), total proteins (1.36±0.81), calcium (7.73±2.78) and phosphorus (8.39 ± 1.95) were noted. On comparing values in saliva and serum, among two groups, an insignificant difference (p>0.005) was found between few of them. CONCLUSION Values regarding blood and salivary biochemical parameters were distinctly different between two groups suggesting salivary parameters can be used as a diagnostic alternative to blood parameters for diabetes mellitus.
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Affiliation(s)
- Amit Ladgotra
- Post Graduate Student, Department of Oral Medicine and Radiology, Surendera Dental College & Research Institute , Sriganganagar, Rajasthan, India
| | - Pradhuman Verma
- Reader, Department of Oral Medicine and Radiology, Surendera Dental College & Research Institute , Sriganganagar, Rajasthan, India
| | - Seetharamaiah Sunder Raj
- Professor and Head, Department of Oral Medicine and Radiology, Surendera Dental College & Research Institute , Sriganganagar, Rajasthan, India
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Pereira LJ, Foureaux RC, Pereira CV, Alves MC, Campos CH, Rodrigues Garcia RCM, Andrade EF, Gonçalves TMSV. Oral physiology, nutrition and quality of life in diabetic patients associated or not with hypertension and beta-blockers therapy. J Oral Rehabil 2016; 43:511-8. [PMID: 27043215 DOI: 10.1111/joor.12398] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2016] [Indexed: 12/16/2022]
Abstract
The relationship between type 2 diabetes oral physiology, nutritional intake and quality of life has not been fully elucidated. We assessed the impact of type 2 diabetes - exclusive or associated with hypertension with beta-blockers treatment - on oral physiology, mastication, nutrition and quality of life. This cross-sectional study was performed with 78 complete dentate subjects (15 natural teeth and six masticatory units minimum; without removable or fixed prostheses), divided into three groups: diabetics (DM) (n = 20; 45·4 ± 9·5 years), diabetics with hypertension and receiving beta-blockers treatment (DMH) (n = 19; 41·1 ± 5·1 years) and controls (n = 39; 44·5 ± 11·7 years) matched for gender, age and socioeconomic status. Blood glucose, masticatory performance, swallowing threshold, taste, food intake, stimulated and unstimulated salivary flow, pH and buffering capacity of saliva were assessed. Glycemia was higher in DM than in controls (P < 0·01). No differences were observed between DM and controls for nutrition and quality of life. Both stimulated and unstimulated salivary flow rate were lower in DMH (P < 0·01), which also presented the lowest number of teeth and masticatory units (P < 0·0001), and reduction in the number of chewing cycles (P < 0·01). Controls showed lower Decayed Missing Filled Teeth index (DMFT) scores in comparison with DMH (P = 0·021). Masticatory performance and saliva buffering capacity were similar among groups. Exclusive type 2 diabetes did not alter oral physiology, nutrition or quality of life. However, when hypertension and beta-blockers treatment were associated with diabetes, the salivary flow rate, chewing cycles and number of teeth decreased.
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Affiliation(s)
- L J Pereira
- Department of Health Sciences, Federal University of Lavras, Lavras, Brazil
| | - R C Foureaux
- Department of Health Sciences, Federal University of Lavras, Lavras, Brazil
| | - C V Pereira
- Department of Dentistry, Lavras University Center, Lavras, Brazil
| | - M C Alves
- Department of Statistics, University of São Paulo - ESALQ, Piracicaba, Brazil
| | - C H Campos
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - R C M Rodrigues Garcia
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - E F Andrade
- Department of Veterinary Sciences, Federal University of Lavras, Lavras, Brazil
| | - T M S V Gonçalves
- Department of Odontology, Federal University of Santa Catarina, Florianópolis, Brazil
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Salivary function impairment in type 2 Diabetes patients associated with concentration and genetic polymorphisms of chromogranin A. Clin Oral Investig 2016; 20:2083-2095. [PMID: 26750135 DOI: 10.1007/s00784-015-1705-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 12/29/2015] [Indexed: 01/17/2023]
Abstract
OBJECTIVES The purpose of this study was to evaluate the effect of type 2 diabetes mellitus (T2DM) on salivary function impairments according to glycemic control status and subsequently compare the concentration of chromogranin A (CHGA) with its genetic profile. MATERIALS AND METHODS Thirty-six patients with controlled T2DM, 36 with poorly controlled T2DM, and 38 nondiabetic subjects underwent salivary flow rate measurements by means of unstimulated labial (ULS), unstimulated whole (UWS), and stimulated whole saliva (SWS) collections. CHGA concentrations were determined in saliva and plasma with ELISA, and two CHGA polymorphisms (T-415C and Glu264Asp) were analyzed by polymerase chain reaction-restriction fragment length polymorphism. RESULTS T2DM patients presented significantly lower ULS and UWS flow rates regardless of glycemic control status compared to controls (P = 0.002 and P = 0.027, respectively). The SWS flow rate in the poorly controlled T2DM was the lowest among the groups (P = 0.026). Significantly higher plasma and salivary CHGA levels were found in T2DM groups (P = 0.019 and P < 0.001, respectively). CHGA gene variants (T-415C and Glu264Asp) revealed significant differences between diabetics and control subjects when associated with lower salivary flow and higher salivary CHGA production (P < 0.05). CONCLUSIONS T2DM causes abnormalities in the function of salivary glands. However, poorly controlled T2DM has the most influence on SWS flow rates. Our findings indicate an association between plasma and salivary CHGA levels and T2DM patients. Furthermore, the results suggest that CGHA polymorphisms might be associated with salivary gland hypofunction and higher salivary CHGA production in T2DM patients. Nevertheless, further epidemiological studies are required to elucidate this clinical implication. CLINICAL RELEVANCE Salivary impairments and high levels of CHGA are associated with T2DM patients. In addition, CGHA polymorphisms might be associated with salivary gland hypofunction and higher salivary CHGA production in T2DM patients. This could be a significant insight to establish a role for salivary CHGA as a potential clinical biomarker to T2DM.
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Selected antibacterial factors in the saliva of diabetic patients. Arch Oral Biol 2014; 60:425-31. [PMID: 25531279 DOI: 10.1016/j.archoralbio.2014.07.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 06/03/2014] [Accepted: 07/17/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Diabetes mellitus leads to many systemic complications, including changes in the morphology, function of the salivary glands, and the composition of saliva. DESIGN The study comprised a randomly selected 156 adults, of both genders, aged from 21 to 79, out of which patients with diabetes type 1 and 2, and healthy subjects forming two control age- and gender matched to the ill subjects. In unstimulated mixed saliva, total protein, peroxidase, myeloperoxidase and immunoglobulin A were measured as well as salivary flow rate. The periodontal condition was assessed with the use of GI, mSBI and PSR index. The obtained data were analysed with the use of U Mann-Whitney's test, Spearman's rang correlation and Chi-square test at a significant level of p < 0.05 with use of Statistica 9.0 software. RESULTS Type 1 diabetics in comparison to healthy age and gender matched control group had a lower salivary flow rate (p < 0.01), a higher content of total protein (p < 0.01), myeloperoxidase (p < 0.001) and immunoglobulin A (p < 0.001). Similarly, type 2 diabetics in comparison to control subjects had a higher level of total protein concentration (p < 0.01), myeloperoxidase (p < 0.05) and immunoglobulin A (p < 0.001). We also found worse periodontal condition. CONCLUSION Within the limitation of the study it may be stated that diabetes type 1 and 2 can cause abnormalities in salivary glands function resulting in the diminishing of salivary flow rate and the increase in total protein content. Higher levels of myeloperoxidase and IgA in the saliva can be linked to worse periodontal condition in the diabetic patients.
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Kallapur B, Ramalingam K, Bastian, Mujib A, Sarkar A, Sethuraman S. Quantitative estimation of sodium, potassium and total protein in saliva of diabetic smokers and nonsmokers: A novel study. J Nat Sci Biol Med 2013; 4:341-5. [PMID: 24082729 PMCID: PMC3783777 DOI: 10.4103/0976-9668.117006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Aims: The aim of the study was to evaluate the difference in sodium, potassium, total protein in whole saliva in diabetic smokers, diabetic nonsmokers and healthy controls. Materials and Methods: Nonstimulated saliva samples were collected from a group of diabetic smokers, diabetic nonsmokers, and controls. Supernatant after centrifugation was used to determine the levels of sodium, potassium, and total protein by using semiautomatic analyzer. Results: There exists a statistical difference in the levels of potassium and total protein between diabetic smokers, nondiabetic smokers, and controls. Difference in the levels of sodium is only significant with nondiabetic smokers and controls. Conclusion: Diabetes mellitus is known to alter the composition of saliva. The purpose of this study was to estimate and compare the levels of salivary potassium, sodium, and total protein in smoker diabetic patients and nondiabetic smokers and controls, and to explore potential of salivary electrolytes [Na+, K+] and total proteins as markers. The estimated values of salivary constituents add to the data already recorded in Indian population. However, further studies using large samples are required to evaluate the findings in our study.
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Affiliation(s)
- Basavaraj Kallapur
- Department of Oral Pathology and Oral Biology, Al-jabal Al-gharbi University, Gharian, Libya
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Branco-de-Almeida LS, Alves CMC, Lopes FF, Pereira ADFV, Guerra RNM, Pereira ALA. Salivary IgA and periodontal treatment needs in diabetic patients. Braz Oral Res 2011; 25:550-5. [DOI: 10.1590/s1806-83242011000600013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2011] [Accepted: 09/14/2011] [Indexed: 11/21/2022] Open
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Shankaraia P, Reddy Y. α-amylase Expressions in Indian Type-2 Diabetic Patients. JOURNAL OF MEDICAL SCIENCES 2011. [DOI: 10.3923/jms.2011.280.284] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Piras M, Hand AR, Mednieks MI, Piludu M. Amylase and cyclic amp receptor protein expression in human diabetic parotid glands. J Oral Pathol Med 2010; 39:715-21. [DOI: 10.1111/j.1600-0714.2010.00898.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Panchbhai AS, Degwekar SS, Bhowte RR. Estimation of salivary glucose, salivary amylase, salivary total protein and salivary flow rate in diabetics in India. J Oral Sci 2010; 52:359-68. [DOI: 10.2334/josnusd.52.359] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Soell M, Hassan M, Miliauskaite A, Haïkel Y, Selimovic D. The oral cavity of elderly patients in diabetes. DIABETES & METABOLISM 2007; 33 Suppl 1:S10-8. [PMID: 17702095 DOI: 10.1016/s1262-3636(07)80053-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Diabetes mellitus is a common and growing global health problem leading to several complications. Among these periodontal diseases are considered as the sixth complication of diabetes mellitus. This article reviews the relationship between diabetes and oral health, particularly focusing on periodontal diseases, dental caries and xerostomia. There is a bidirectional interrelationship between diabetes and periodontal diseases. Periodontitis is more prevalent and severe in patients with diabetes than in normal population. Therapy of periodontal infection contributes to a positive glycaemic control management and enables reduction of the burden of complications of diabetes mellitus. Diabetics have an increased predisposition to the manifestation of oral diseases like candidiasis which is associated with poor glycaemic control and therapeutic dentures. This predisposition also contributes to xerostomia, which may be due to increased glucose levels in oral fluids or immune dysregulation.
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Affiliation(s)
- M Soell
- Department of Periodontology, Dental Faculty Strasbourg, Inserm U 595, Strasbourg, France
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Abstract
During the past decade, many salivary parameters have been used to characterize disease states. Ghrelin (GAH) is recently-discovered peptide hormone secreted mainly from the stomach but also produced in a number of other tissues including salivary glands. The aim of this work was to examine the relationship between active (aGAH) and inactive (dGAH) ghrelin in the saliva and other salivary parameters in type II diabetic patients and healthy controls. Salivary parameters were assessed in a single measurement of unstimulated whole saliva from 20 obese and 20 non-obese type II diabetes patients, and in 22 healthy controls. Total protein and alpha-amylase were determined by colorimetric methods, and glucose by the glucose-oxidase method. Saliva aGAH and dGAH levels were measured using a commercial radioimmunoassay (RIA) kit. Salivary concentrations of aGAH and dGAH ghrelin were more markedly decreased in obese diabetic subjects than in the two other groups. Glucose and alpha-amylase levels were higher in diabetic subjects than in controls. Furthermore, there were correlations between GAH levels and BMI, and between GAH and blood pressure. However, there was no marked variability in saliva flow rates among the groups. These results indicate that measurement of salivary GAH and its relationship to other salivary parameters might help to provide insight into the role of ghrelin in diabetes.
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Affiliation(s)
- Suleyman Aydin
- Department of Biochemistry and Clinical Biochemistry, Firat University, Medical School (Firat Medical Center), 23119 Elazig, Turkey.
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Abstract
The purpose of this study was to compare sIgA salivary concentrations between Caucasian and African-American postmenopausal women. The age, height, weight and history of hormone replacement therapy were recorded and the BMI was calculated for each individual. Whole, stimulated saliva was assayed for sIgA and total protein. Logistic regression analysis evaluated the relationships between the outcome variables. Total salivary sIgA and adjusted sIgA (adjusted for protein) concentrations were significantly higher in the African-American women (p<0.01). There were significant statistical correlations between sIgA concentrations and race (p<0.01). Our data suggest that racial differences in salivary sIgA concentrations in elderly women could be an important variable for planning future studies utilizing salivary samples as biological markers.
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Affiliation(s)
- Roger B Johnson
- Department of Periodontics, University of Mississippi Medical Center, 2500 North State Street, Jackson, Miss. 39216-4505, USA.
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Lin CC, Sun SS, Kao A, Lee CC. Impaired salivary function in patients with noninsulin-dependent diabetes mellitus with xerostomia. J Diabetes Complications 2002; 16:176-9. [PMID: 12039402 DOI: 10.1016/s1056-8727(01)00174-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
To test this hypothesis, salivary function was measured by quantitative salivary scintigraphy in noninsulin-dependent diabetes mellitus (NIDDM) patients, as well as in age- and sex-matched controls for comparison. Seventy-two patients with NIDDM history of over 10 years and 36 healthy age- and sex-matched controls were enrolled in the study. All of the 72 NIDDM patients had good blood sugar control. None presented with autonomic neuropathy. These 72 NIDDM patients were separated into two subgroups. Group 1: 36 patients with xerostomia and Group 2: 36 patients without xerostomia. After intravenous injection of 5mCi Tc-99m pertechnetate, sequential images at 1 min/frame were acquired for 30 min. The 1st and 15th minute uptake ratios (UR) were calculated from the tracer uptakes in the four major salivary glands over the background regions of interest. Saliva excretion was stimulated by one tablet of 200 mg ascorbic acid given orally 15-min postinjection of the tracer. Then, the maximal excretion ratios (ER) of the four major salivary glands after sialagogue stimulation were calculated. Significantly poorer salivary function was found, represented by significantly decreased UR and ER values, in 36 NIDDM patients with xerostomia, when compared with 36 NIDDM patients without xerostomia and 36 healthy controls, via objective and quantitative salivary scintigraphy. It has been speculated that impaired salivary function contributes to NIDDM with xerostomia. However, further studies with a larger series of NIDDM patients are necessary to confirm our findings.
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Affiliation(s)
- Cheng Chieh Lin
- Department of Family Medicine, China Medicine College Hospital, Taichung, Taiwan
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Chávez EM, Borrell LN, Taylor GW, Ship JA. A longitudinal analysis of salivary flow in control subjects and older adults with type 2 diabetes. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2001; 91:166-73. [PMID: 11174593 DOI: 10.1067/moe.2001.112054] [Citation(s) in RCA: 97] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Many diabetics complain of xerostomia, a condition that can affect oral health, nutritional status, and diet selection. This study's purposes were (1) to investigate the effect on salivary flow of type 2 diabetes and change in glycemic control in a group of older adults over time and (2) to compare flow rates with subjective complaints of xerostomia. STUDY DESIGN A total of 39 older adults, 24 with type 2 diabetes and 15 who were nondiabetic (controls), aged 54-90 years, participated in a 1-year follow-up study. Diabetic status was determined by means of glycosylated hemoglobin (HbA1c) levels and 2-hour glucose tolerance tests. Poor glycemic control was defined as HbA1c > 9%. Unstimulated whole, unstimulated parotid, and stimulated parotid saliva flow rates were measured for all subjects by a single examiner at baseline and 1 year later. Each subject completed a standardized xerostomia questionnaire at every visit. RESULTS Age, sex, and duration of diabetes did not adversely affect salivary flow rates. Subjects with poorly controlled diabetes had significantly lower stimulated parotid saliva flow rates at both visits. There were no significant changes in flow rates over time on the basis of diabetic status or glycemic control. Subjects with diabetes reported significantly more complaints of thirst but not of xerostomia at 1 year. CONCLUSIONS These results suggest that older adults with poorly controlled diabetes may have impaired salivary flow in comparison with subjects with better controlled diabetes and nondiabetic subjects, yet they may not have concomitant xerostomic complaints. There were no significant changes in salivary flow rates or glycemic control over the 1-year period.
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Affiliation(s)
- E M Chávez
- Department of Oral Medicine/Pathology/Oncology, University of Michigan School of Dentistry, Ann Arbor, USA
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Chavez EM, Taylor GW, Borrell LN, Ship JA. Salivary function and glycemic control in older persons with diabetes. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2000; 89:305-11. [PMID: 10710454 DOI: 10.1016/s1079-2104(00)70093-x] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE There is no consensus on the possible association between diabetes and salivary dysfunction in older persons with diabetes. This study's purpose was to investigate the effect of diabetes and glycemic control on salivary function in an older population. STUDY DESIGN Twenty nine persons with type 2 diabetes and 23 nondiabetic control subjects participated (age range, 54-90 years). Diabetic status was determined by a glycosylated hemoglobin (HbA(1c)) test and a 2-hour glucose tolerance test. Poor glycemic control was defined as HbA(1c) >9%. Unstimulated whole saliva, unstimulated parotid, and stimulated parotid flow rates were measured, and subjects completed a standardized xerostomia questionnaire. RESULTS Persons with poorly controlled diabetes had lower (P =.01) stimulated parotid flow rates than persons with well-controlled diabetes and nondiabetic control subjects. There were no significant differences in xerostomic complaints based on diabetic or glycemic control status or salivary flow rates. CONCLUSIONS These results provide some evidence that poorly controlled diabetes may be associated with salivary dysfunction in older adults who have no concomitant complaints of xerostomia.
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Affiliation(s)
- E M Chavez
- Department of Oral Medicine, Pathology, Oncology, School of Dentistry, University of Michigan, Ann Arbor, USA
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Dodds MW, Dodds AP. Effects of glycemic control on saliva flow rates and protein composition in non-insulin-dependent diabetes mellitus. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1997; 83:465-70. [PMID: 9127379 DOI: 10.1016/s1079-2104(97)90147-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The objective of this study was to determine whether improvements in the level of diabetic control in a group of subjects with poorly controlled non-insulin-dependent diabetes mellitus influence salivary output and composition. STUDY DESIGN Repeated whole unstimulated and stimulated parotid saliva samples were collected from diabetic patients attending an outpatient diabetes education program and a matched nondiabetic control group. Saliva was analyzed for flow rates, parotid protein concentration and composition, and amylase activity. Subjective responses to questions about salivary hypofunction were tested. RESULTS There were no significant differences in whole unstimulated and stimulated parotid flow rates or stimulated parotid protein concentration and composition between diabetics and the control group. Amylase activity was higher in diabetics and decreased with improved glycemic control. Subjects reporting taste alterations had higher mean blood glucose levels than subjects with normal taste sensation. CONCLUSIONS Poorly controlled non-insulin-dependent diabetes mellitus has no influence on saliva output, although amylase activity may be elevated, and there may be taste alterations.
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Affiliation(s)
- M W Dodds
- Department of Community Dentistry, University of Texas Health Science Center at San Antonio, USA
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