ABSTRACT
The study was conducted to assess the serum and salivary biomarkers in people with and without diabetes. Among the 100 participants in this cross-sectional comparative study, 59 men and 61 women aged 32 to 59 years old were randomly assigned to category I (consisting of 50 diabetes mellitus (DM) patients of both types 1 and 2) or category II (consisting of 50 healthy volunteers) to serve as comparisons. Since there is no difference in the amounts of salivary biomarkers across the various types of diabetes, they are all grouped together. Several biochemical indicators were measured by measuring the amounts in the participants’ saliva and serum samples. There was little to no difference between the two categories when comparing saliva and serum levels. Although there was a strong correlation between serum and salivary glucose, amylase, total proteins, albumin, and globulin levels in DM patients, there was also a strong correlation between diabetics and non-diabetics for these same markers.
KEYWORDS: Biomarkers, salivary, serum
INTRODUCTION
Complications of the clinical illness known as diabetes mellitus (DM) include, but are not limited to, retinopathy, cardiovascular disease symptoms, and so on. DM is characterized by disturbances in glucose, lipid, and protein metabolism. Because of its potential benefits, saliva has been studied for use as a diagnostic tool in illness monitoring. Albumin is a serum ultrafiltrate that may diffuse into mucosal secretions in the oral cavity, where it is recognized. Conditions including immunosuppression, radiation, and diabetes have been linked to elevated amounts of salivary albumin. In recent years, more accurate and sensitive methods have been used to identify the whole salivary proteome. Albumin and globulin detection and analysis are important not only for oral pathology but also as a potential biomarker for systemic sickness. Changes in serum electrolyte concentrations may have a role in the development of systemic illness. Enamel remineralization is greatly aided by the calcium ions found in saliva. Diabetic individuals’ saliva had more calcium than that of healthy controls.[1] Having a lot of calcium in your saliva is an excellent indicator of proper oral hygiene. This allows glucose to more easily move from the blood into the saliva and gingival crevicular fluid. Amylase abnormalities are more severe in type 1 diabetes due to the lack of insulin than in type II diabetes.[2]
MATERIAL AND METHODS
Among the 100 participants in this cross-sectional comparative study, 59 men and 61 women aged 32 to 59 years old were randomly assigned to category I (consisting of 50 DM patients of both types 1 and 2) or category II (consisting of 50 healthy volunteers) to serve as comparisons. Since there is no difference in the amounts of salivary biomarkers across the various types of diabetes, they are all grouped together. Several biochemical indicators were measured by measuring the amounts in the participants’ saliva and serum samples.
RESULTS
There was little to no difference between the two categories when comparing saliva and serum levels.There were significant relationship found in saivary amylase, glucose, calcium, A/G and phosphorous with category 1 and category 2 [Table 1]. Serum glucose, total protein, globulin and serum calcium were showing significant relationship with category 1 and Category 2 [Table 2].
Table 1.
Salivary component in category 1 and category 2
| Variables | Category 1 (mg/dl) | Category 2 (mg/dl) | P value |
|---|---|---|---|
| Amylase | 1652±211 | 1415±203 | Significant |
| Glucose | 15.22±2.11 | 6.77±1.02 | Significant |
| Total Protein | 1.44±0.16 | 1.45±0.02 | Non-significant |
| Globulin | 0.61±0.11 | 0.81±0.21 | Non-significant |
| Albumin | 0.81±0.11 | 0.59±0.09 | Non-significant |
| Calcium | 11.44±1.39 | 8.10±1.57 | Significant |
| A/G | 2.11±0.44 | 1.31±0.47 | Significant |
| Phosphorous | 14.12±2.48 | 9.02±1.87 | Significant |
Table 2.
Serum component in category 1 and category 2
| Variables | Category 1 (mg/dl) | Category 2 (mg/dl) | P value |
|---|---|---|---|
| Amylase | 84.41±6.58 | 81.22±5.77 | Non-significant |
| Glucose | 209.67±12.58 | 91.58±11.87 | Significant |
| Total Protein | 6.77±1.02 | 6.42±1.12 | Significant |
| Globulin | 277±15.85 | 249±14.75 | Significant |
| Albumin | 4.12±1.00 | 4.01±1.03 | Non-significant |
| Calcium | 7.44±1.21 | 7.84±1.25 | Significant |
| A/G | 1.51±0.11 | 1.59±0.12 | Non-significant |
| Phosphorous | 3.79±0.45 | 4.03±0.54 | Non-significant |
DISCUSSION
Category 1 had significantly higher fasting salivary glucose levels compared to Category 2, according to the present study. The results lined up with what has been found before.[3,4] The link between salivary and blood glucose was not established in other research including DM patients.[5] Their evaluation participants were not fasting, and it was not specified what kind of meals the individuals had eaten, which may account for the discrepancy. In this study, amylase levels in diabetics’ saliva were much higher than those in their serum. The results lined up with the literature.[6] Another study revealed that those with well-controlled diabetes had greater levels of serum total proteins than those with uncontrolled diabetes, and the present investigation confirmed this finding.[4] Total salivary protein concentration was not significantly different between diabetes and control categories. Results from other studies have been consistent with these.[5,6] Patients with diabetes were shown to have reduced levels of salivary globulin compared to healthy controls. This may be because cytokines directly block globulin, resulting in decreased immunoglobulin migration in the saliva. The results were at odds with previous studies that had shown a rise in salivary globulin levels.[7] We also discovered that the mean serum globulin levels of people with diabetes were greater than those without diabetes. Similar results were seen in another study.[5] As a result of insulin deficiency, serum calcium levels fall, diminishing the hormone’s ability to stimulate osteoblast growth and impairing calcium homeostasis. How much glucose is present in the urine is correlated with how much calcium and phosphorus are lost in the same way. The levels of phosphorus in the saliva of people with diabetes were found to be significantly greater than those of healthy controls. These results were also replicated in another study.[7]
CONCLUSION
Although there was a strong correlation between serum and salivary glucose, amylase, total proteins, albumin, and globulin levels in DM patients, there was also a strong correlation between diabetics and non-diabetics for these same markers.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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