Salivary profile in diabetic patients: biochemical and immunological evaluation

Correlational analysis between salivary and blood glucose levels in individuals with and without diabetes mellitus: a cross-sectional study

OBJECTIVE

To estimate the association of patient-related demographic, socioeconomic status, physical activity, stress, and dietary factors influencing the relationship between salivary and blood glucose levels in individuals with and without diabetes mellitus (DM).

METHOD

This cross-sectional study was conducted on 166 participants with and without DM. Saliva and blood were collected to estimate the glucose levels. Age, gender, occupation, socioeconomic and education level, BMI, hip to waist circumference, stress, dietary pattern, lifestyle, physical activity, family history of diabetes, and type of diabetes were recorded. The association of saliva to predict blood glucose levels was analysed using Spearman Rank Correlation and how these patient-related factors influence the correlation was estimated for future machine learning models. The difference in medians for various groups was calculated using the Mann-Whitney U Test or Kruskal Wallis Test.

RESULTS

Blood glucose level is not significantly correlated to salivary glucose level. However, a statistically significant difference in the median blood glucose levels for diabetic participants (median = 137) compared to healthy controls (p-value < .05) was noted. The correlation between blood and salivary glucose was more positive for higher levels of glucose (Spearman 0.4). Age, alcohol consumption, monthly wages, intake of vegetables, and socioeconomic status affect blood glucose levels.

CONCLUSION

A correlation between saliva and blood glucose levels in healthy individuals was weak. Saliva should only be used as a monitoring tool rather than a diagnostic tool and is more reliable for patients with poorly controlled diabetes mellitus.

Type 1 diabetes, glycemic traits, and risk of dental caries: a Mendelian randomization study

Background: Regarding past epidemiological studies, there has been disagreement over whether type 1 diabetes (T1DM) is one of the risk factors for dental caries. The purpose of this study was to determine the causative links between genetic susceptibility to T1DM, glycemic traits, and the risk of dental caries using Mendelian randomization (MR) approaches. Methods: Summary-level data were collected on genome-wide association studies (GWAS) of T1DM, fasting glucose (FG), glycated hemoglobin (HbA1c), fasting insulin (FI), and dental caries. MR was performed using the inverse-variance weighting (IVW) method, and sensitivity analyses were conducted using the MR-Egger method, weighted median, weighted mode, replication cohort, and multivariable MR conditioning on potential mediators. Results: The risk of dental caries increased as a result of genetic susceptibility to T1DM [odds ratio (OR) = 1.044; 95% confidence interval (CI) = 1.015-1.074; p = 0.003], with consistent findings in the replication cohort. The relationship between T1DM and dental caries was stable when adjusted for BMI, smoking, alcohol intake, and type 2 diabetes (T2DM) in multivariable MR. However, no significant correlations between the risk of dental caries and FG, HbA1c, or FI were found. Conclusion: These results indicate that T1DM has causal involvement in the genesis of dental caries. Therefore, periodic reinforcement of oral hygiene instructions must be added to the management and early multidisciplinary intervention of T1DM patients, especially among adolescents and teenagers, who are more susceptible to T1DM.

Salivary Aspartate Aminotransferase, Alanine Aminotransferase and IgA as biomarkers for Type I Diabetes Mellitus: A Systematic Review

Introduction:

Type I diabetes mellitus (T1DM) is an autoimmune disorder characterized by absolute insulin deficiency, which is caused by progressive destruction of the β-islet cells of the pancreas. Aminotransferases participate in the interconversion of amino acids and oxalic acids by transfer of amino groups. Organ damage leads to leakage of transaminases into the blood. IgA is the only immunoglobulin that is found in saliva and forms the first line of defense. Alteration in the levels of secretory IgA often indicates a local or systemic disease. The aim of this systematic review is to evaluate the role of salivary aspartate aminotransferase (AST), alanine aminotransferase (ALT), and IgA as biomarkers for T1DM patients.

Materials and Methods:

An electronic literature search was conducted by two independent reviewers using PubMed, Medline and Google scholar without any date filter. The inclusion criteria included case control and cross-sectional studies. Publications in languages other than English, review articles, letters to the editor, and studies done on animal models were excluded from the review. The difference in the levels of salivary AST, ALT, or IgA in T1DM patients and in healthy individuals were compared. Risk of bias assessment was done using the ROBINS-I tool.

Results:

A total of eight relevant articles were assessed, out of which three studies showed elevated salivary AST and ALT levels and five studies showed elevated salivary IgA levels in patients with T1DM.

Conclusion:

Our review reflected that salivary AST, ALT, and IgA were elevated in T1DM patients, and they can be used for monitoring these patients. Further studies are needed to establish the diagnostic accuracy of these parameters for clinical application.

Assessment of redox state and biochemical parameters of salivary glands in streptozotocin-induced diabetic male rats treated with mate tea (Ilex paraguariensis)

OBJECTIVE

The study aimed to assess the effects of mate tea [Ilex paraguariensis] on the redox state and biochemical parameters of salivary glands in diabetic male rats.

DESIGN

Twenty-four male Wistar rats (3 months old) were randomly divided into groups (n = 8 per group): control rats that received water (C); diabetic rats that received water (D); diabetic rats treated with mate tea (DMT). The treated streptozotocin-induced diabetic rats were given mate tea powder by intragastric gavage at a dose of 20 mg/kg daily for 28 days. Content of total protein, amylase, oxidative lipid damage, measured as thiobarbituric acid reactive substances (TBARs), oxidative protein damage, measured as protein carbonyl, total antioxidant capacity, uric acid, reduced glutathione (GSH), superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) were examined by the spectrophotometric method in the parotid and submandibular glands.

RESULTS

The D group showed lower total protein, amylase, TBARs, protein carbonyl, total antioxidant capacity, GSH, uric acid, and GPx than the C group in both salivary glands, as well as higher SOD and CAT activities. The DMT group showed higher total protein, amylase, total antioxidant capacity, GSH, uric acid, and GPx than the D group in both salivary glands. Moreover, mate tea increased SOD in the parotid gland and CAT in the submandibular gland of diabetic rats but did not influence TBARs and protein carbonyl in either salivary gland compared to D group.

CONCLUSION

Mate tea increased tissue protein synthesis and improved antioxidant defenses in the salivary glands of streptozotocin-induced diabetic male rats.

Implication of Salivary Biochemical Parameters for Diagnosis and Prognosis of Type 2 Diabetes Mellitus

Background. Clinical laboratory diagnosis and prognosis for diabetes mellitus is performed using blood as a major specimen; however, saliva may represent as an alternative noninvasive specimen of choice. This study aims to evaluate salivary biochemical parameters in diabetic and healthy individuals to substantiate saliva’s role in the diagnosis and prognosis of type 2 diabetes mellitus (T2DM). Methods. This case-control study included 150 T2DM patients and 150 apparently healthy individuals. Socio-demographic data and anthropometric measurements were recorded using a standard questionnaire. Correlation between salivary and blood levels for each parameter was determined using Pearson correlation. Linear regression was performed to estimate the blood levels of the parameters from their salivary levels. Receiver operating characteristics (ROC) analysis was done to determine the diagnostic ability of salivary glucose and establish a sensitivity, specificity, and cut-off value. Results. Salivary glucose, TC, LDL-C, urea, and creatinine were significantly higher in people with diabetes than in the control population ( $p<0.05$ ). A significant positive correlation was found between salivary and blood parameters including glucose, TC, TG, LDL-C, urea, and creatinine except for HDL-C in both case and control groups. The linear relationship for each parameter, except glucose in case population and HDL-C in case, control, and the total population was observed between blood and saliva. ROC analysis gave a cut-off value of 1.9 mg/dl for salivary glucose with 71.4% sensitivity and 72.3% specificity. Conclusion. Salivary estimation significantly reflects the blood parameters in this study, indicating that saliva can be a noninvasive specimen for the diagnosis and prognosis of T2DM.

Changes in salivary biomarkers associated with periodontitis and diabetic neuropathy in individuals with type 1 diabetes

The objective of this pilot clinical study was to identify salivary biomarkers that are associated with periodontal disease and measures of diabetic autonomic dysfunction. Saliva samples from 32 participants were obtained from 3 groups: healthy (H), type 1 diabetes mellitus (DM), and type 1 diabetes mellitus with neuropathy (DMN). Based on the periodontal examination, individuals’ mean Periodontal Screening and Recording scores were categorized into two groups (periodontally healthy and gingivitis), and correlated to specific salivary inflammatory biomarkers assessed by a customized protein array and enzyme assay. The mean salivary IgA level in DM was 9211.5 ± 4776.4 pg/ml, which was significantly lower than H (17,182.2 ± 8899.3 pg/ml). IgA in DMN with healthy periodontium was significantly lower (5905.5 ± 3124.8 pg/ml) compared to H, although IgA levels in DMN patients with gingivitis (16,894. 6 ± 7084.3) were not. According to the result of a logistic regression model, IgA and periodontal condition were the indicators of the binary response given by H versus DM, and H versus DMN, respectively. These data suggest that selected salivary biomarkers, such as IgA, combined with a periodontal examination prior to obtaining salivary samples can offer a non-invasive method to assess risk for developing diabetic neuropathy.

Novel antibody assessment method for microbial compositional alteration in the oral cavity

Recently, it has been demonstrated that dysbiosis, an alteration in commensal microflora composition, is intimately involved in the onset of a variety of diseases. It is becoming increasingly evident that the composition of commensal microflora in the oral cavity is closely connected to oral diseases, such as periodontal disease, and systemic diseases, such as inflammatory bowel disease. Next-generation sequencing techniques are used as a method to examine changes in bacterial flora, but additional analytical methods to assess bacterial flora are needed to understand bacterial activity in more detail. In addition, the oral environment is unique because of the role of secretory antibodies contained in saliva in the formation of bacterial flora. The present study aimed to develop a new method for evaluating the compositional change of microbiota using flow cytometry (FCM) with specific antibodies against the bacterial surface antigen, as well as salivary antibodies. Using specific antibodies against Streptococcus mutans, a causative agent of dental caries, and human IgA, bacterial samples from human saliva were analyzed via FCM. The results showed that different profiles could be obtained depending on the oral hygiene status of the subjects. These results suggest that changes in the amount and type of antibodies that bind to oral bacteria may be an indicator for evaluating abnormalities in the oral flora. Therefore, the protocol established in this report could be applied as an evaluation method for alterations in the oral microbiota.

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We aimed to develop a new method for evaluating dysbiosis using flow cytometry.

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We used bacterial surface antigen-specific antibodies and salivary antibodies.

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Different profiles could be obtained depending on oral hygiene status.

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Changes in antibodies bound to oral bacteria may indicate oral flora abnormalities.

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Our method can be used to evaluate alterations in the oral microbiota.

Salivary parameters of adults with diabetes mellitus: a systematic review and meta-analysis

OBJECTIVE

Among the oral manifestations of diabetes mellitus (DM), salivary alterations stand out when considering that they can be linked to environmental changes that prompt other oral diseases. This study aimed to compare whether salivary parameters such as salivary flow, ionic composition, pH, and buffer capacity are altered in adults with DM.

STUDY DESIGN

A literature search was performed in 8 databases and the gray literature. Observational and clinical studies with populations >30 years old were included. The methodological quality of individual studies was assessed, 7 meta-analyses were performed, and the certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations approach (protocol registered at PROSPERO-CRD42021214632).

RESULTS

Of the 5,816 titles retrieved, 22 observational studies were included, representing a total of 1,202 individuals with DM and 946 normoglycemic control subjects. Individuals with DM had significantly lower unstimulated (mean difference [Md] = 0.13 mL/min; CI = 0.06-0.2; P = .0005) and stimulated (Md = 0.44 mL/min; CI = 0.13-0.75; P = .005) salivary flow rates, a lower pH when evaluated with electrodes (Md = 0.45; CI = 0.19-0.71; P = .0007), and a higher salivary urea (standard Md = 1.52; CI = 0.19-2.85; P = .03). No significant differences were found in the other parameters.

CONCLUSIONS

Although the certainty of evidence was low because of the type of studies included, this review indicated salivary alterations in individuals with DM, such as hyposalivation, pH, and urea concentration.

Preparation of substrates for microarray protein chips with different ending functional groups

Protein microarray chips are composed of three components, these are pre-treatment substrates, surface chemical modification, and immobilizing protein on substrate surfaces. In this study, self-assembly monolayers are used for surface chemical modification. Using this method, silanization on a glass and silicon chip is achieved, forming the terminal group substrates. Modification of the substrate surface to provide COOH and NH₂ terminal functional groups provides a mechanism to proteins to immobilize on the substrate surface. To observe immobilized proteins on the substrate surface, they are first labeled with Cy5 fluorescent dye before analysis using a GenePix 4000B Microarray Scanner. The scanner induces fluorescence in the labelling dye and the resulting light is analyzed to provide information concerning both the quantity of immobilized protein, and the orientation of attachment. The antigen of the HSV-1 virus, a common human virus, was used in this study, performing an antigen-antibody analysis to determine the efficacy of the method under test for clinical diagnosis.

Impact of the Glycemic Level on the Salivary Proteome of Middle-Aged and Elderly People With Type 2 Diabetes Mellitus: An Observational Study

Type 2 diabetes mellitus (T2DM) is an increasing global public health concern, but its impact on the salivary proteome is still unclear. To evaluate the effect of glycemic levels in middle-aged and elderly individuals with T2DM on salivary proteomics, we compared the differences by liquid chromatography tandem mass spectrometry (LC–MS/MS). Unstimulated whole saliva samples from 8 T2DM patients with good glycemic control (G group, HbA1c <6.5%) and 16 patients with poor control (P group, HbA1c ≥6.5%) were analyzed by LC–MS/MS in the data-independent acquisition mode (Clinical register number: ChiCTR1900023582.). After functional annotation, cluster analysis and receiver operating characteristic (ROC) curve analysis were carried out to screen and evaluate candidate proteins. A total of 5,721 proteins were quantified, while 40 proteins differed significantly. In the P group, proteins involved in oxidative stress-related processes were upregulated, whereas proteins related to salivary secretion were downregulated. The combination of thioredoxin domain-containing protein 17, zymogen granule protein 16B, and FAM3 metabolism regulating signaling molecule D yielded an area under the curve of 0.917 which showed a robust ability to distinguish the P and G groups. In conclusion, poorly controlled hyperglycemia may affect salivary proteins through various pathways, including oxidative stress and glandular secretion. Furthermore, the differentially expressed proteins, especially the three proteins with the best differentiation, might serve as an anchor point for the further study of hyperglycemia and oral diseases.

The potential of salivary biomarkers of nutritional status and dietary intake: A Systematic Review

OBJECTIVES

To explore whether nutritional salivary biomarkers could be used to aid nutritional status assessment and/or support traditional dietary assessment methods for patients.

DATA AND SOURCES

Searches were performed using four electronic databases; MEDLINE, EMBASE, Scopus and Web of Science. Trial registers (i.e. Cochrane), grey literature and reference lists were searched.

STUDY SELECTION

Studies which measured nutritional salivary biomarkers related to nutritional status and/or dietary intake outcome were included. No restrictions on participants' age, study design, publication date, setting or health status. Animal studies, non-English language studies, commentaries, and conference abstracts were excluded.

RESULTS

Study titles and abstracts were screened (n = 7982), full-texts assessed (n = 176) and 85 studies were included in a narrative synthesis. The most promising salivary biomarkers for nutritional status included: glucose, where saliva and serum levels were positively correlated in those with type 2 diabetes (T2D), higher salivary calcium levels in post-menopausal women in general and specifically those with lower bone mineral density (BMD), and salivary vitamin D to assess vitamin D status in healthy volunteers. Higher salivary total antioxidant capacity (TAC), nitrate/nitrite and fluoride were observed with increased antioxidant, nitrate/nitrite and fluoride dietary intake, respectively. A meta-analysis found significantly higher mean salivary glucose (n = 12) in T2D compared with healthy controls, but there was substantial heterogeneity (I²=94%) and evidence of publication bias.

CONCLUSIONS

The most promising salivary biomarkers identified in this systematic review were, glucose, vitamin D, calcium, TAC, nitrate/nitrite and fluoride. However, this was based on a small number of studies of varying quality, with many lacking a salivary assay performance assessment.

CLINICAL SIGNIFICANCE

At present, nutritional salivary biomarkers cannot be used alone to assess nutritional status or dietary intake. Further research into the most promising nutritional salivary biomarkers is required.

Salivary gland proteins alterations in the diabetic milieu

Salivary glands are considered the chief exocrine glands of the mouth and physiologically contribute to the maintenance of the homeostasis of the oral cavity. They consist of the parotid, submandibular and sublingual glands, which come in pairs and are collectively called the major glands, and the minor glands, which are much smaller and are dispersed throughout the buccal cavity. Salivary glands are distinguished by their size, amount of saliva secretion and their location in the oral cavity. Salivary glands pathophysiology has been a subject of interest in various worldwide metabolic disorders, including diabetes mellitus. Diabetes mellitus (DM), a global health concern, with a pathological imprint involved in vasculature, promotes microvascular and macrovascular complications among which periodontitis ranks sixth. Indeed, DM has also been directly associated with oral health lesions. Specifically, salivary glands in the context of diabetes have been a focal point of study and emphasis in the research field. There is evidence that relates salivary secretion content and diabetes progression. In this review, we present all the reported evidence of the deregulation of specific salivary proteins associated with the progression of diabetes in parallel with changes in salivary gland morphology, cellular architecture, and salivary secretion and composition more generally.

Changes in Salivary Amylase and Glucose in Diabetes: A Scoping Review

BACKGROUND AND OBJECTIVE

Diabetes mellitus (DM) is a common long-term disease which can be related with salivary amylase levels. DM has recently been associated with salivary amylase diagnostics that could further impair diagnoses in the diabetic population, as well as being an interesting alternative to traditional methods of determine glucose levels. The main advantage of this method is related to the fact that it is a fast diagnostic method. The DM population experiences changes to their metabolism which affects their salivary parameters, making this an alternative procedure for diagnosis and follow-up of the illness due to the non-invasive nature of salivary analyzes. The objective of this review is to summarize the evidence regarding the changes in salivary amylase and glucose levels, and their relationship with blood markers of glycemic control used in clinical settings such as blood glucose and glycated hemoglobin. The differences in salivary amylase levels depending on the method of saliva collection under fasting or non-fasting conditions. The changes in salivary amylase depends on the type of diabetes, the type of insulin treatment or the quality of glycemic control.

CONCLUSIONS

Salivary amylase concentration is increased in diabetic patients in most of the studies and salivary glucose concentration in all studies in both fasting and non-fasting (post-prandial) conditions. Salivary amylase and glucose concentration represent potential non-invasive biomarkers to evaluate glycemic control and clinical management of diabetic patients, although it is necessary to evaluate the influence of potential modulating factors such as age, duration diseases, sex and the effects of pharmacological treatments in these outcomes which remained to be elucidated.

Diabetes as a Risk Factor for Orthopedic Implant Surface Performance: A Retrieval and In Vitro Study

Orthopedic devices are often associated with increased risk for diabetic patients due to impaired wound healing capabilities. Adverse biological responses for immunocompromised patients at the implant-tissue interface can lead to significant bone resorption that may increase failure rates. The goal of this study was to characterize the surface of implants removed from diabetic patients to determine underlying mechanisms of diabetes-induced impaired osseointegration. Thirty-nine retrieved titanium and stainless-steel orthopedic devices were obtained from diabetic and non-diabetic patients, and compared to non-implanted controls. Optical Microscopy, Scanning Electron Microscopy, Energy Dispersive X-ray Spectroscopy, and X-ray Photoelectron Spectroscopy revealed changes in morphology, chemical composition, oxidation state, and oxide thickness of the retrieval specimens, respectively. Additionally, titanium disks were immersed for 28 days in simulated in vitro diabetic conditions followed by Inductively Coupled Plasma-Optical Emission Spectroscopy to quantify metal dissolution. Electrochemical testing was performed on specimens from retrievals and in vitro study. Aside from biological deposits, retrievals demonstrated surface discoloration, pit-like formations and oxide thinning when compared to non-implanted controls, suggesting exposure to unfavorable acidic conditions. Cyclic load bearing areas on fracture-fixation screws and plates depicted cracking and delamination. The corrosion behavior was not significantly different between diabetic and non-diabetic conditions of immersed disks or implant type. However, simulated diabetic conditions elevated aluminum release. This elucidates orthopedic implant failures that potentially arise from diabetic environments at the implant-tissue interface. Design of new implant surfaces should consider specific strategies to induce constructive healing responses in immunocompromised patients while also mitigating corrosion in acidic diabetic environments.

Interaction Effect Between Copy Number Variation in Salivary Amylase Locus (AMY1) and Starch Intake on Glucose Homeostasis in the Malmö Diet and Cancer Cohort

Salivary amylase initiates the digestion of starch and it has been hypothesized that salivary amylase may play a role in the development of insulin resistance and type 2 diabetes. The aim was to examine the interaction between copy number variation in the salivary amylase gene AMY1 and starch intake. We studied 3,624 adults without diabetes or elevated blood glucose in the Malmö Diet Cancer cohort. We assessed the associations and interactions between starch intake, AMY1 copies and glucose homeostasis traits (i.e., fasting plasma glucose, insulin and HOMA-IR) and risk of type 2 diabetes over an average of 18 follow-up years. AMY1 copy number was not associated with glucose, insulin or HOMA-IR. We observed a significant interaction between starch intake and AMY1 copies on insulin and HOMA-IR after adjusting for potential confounders (p < 0.05). The inverse association between starch intake and insulin and HOMA-IR was stronger in the group with 10 or more copies (P _trend < 0.001). In addition, we observed an inverse association between starch intake and type 2 diabetes in the group with 10 or more copies (p _trend = 0.003), but not in the other groups. This cross-sectional observational study suggests that AMY1 copy numbers might interact with starch intake on glucose homeostasis traits. Interventional studies are required to determine whether individuals with high AMY1 copy numbers may benefit from a high starch intake.

Investigation of carbonic anhydrase 6 gene polymorphism rs2274327 in relation to the oral health status and salivary composition in type 2 diabetic patients

OBJECTIVE

The aim of the present study was to investigate the oral manifestations and salivary composition in type 2 diabetics with periodontitis and to evaluate their association with CA6 gene polymorphism rs2274327.

METHODS

Oral examination was performed by a single periodontist for 300 type 2 diabetics. Whole unstimulated saliva and blood were collected. The salivary pH, buffer capacity and flow rate were later measured. Immunoglobulin A and electrolytes were assessed using an autoanalyzer. CA6 gene polymorphism rs2274327 was screened by PCR-RFLP assay. The statistical analysis was performed using the SPSS 20.0 version.

RESULTS

The salivary pH, buffer capacity and flow rate were significantly lower in the patients carrying TT genotype compared to CC and CT genotype carriers (p < .05). Furthermore, the DMFT index, OHI-s, PI, PPD and CAL were significantly higher in the subjects with TT genotype (p < .05). Carrying at least one T allele seemed to increase the risk of dental caries (OR = 2.59, p < .001), xerostomia (OR = 2.11, p=.003) and taste impairment (OR = 1.97, p < .05).

CONCLUSION

CA6 gene polymorphism rs2274327 seemed to increase the risk of developing, dental caries, periodontitis, xerostomia and taste impairment in type 2 diabetics.

Saliva diagnostic utility in patients with type 2 diabetes: Future standard method

Background

The purpose of the present study was to assess saliva reliability in diagnosis and monitoring type 2 diabetes instead of blood.

Methods

Blood and unstimulated whole saliva were collected from 300 type 2 diabetic subjects and 300 healthy controls in fasting. Then, the salivary flow rate was calculated. All parameters including glucose, urea, amylase, total protein, albumin, C-reactive protein (CRP), immunoglobulin A (IgA), potassium, calcium and chloride were assessed in the supernatant, using an autoanalyzer. Oral exam was conducted by a single examiner on full mouth excluding third molars. Statistical analysis was performed by the SPSS 20.0 version.

Results

Saliva screening showed that glucose, urea, amylase, total protein, potassium, calcium and chloride were significantly higher in patients compared to controls (p < 0.05). Whereas, the IgA level and salivary flow rate were significantly reduced in patients (p < 0.05). No significant difference was found in albumin and CRP levels (p > 0.05). There was a significant positive correlation between salivary and plasma glucose levels (r = 0.887, and r = 0.900, p < 0.001), as well as, salivary and blood urea (r = 0.586, and r = 0.688, p < 0.001) in patients and controls, respectively.

Conclusions

From this study, saliva could be suggested as a useful diagnostic tool for type 2 diabetes.

Measurement of α-dicarbonyl compounds in human saliva by pre-column derivatization HPLC

Background α-Dicarbonyl compounds (α-DCs) have been detected in body fluids including plasma and urine and elevation of this sort of compounds in vivo has been associated with the development of many kinds of chronic diseases. However whether α-DCs are present in human saliva, and if their presence/absence can be related with various chronic diseases is yet to be determined. Methods In this study, a pre-column derivatization HPLC-UV method was developed to measure 3-deoxyglucosone (3-DG), glyoxal (GO), methylglyoxal (MGO), diacetyl (DA), and pentane-2,3-dione (PD) in human saliva employing 4-(2,3-dimethyl-6-quinoxalinyl)-1,2-benzenediamine (DQB) as a derivatizing reagent. The derivatization of the α-DCs is fast and the conditions are facile. The method was evaluated and the results show that it is suitable for the quantification of α-DCs in human saliva. Results In the measurements of these α-DCs in the saliva of 15 healthy subjects and 23 type 2 diabetes mellitus (T2DM) patients, we found that the concentrations of GO and MGO in the saliva of the diabetic patients were significantly higher than those in healthy subjects. As far as we know, this is the first time that salivary α-DC concentrations have been determined and associated with T2DM. Conclusions The developed method would be useful for the measurement of the salivary α-DC levels and the data acquired could be informative in the early screening for diabetes.

Association of salivary levels of immunoglobulin-a and amylase with oral-dental manifestations in patients with controlled and non-controlled type 2 diabetes

Background

Oral health is related to general health and one of the most prevalent chronic diseases is diabetes mellitus. Diabetes can have adverse effects on oral health and vice versa. Saliva analysis can be used as a non-invasive method to obtain information about diseases status like diabetes. The aim of present study was to evaluate the salivary immunoglobulin-A (s-IgA) and salivary amylase levels and their associations with oral-dental manifestations in patients with controlled and non-controlled type 2 diabetes.

Methods

This case-control study was carried out on 90 subjects who referred to the Diabetes Center of Shahid Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran. Participants were divided into three groups: 1) uncontrolled diabetic patients (n = 30); 2) controlled diabetic patients (n = 30); and 3) healthy individuals (n = 30). Unstimulated salivary levels of I-A and amylase were measured. All participants underwent a dental and periodontal examination to explore the oral and dental manifestations. T-test, chi-square and ANOVA tests were used for data analysis in SPSS 18.

Results

Significant higher level of s-IgA was found in uncontrolled diabetic patients compared to controlled diabetic (P ≤ 0.0001) and the control group (P = 0.004). Moreover, the mean levels of s-amylase in uncontrolled patients was significantly higher compared to controlled diabetic (P = 0.01) and the control group (P ≤ 0.0001). Uncontrolled diabetic patients with oral candidiasis, erythematous candidiasis, abscesses, or xerostomia had higher s-IgA levels compared to the controlled diabetic participants. Moreover, uncontrolled diabetic patients with oral candidiasis or erythematous candidiasis showed a significant higher levels of s-amylase compared to controlled diabetic patients. Also, significant positive correlations were found between s-IgA and DMFT and s-IgA and PDI (r = 0.444, P = 0.014 and r = 0.386, P = 0.035, respectively).

Conclusion

In conclusion, higher s-amylase and s-IgA concentrations may reflect oral-dental manifestations in T2DM. Moreover, the current findings suggest that s-amylase and s-IgA may serve as a complementary and alternative fluid in screening for diabetes mellitus.

Saliva Proteomics Analysis Offers Insights on Type 1 Diabetes Pathology in a Pediatric Population

The composition of the salivary proteome is affected by pathological conditions. We analyzed by high resolution mass spectrometry approaches saliva samples collected from children and adolescents with type 1 diabetes and healthy controls. The list of more than 2000 high confidence protein identifications constitutes a comprehensive characterization of the salivary proteome. Patients with good glycemic regulation and healthy individuals have comparable proteomic profiles. In contrast, a significant number of differentially expressed proteins were identified in the saliva of patients with poor glycemic regulation compared to patients with good glycemic control and healthy children. These proteins are involved in biological processes relevant to diabetic pathology such as endothelial damage and inflammation. Moreover, a putative preventive therapeutic approach was identified based on bioinformatic analysis of the deregulated salivary proteins. Thus, thorough characterization of saliva proteins in diabetic pediatric patients established a connection between molecular changes and disease pathology. This proteomic and bioinformatic approach highlights the potential of salivary diagnostics in diabetes pathology and opens the way for preventive treatment of the disease.

Salivary changes in type 2 diabetic patients

OBJECTIVE

this study was conducted to determine the effect of type 2 diabetes mellitus on salivary secretion of glucose, amylase and immunoglobulin A levels and also to fined out if saliva could be used as anon invasive method to monitor glycaemic control in type 2 diabbetes. This study was conducted on 40 human subjectes, They were 20 males and 20 females, their ages ranged from 35 years to 64 years,and they were divided into two groups, the first one is the patient group which contains 20 diabetic paient. (10 males and 10 females,aged between 38 years to 64 years). the second one is the control group which contains 20 healthy adult (10 males and 10 females,aged between 35 years to 60 years) they were age and sex matched. All studied group were subjected to clinical and laboratory investigation which includes post prandial blood glucose, HA1C, salivary glucose, salivary amylase, and salivary immunoglobulin A.

RESULTS

there was a highly significant increase in the level of post prandial blood glucose, HBA1C; Salivary glucose, Salivary amylase & Salivary immunoglobulin A in diabetic group compared with control group and There was a significant positive correlation between post prandial blood glucose and salivary glucose in diabetic group.

CONCLUSIONS

These results suggest that diabetes influences the composition of saliva and that saliva can be used as less painful,non invasive biomarker for monitoring the blood glucose concentration in the patients with diabetes mellitus.

Correlation between Salivary Glucose and Blood Glucose and the Implications of Salivary Factors on the Oral Health Status in Type 2 Diabetes Mellitus Patients

AIMS AND OBJECTIVES

The purpose of this study was to estimate and assess any correlation between random capillary blood glucose (RCBG) and unstimulated whole salivary glucose (UWSG), as well as to estimate various salivary parameters, such as flow rate, pH, buffering capacity, and the influence of these factors on the oral health status in type 2 diabetes mellitus (DM).

MATERIALS AND METHODS

Sixty individuals suffering from type 2 DM and 40 healthy individuals in the age group of 30-60 years were included in the study. RCBG was estimated using glucometer and UWSG was estimated using photocolorimeter. Salivary parameters such as flow rate, pH, and buffering capacity were assessed using GC® Saliva kit. Oral health status was recorded using the Russell's periodontal index (RPI) and the Decayed Missing Filled Teeth (DMFT) index. The Statistical Package for the Social Sciences version 16 was used for statistical analysis.

RESULTS

Type 2 diabetics had higher mean values for RCBG levels and UWSG. Type 2 diabetics had low mean salivary flow rate, pH, and buffering capacity. Type 2 diabetics had higher mean values for RPI.

CONCLUSION

Among the salivary factors studied, salivary glucose significantly influenced the periodontal status in Type 2 diabetics.