Association between Salivary Leptin Levels and Taste Perception in Children

Gustatory and olfactory shifts during pregnancy and the postpartum period: A systematic review and meta-analysis

Pregnancy is a transformative phase marked by significant behavioral and physiological changes. Substantial changes in pregnancy-related hormones are thought to induce changes in chemosensory perception, as often observed in non-human animals. However, empirical behavioral research on pregnancy-related olfactory or gustatory changes has not yet reached a consensus. This PROSPERO pre-registered systematic review and meta-analysis evaluated published data of olfactory and gustatory changes in pregnant individuals, across the three pregnancy trimesters and postpartum period. Our comprehensive search strategy identified 20 relevant studies, for inclusion in the meta-analysis. The meta-analysis revealed that pregnant individuals, regardless of trimester, performed significantly poorer in terms of odour identification, however, no difference was detected between non-pregnant controls and women postpartum. Additionally, pregnant women in the second and third trimester rated olfactory stimuli to be more intense. A slight decline in odour pleasantness ratings was observed amongst those in the second trimester. No major difference was observed between pregnant and non-pregnant subjects in terms of gustatory functions, except the first trimester appeared to be associated with increased pleasantness for the sweet taste. Post-hoc meta-regression analyses revealed that pregnancy stage was a significant predictor for observed effect size for odour intensity ratings, but not for odour identification scores. These findings provide valuable insights into the interplay between pregnancy and chemosensory perception, highlighting systematic physiological changes due to pregnancy. Healthcare providers can also utilize the knowledge of sensory shifts to better support pregnant women in making appropriate dietary choices, managing sense-related discomfort, and leading to potential sensory interventions. Overall, this research enhances our comprehension of sensory shifts during pregnancy, benefiting maternal health and pregnancy-related care.

“ESTIMATION OF SALIVARY LEPTIN LEVELS IN CHILDREN WITH EARLY CHILDHOOD CARIES – AN INTERVENTIONAL STUDY”

Background: Early childhood caries (ECC) is a pathologic condition of multifactorial nature. The diagnosis of the same has been limited to clinical and radiographic aids with very little significance to assess its inflammatory component. objectives: The present study aims to evaluate the role of leptin, an adipocytokine as a non-invasive inflammatory biomarker in ECC. Materials and Method: A total of 60 children between the age of (3-5) years were selected for the study. The study subjects were divided into three groups of 20 each including Group 1 as control, Group 2 with mild to moderate ECC and Group 3 with severe ECC. Saliva samples were taken from all subjects and collected again after 2 months following rehabilitative intervention. Levels of salivary leptin were determined using Enzyme-Linked Immunosorbent Assay (ELISA). Results: Levels of salivary leptin were significantly associated with severity of dental caries. The intragroup comparisons of pre and post treatment levels of salivary leptin showed significant reductions in both mild to moderate ECC and severe ECC groups following caries control. Inter group evaluation between mild to moderate ECC and severe ECC post treatment showed statistically significant decline of leptin levels in comparison to baseline values. Conclusion: There was a statistically significant decline in salivary leptin levels between the mild moderate and severe ECC group, after 2 months following caries control. Thus, leptin holds a potential to be recognized as a reliable future prognostic and diagnostic inflammatory marker in early childhood caries.

Tongue Leptin Decreases Oro-Sensory Perception of Dietary Fatty Acids

Leptin, an anorectic hormone, regulates food intake, energy expenditure and body weight. We assessed the implication of tongue leptin in the modulation of oro-sensory detection of dietary fatty acids in mice. The RT-PCR analysis showed that mRNA encoding leptin and leptin receptor (Ob-Rb) was expressed in mice taste bud cells (TBC). Confocal microscopic studies showed that the lipid sensor CD36 was co-expressed with leptin in mice TBC. Silencing of leptin or Ob-Rb mRNA in tongue papillae upregulated preference for a long-chain fatty acid (LCFA), i.e., linoleic acid (LA), in a two-bottle paradigm in mice. Furthermore, tongue leptin application decreased the preference for the LCFA. These results suggest that tongue leptin exerts an inhibitory action on fatty acid preference. In isolated mice TBC, leptin decreased LCFA-induced increases in free intracellular calcium concentrations, [Ca²⁺]i. Leptin and LCFA induced the phosphorylation of ERK1/2 and STAT-3 and there were no additive or opposite effects of the two agents on the degree of phosphorylation. However, leptin, but not the LCFA, induced phosphoinositide-3-kinase (PI-3-K)-dependent Akt phosphorylation in TBC. Furthermore, leptin induced hyperpolarization, whereas LCFA induced depolarization in TBC. Our study demonstrates that tongue leptin exerts an inhibitory action on oro-sensory detection of a dietary fatty acid by interfering with Ca²⁺ signaling and membrane potential in mice TBC.

Covid-19: Signs and symptoms related to the feeding behavior

COVID-19 reached pandemic level in March 2020 and the number of confirmed cases continued to increase worldwide. The clinical course of the disease has not yet been fully characterized, and some specific symptoms related to smell, taste, and feeding behavior require further examination. The present study aimed to assess the presence of symptoms related to the feeding behavior occurred during and/or after COVID-19 in adults residing in Portugal and to link them to disease severity using a multivariate approach. Data were collected from May to September 2020, through a questionnaire answered online containing questions about general and specific symptoms before, during and after COVID-19. 362 participants were included: 201 were symptomatic, being 15 hospitalized and 186 non-hospitalized. Cluster analysis grouped the symptomatic non-hospitalized participants as mild and severe cases. For these patients, the most frequent symptoms related to the feeding process were smell disorders in 40% and 62%, taste disorders in 37% and 60%, and dry mouth, in 23% and 48% of the mild and severe cases, respectively. Dry mouth was significantly associated with difficulty to swallow, pain during swallow, choking when eating or drinking, and preference for mushy/pasty foods (p < 0.01; Chi-squared test). Among the severe cases, the incidence of coughing during the meal (31%), difficulty (19%) and pain during swallow (17%), preference for mushy/pasty foods (10%) and choking when eating or drinking (6%) were clinically relevant and may indicate the presence of swallowing disorders. This group also showed a higher frequency of general symptoms, such as fever, headache, abdominal pain, tiredness, diarrhea, nausea, and shortness of breath (p < 0.05; Chi-squared test). Smell disorders, taste disorders and dry mouth were the most frequent symptoms related to the feeding behavior for both mild and severe cases. Dry mouth was significantly associated with swallowing difficulties and future research should investigate it as a frequent symptom and as a predictive of the presence of eating and swallowing disorders in COVID-19 cases.

Evaluation of Salivary Leptin Levels and Its Correlation with Class I, Class II, and Class III Facial Skeletal Pattern: A Prefatory Study

Objective The aim of this study was to assess and compare the salivary leptin hormone levels between different classes of facial skeletal pattern (Class I, II, and III).

Materials and Methods A sample of 62 patients were selected prior to the orthodontic treatment from a population that attended the International Islamic University Malaysia Specialist Orthodontic Clinic. Based on the lateral cephalometric analysis, the subjects were grouped into Class I, Class II, and Class III facial skeletal patterns, according to Eastman and Wits appraisal. Subsequently, unstimulated saliva samples were taken and purified to undergo leptin enzyme-linked immunosorbent assay analysis to determine the levels of leptin hormone. Statistical analysis using the Kruskal–Wallis test was used to analyze the data obtained.

Results The results showed that there was a significant difference between the levels of leptin hormone between Class I and Class II skeletal patterns and between Class I and Class III facial skeletal patterns. No statistical difference was noted between the levels of leptin of Class II and Class III facial skeletal patterns.

Conclusion Salivary leptin hormone levels are higher in patients with Class II and Class III facial skeletal patterns compared with Class I.

Salivary Protein Profile and Food Intake: A Dietary Pattern Analysis

Saliva research has gained interest due to its potential as a source of biomarkers. One of the factors inducing changes in saliva, in the short term, is food intake, and evidence exist about changes in salivary proteome induced by some food components. Since this topic of research is in its early stages, it was hypothesized that saliva protein composition could be associated with different levels of adherence to dietary patterns that contain higher amounts of plant products. The aim of the present study was to test this hypothesis, in adults, by comparing salivary protein electrophoretic profiles of individuals with different diet characteristics, particularly dietary patterns (DP) that exhibit different proportions of animal and plant-based products. Dietary habits were assessed in 122 adults (61 from each sex, with ages ranging from 20 to 59 years) using Food Frequency Questionnaires. To identify the dietary patterns, a principal component analysis was used. Individual's non-stimulated saliva was evaluated for flow rate, pH, protein concentration, α-amylase activity, and electrophoretic protein profiles. Seven dietary patterns (DP) were identified. Salivary amylase enzymatic activity was positively associated with animal-based and starchy foods DP, and with plant-based fatty foods without wine DP. At the same time, protein bands containing amylase and type S cystatins were positively associated with the cheese/yoghurt and wine DP. Our results support the association of salivary proteomics and different dietary patterns and highlight the need of considering food consumption habits in studies using saliva, since this is a factor associated with variations in the composition of this fluid.

Phosphatidylinositol-3 kinase mediates the sweet suppressive effect of leptin in mouse taste cells

Leptin is known to selectively suppress neural and taste cell responses to sweet compounds. The sweet suppressive effect of leptin is mediated by the leptin receptor Ob-Rb, and the ATP-gated K⁺ (K_ATP ) channel expressed in some sweet-sensitive, taste receptor family 1 member 3 (T1R3)-positive taste cells. However, the intracellular transduction pathway connecting Ob-Rb to K_ATP channel remains unknown. Here we report that phosphoinositide 3-kinase (PI3K) mediates leptin's suppression of sweet responses in T1R3-positive taste cells. In in situ taste cell recording, systemically administrated leptin suppressed taste cell responses to sucrose in T1R3-positive taste cells. Such leptin's suppression of sucrose responses was impaired by co-administration of PI3K inhibitors (wortmannin or LY294002). In contrast, co-administration of signal transducer and activator of transcription 3 inhibitor (Stattic) or Src homology region 2 domain-containing phosphatase-2 inhibitor (SHP099) had no effect on leptin's suppression of sucrose responses, although signal transducer and activator of transcription 3 and Src homology region 2 domain-containing phosphatase-2 were expressed in T1R3-positive taste cells. In peeled tongue epithelium, phosphatidylinositol (3,4,5)-trisphosphate production and phosphorylation of AKT by leptin were immunohistochemically detected in some T1R3-positive taste cells but not in glutamate decarboxylase 67-positive taste cells. Leptin-induced phosphatidylinositol (3,4,5)-trisphosphate production was suppressed by LY294002. Thus, leptin suppresses sweet responses of T1R3-positive taste cells by activation of Ob-Rb-PI3K-K_ATP channel pathway.

Eating behaviour in contrasting adiposity phenotypes: Monogenic obesity and congenital generalized lipodystrophy

Most known types of nonsyndromic monogenic obesity are caused by rare mutations in genes of the leptin-melanocortin pathway controlling appetite and adiposity. In contrast, congenital generalized lipodystrophy represents the most extreme form of leanness in humans caused by recessive mutations in four genes involved in phospholipid/triglyceride synthesis and lipid droplet/caveolae structure. In this disease, the inability to store triglyceride in adipocytes results in hypoleptinemia and ectopic hepatic and muscle fat accumulation leading to fatty liver, hypertriglyceridemia and severe insulin resistance. As a result of hypoleptinemia, patients with lipodystrophy show alterations in eating behaviour characterized by constant increased energy intake. As it occurs in obesity caused by genetic leptin deficiency, exogenous leptin rapidly reduces hunger scores in patients with congenital generalized lipodystrophy, with additional beneficial effects on glucose homeostasis and metabolic profile normalization. The melanocortin-4 receptor agonist setmelanotide has been used in the treatment of monogenic obesities. There is only one report on the effect of setmelanotide in a patient with partial lipodystrophy resulting in mild reductions in hunger scores, with no improvements in metabolic status. The assessment of contrasting phenotypes of obesity/leanness represents an adequate strategy to understand the pathophysiology and altered eating behaviour associated with adipose tissue excessive accumulation/paucity.

Consequences of Obesity on the Sense of Taste: Taste Buds as Treatment Targets?

Premature obesity-related mortality is caused by cardiovascular and pulmonary diseases, type 2 diabetes mellitus, physical disabilities, osteoarthritis, and certain types of cancer. Obesity is caused by a positive energy balance due to hyper-caloric nutrition, low physical activity, and energy expenditure. Overeating is partially driven by impaired homeostatic feedback of the peripheral energy status in obesity. However, food with its different qualities is a key driver for the reward driven hedonic feeding with tremendous consequences on calorie consumption. In addition to visual and olfactory cues, taste buds of the oral cavity process the earliest signals which affect the regulation of food intake, appetite and satiety. Therefore, taste buds may play a crucial role how food related signals are transmitted to the brain, particularly in priming the body for digestion during the cephalic phase. Indeed, obesity development is associated with a significant reduction in taste buds. Impaired taste bud sensitivity may play a causal role in the pathophysiology of obesity in children and adolescents. In addition, genetic variation in taste receptors has been linked to body weight regulation. This review discusses the importance of taste buds as contributing factors in the development of obesity and how obesity may affect the sense of taste, alterations in food preferences and eating behavior.

Preference for dietary fat: From detection to disease

Recent advances in the field of taste physiology have clarified the role of different basic taste modalities and their implications in health and disease and proposed emphatically that there might be a distinct cue for oro-sensory detection of dietary long-chain fatty acids (LCFAs). Hence, fat taste can be categorized as a taste modality. During mastication, LCFAs activate tongue lipid sensors like CD36 and GPR120 triggering identical signaling pathways as the basic taste qualities do; however, the physico-chemical perception of fat is not as distinct as sweet or bitter or other taste sensations. The question arises whether "fat taste" is a basic or "alimentary" taste. There is compelling evidence that fat-rich dietary intervention modulates fat taste perception where an increase or a decrease in lipid contents in the diet results, respectively, in downregulation or upregulation of fat taste sensitivity. Evidently, a decrease in oro-sensory detection of LCFAs leads to high fat intake and, consequently, to obesity. In this article, we discuss recent relevant advances made in the field of fat taste physiology with regard to dietary fat preference and lipid sensors that can be the target of anti-obesity strategies.

Late bedtime and dental caries incidence in Kuwaiti children: A longitudinal multilevel analysis

OBJECTIVE

Inadequate sleep contributes to several adverse systemic health outcomes due to hormonal and metabolic disorders. The purpose of this study was to determine the effect of bedtime on the development of dental caries and the relationship with salivary ghrelin and leptin in a prospective cohort study of Kuwaiti children.

METHODS

Data were collected from 5456 10-year-old children in 2012 and repeated in 2014. We selected children from 138 middle schools representing the six governorates of Kuwait. We derived data from oral examinations, self-reported sleep interviews, body and weight measurements, and chemical analysis of whole saliva samples. Leptin and ghrelin were determined by salivary assay in a subset of 744. Two separate analyses were performed. a) Using the entire longitudinal data set (n = 5456), multilevel random intercept analysis was conducted to assess the relationship between reported bedtime and dental caries. b) Using data from a subset of the original sample (n = 744), multiple linear regression analysis was conducted to determine the relationship between dental caries and salivary ghrelin and leptin. The outcome variable was the development of dental caries in children. The independent explanatory variables and confounders were bedtime, sleep duration, salivary ghrelin and leptin; confounders assessed were gingivitis, sex, age and governorate (school location).

RESULTS

With every additional hour past 8 pm for bedtime, there was a 20% increase in dental caries incidence over two years (B = 0.2, P = .01), adjusting for age, gender, gingivitis and governorate. There was a significant difference in the magnitude of dental caries between the six governorates of Kuwait. Lower levels of salivary leptin and higher levels of salivary ghrelin were associated with increased dental caries, and sleep duration was an effect modifier that negatively affected the relationship between leptin and dental caries (B = -0.09, P < .05) and positively affects the relationship between ghrelin and dental caries (B = 0.07, P < .05). Additionally, there was a significant clustering effect within schools in this cohort.

CONCLUSION

In a cohort study of Kuwaiti children, late bedtime was associated with increased dental caries incidence. Additionally, dental caries experience increased with higher levels of salivary ghrelin and lower levels of salivary leptin, and sleep duration mediates the relationship between these two biomarkers and dental caries.

Association between obesity and adipokines levels in saliva and gingival crevicular fluid: A systematic review and meta-analysis

AIM

This systematic review and meta-analysis aimed to compare adipokines' levels in gingival crevicular fluid (GCF) and saliva between individuals with obesity and individuals without obesity.

METHODS

Computerized searches were conducted in four electronic databases (PubMed, Medline via Ovid, Web of Science, and Scopus). Manual searches and a Google Scholar search, limiting the search to the first 100 hits, were also conducted. Two calibrated authors performed the study selection, data extraction, and quality assessment of included articles. The quality of the included articles was evaluated using the University of Adelaide Tool.

RESULTS

The electronic searches retrieved 929 titles/abstracts. Following the removal of duplicated references, 613 titles/abstracts were assessed. Thirty-four articles were included. Meta-analysis demonstrated that tumor necrosis factor-α (TNF-α) concentration in saliva was statistically increased in individuals with obesity compared with individuals without obesity (P < 0.05). By contrast, the meta-analysis showed no difference in the concentrations of resistin, adiponectin, leptin, ghrelin, and interleukin 6 in saliva and of resistin, adiponectin, leptin, interleukin 6, interleukin 8, tumor necrosis factor α, and plasminogen activator inhibitor 1 in GCF between individuals with and without obesity (P > 0.05).

CONCLUSIONS

Individuals with obesity presented higher levels of TNF-α in saliva than individuals without obesity. TNF-α in saliva sampling may be a helpful marker for obesity. For the other adipokines, no difference was observed, but the limited availability and heterogeneity of data do not allow us to assertively state whether changes of adipokines in GCF and saliva are associated with obesity.

Comparison of salivary proteome of children with different sensitivities for bitter and sweet tastes: association with body mass index

BACKGROUND/OBJECTIVES

Oral sensorial perception is a key aspect in food choices and knowing the mechanisms modulating such perception is of major importance in the context of child obesity, which is reaching high rates in Mediterranean countries. Salivary proteome has been linked to taste sensitivity in adults. The aim of this study was to search for differences in salivary proteomes of children with different bitter or sweet taste sensitivities and to assess if these potential differences are associated with their body mass index percentile (BMI percentile).

SUBJECTS/METHODS

387 children aged 8-9 years old were assessed for BMI percentile and classified according to their sensitivity to bitter and sweet tastes, according to their caffeine and sucrose detection thresholds, respectively. Saliva protein composition was compared among taste sensitivity groups, taking into account BMI percentile and gender, using gel-based proteomics approaches, coupled to mass spectrometry for protein identification.

RESULTS

Among the salivary proteins related to bitter taste sensitivity, higher levels of cystatins were observed in bitter-sensitive children, in the case of those of normal weight, and in bitter low-sensitive, in the case of overweight children. For sweetness, the relationship between saliva and taste perception was also dependent on BMI percentile, with several proteins (including salivary cystatins) differing between taste sensitivity groups, with disparities arising between normal-weight and overweight children. Cystatin isoforms A, B and SA were observed to be considerably increased in saliva from obese children.

CONCLUSIONS

Salivary proteome is related with sensitivities to bitter and sweet tastes in children, but the association is dependent on BMI percentile and gender.

Salivary fingerprint of simple obesity

BACKGROUND

The nature of a link between poor oral health and obesity is not fully understood. It is also unclear if saliva contributes to it and whether the properties of saliva change as a result of an increase in body mass or rather as a consequence of obesity-associated comorbidities. This pilot study was undertaken in an attempt to determine if salivary biomarkers can identify obesity per se.

METHODS

Whole mixed saliva was analysed for 16 soluble parameters covering 4 categories (inflammation, oxidative stress, endothelial dysfunction, adipokines). In the discovery group, 19 obese and 25 non-obese women matched for age, with similar hygiene habits, with no comorbidities and not taking any medication known to affect saliva secretion were analysed. In the validation group, a cohort of no-preselected 81 individuals (34 obese) were analysed.

RESULTS

Individuals with obesity had significantly higher salivary concentrations of several cytokines and adipokines, of which TNF-R1, serpin A12 and PAI-1 were identified as parameters discriminating between obese and non-obese subjects with the highest sensitivity and specificity.

CONCLUSIONS

Obesity per se leads to distinct changes in the concentration of several parameters in saliva. These findings may have diagnostic implications for distinguishing the effects of obesity and obesity-linked comorbidities on oral health.

A Review of Selected Studies That Determine the Physical and Chemical Properties of Saliva in the Field of Dental Treatment

Physiological whole saliva is a unique body fluid constantly washing the mucous membranes of the mouth, throat, and larynx. Saliva is a clear, slightly acidic mucinous-serous secretion, composed of various electrolytes, small organic substances, proteins, peptides, and polynucleotides. There are many ways to use saliva as a biological fluid (biofluid). The significant advantages of saliva as a unique diagnostic material are its availability and the noninvasive method of collection. The aim of this review is to emphasize the diagnostic value of saliva as a research material in the configuration of its structure and secretion disorders. The data were obtained using the MEDLINE (PubMed) search engine, as well as an additional manual search. The analysis covered 77 articles selected from a group of 1986 publications and initially qualified for devising. The results were evaluated and checked for the correctness of qualifying in accordance with inclusion and exclusion criteria. The diagnostic use of saliva has attracted the attention of many researchers due to its noninvasive nature and relative simplicity of collection. In addition, it should be noted that the determination of chemical and physical saliva parameters can be effectively performed in the patient's presence in the dental office.