Relationship of stimulated whole saliva cortisol level with the severity of a feeling of dry mouth in menopausal women

World Workshop on Oral Medicine VIII: Development of a Core Outcome Set for Dry Mouth: A Systematic Review of Outcome Domains for Xerostomia

OBJECTIVE

The purpose of this study was to identify all outcome domains used in clinical studies of xerostomia, that is, subjective sensation of dry mouth. This study is part of the extended project "World Workshop on Oral Medicine Outcomes Initiative for the Direction of Research" to develop a core outcome set for dry mouth.

STUDY DESIGN

A systematic review was performed on MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials databases. All clinical and observational studies that assessed xerostomia in human participants from 2001 to 2021 were included. Information on outcome domains was extracted and mapped to the Core Outcome Measures in Effectiveness Trials taxonomy. Corresponding outcome measures were summarized.

RESULTS

From a total of 34,922 records retrieved, 688 articles involving 122,151 persons with xerostomia were included. There were 16 unique outcome domains and 166 outcome measures extracted. None of these domains or measures were consistently used across all the studies. The severity of xerostomia and physical functioning were the 2 most frequently assessed domains.

CONCLUSION

There is considerable heterogeneity in outcome domains and measures reported in clinical studies of xerostomia. This highlights the need for harmonization of dry mouth assessment to enhance comparability across studies and facilitate the synthesis of robust evidence for managing patients with xerostomia.

Magnetic bioassembly platforms for establishing craniofacial exocrine gland organoids as aging in vitro models

A multitude of aging-related factors and systemic conditions can cause lacrimal gland (LG) or salivary gland (SG) hypofunction leading to degenerative dry eye disease (DED) or dry mouth syndrome, respectively. Currently, there are no effective regenerative therapies that can fully reverse such gland hypofunction due to the lack of reproducible in vitro aging models or organoids required to develop novel treatments for multi-omic profiling. Previously, our research group successful developed three-dimensional (3D) bioassembly nanotechnologies towards the generation of functional exocrine gland organoids via magnetic 3D bioprinting platforms (M3DB). To meet the needs of our aging Asian societies, a next step was taken to design consistent M3DB protocols to engineer LG and SG organoid models with aging molecular and pathological features. Herein, a feasible step-by-step protocol was provided for producing both LG and SG organoids using M3DB platforms. Such protocol provided reproducible outcomes with final organoid products resembling LG or SG native parenchymal epithelial tissues. Both acinar and ductal epithelial compartments were prominent (21 ± 4.32% versus 42 ± 6.72%, respectively), and could be clearly identified in these organoids. Meanwhile, these can be further developed into aging signature models by inducing cellular senescence via chemical mutagenesis. The generation of senescence-like organoids will be our ultimate milestone aiming towards high throughput applications for drug screening and discovery, and for gene therapy investigations to reverse aging.

Serum and Saliva Myelin Basic Protein as Multiple Sclerosis Biomarker

Introduction:

Multiple Sclerosis (MS) is presented with motor and sensory function loss. It is caused by demyelination and following axonal lesion. As Myelin Basic Protein (MBP) is one of the key elements of the myelin cover, we examined the level of MBP in serum, stimulated, and unstimulated saliva as a suitable biomarker for detecting MS.

Methods:

A case-control study was performed in 29 healthy women and 32 definitive relapsing-remitting MS patients hospitalized in Imam Reza hospital, Tehran, Iran. MBP level was assayed in serum and stimulated and unstimulated whole saliva.

Results:

MBP was expressed at a lower level in serum and stimulated saliva of MS patients compared to the control group. The serum MBP level had a considerable correlation with its stimulated saliva level. The receiver operating characteristic analysis showed significant diagnostic ability for MBP to discriminate MS patients with serum and stimulated saliva from controls.

Conclusion:

Serum and saliva level of MBP is lower in MS, so it may be considered a potential biomarker in MS.

Salivary microRNA-126 and 135a: a potentially non-invasive diagnostic biomarkers of type- 2 diabetes

Purpose

Emerging of miRNAs have illustrated the new mechanistic layer to regulate type 2 diabetes process and suggests a possible role of these RNAs in this defect. Thus, we designed this study to improve our understanding of salivary miRNA-126 and 135a expression utility as an easy of collection and non-invasive way in diabetic patients instead of blood sample.

Methods

This case-control study was done on T₂D (n = 40) and healthy individuals (n = 40). The level of biochemical parameters were determined by enzymatic methods as well as glycosylated hemoglobin (HbA1c) was measured by immunoturbidimetry. We used the pooled whole stimulated saliva sample from cases and controls to assess the differentiation expression of miRNA 126 and 135-a with quantitative RT-PCR method. Unpaired Student's t test, Pearson's correlation coefficient and Receiver Operating Characteristic (ROC) analysis were used.

Results

A correlation was observed between the level of HbA1c, glucose and lipid profiles (TG, TC, and LDL) in serum and whole stimulated saliva samples in T₂D patients compared to control (p < 0.001). miR-135a expression was considerably higher by 4.7-fold in T₂D compared to the control group (1.8-fold) (p < 0.001) while the miR126 expression was significantly decreased by 3.9-fold in T₂D compared to the controls (6.3-fold) (p < 0.001).

Conclusions

The results of this case and control study showed that miR-135a and miR126 expression in saliva fluid as a reliable biomarkers and non-invasive approach in combination by change of lipid profiles, glucose and HbA1c may be used to monitor diabetic and non-diabetic patients, while further research is needed to investigate the relationship of these salivary miRNAs (miR135a, miR126) levels change on shifting the levels of clinical laboratory outcomes.

Analysis of medication-induced xerostomia in elderly Japanese patients

Objectives

To determine the general condition of elderly xerostomia patients, we collected their background and medication data in order to potentially treat their xerostomia. It is critical to identify the drugs causing xerostomia in elderly patients. A total of 521 patients who were examined at the Xerostomia Clinic of Osaka University Dental Hospital were included in the study. We obtained patients’ data on age, sex, number of primary illnesses, Saxon test scores, oral moisture test, subjective symptoms, and drug types from their clinical records.

Results

The mean age of the patients was 65.2 ± 13.3 years. Although all patients exhibited xerostomia symptoms, there were a lot of patients without hyposalivation. With respect to medication, each elderly xerostomia patient took an average of 6.8 ± 4.4 medicines. A total of 26.1% of patients in their 70 s took more than ten number of drugs. In addition, the number of frequently used medication medicine was different between elderly and young patients. Most of the medicines had xerostomia as a side effect in medical package inserts. Moreover, the quantity of salivation significantly decreased in patients who took more than seven drugs in comparison with the patients who did not take medicine.

Conclusions

As patients age, the number of medications they take tends to increase, subsequently increasing their risk of xerostomia. For the health of the patients, it is critical that an accurate diagnosis is made.

Clinical relevance

To establish therapeutic strategies for treatment of xerostomia, this study provides new and important information that will help in the development of xerostomia medical treatment.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00784-021-04182-2.

Osteoprotegerin changes in saliva and serum of patients with knee osteoarthritis

OBJECTIVE

The scope of this study was to assess salivary and serum osteoprotegerin (OPG) levels in knee osteoarthritis (OA).

METHODS

Serum and saliva OPG levels of 30 knee OA and 30 matched healthy controls in this cross-sectional study was assessed by ELISA. Knee pain was assessed by WOMAC. Data were analyzed by Student's t-test, Spearman correlation test and ROC.

RESULTS

The mean serum but not saliva OPG level was lower in knee OA than that of the healthy group. WOMAC negatively correlated with serum OPG (r=-0.501; P=0.000). The serum OPG cutoff value was 237.5pg/ml for the diagnosis of knee OA.

CONCLUSIONS

As serum OPG was lower in knee OA and negatively correlated with WOMAC, it seems that detection of OPG in serum but not in saliva may be a probable marker to the diagnosis of knee OA.

KEY MESSAGES

Osteoprotegerin decreases in knee osteoarthritis.

Elevation of Urate in Saliva and Serum of Patients with Knee Osteoarthritis

BACKGROUND

Knee osteoarthritis (knee OA) is the most common joint disease and the leading cause of disability and has a considerable financial burden on the healthcare system.

OBJECTIVE

The aim of the present study was to evaluate urate in saliva and serum of knee OA.

METHODS

Serum and saliva urate levels of 30 knee OA and 30 healthy controls were evaluated in a cross-sectional study. Data were analysed by Student's t test, Pearson correlation test, and receiver operating characteristic.

RESULTS

The mean serum and both stimulated and unstimulated saliva urate levels were higher in the knee OA than that of the healthy group. WOMAC score positively correlated with serum (r = 0.485; p = 0.004), unstimulated saliva (r = 0.575; p = 0.001) and stimulated saliva (r = 0.453; p = 0.009) levels of urate. The serum level of urate significantly correlated with unstimulated (r = 0.442; p < 0.001) and stimulated (r = 0.563; p < 0.001) saliva urate levels. Serum and saliva urate had significant cutoff values (6.4, 4.9, and 3.3 mg/dL in serum, stimulated, and unstimulated saliva, respectively).

CONCLUSION

In this study, urate in serum and saliva was increased in patients with knee OA and positively correlated with WOMAC.

Evaluation of the Saxon test for patients with hyposalivation without Sjögren's syndrome

BACKGROUND

Dry mouth is associated with salivary gland hypofunction, which may result from several conditions such as Sjögren's syndrome (SS), head and neck cancers, and side effects of medications. The Saxon test is a useful diagnostic method for hyposalivation in clinical settings. However, previous reports indicate that the test has mostly been used for patients with SS.

OBJECTIVE(S)

In the present study, we focused on patients with dry mouth who were not diagnosed with SS (patients without SS).

METHODS

For patients without SS (n = 302), we examined the factors affecting Saxon test scores using multiple regression analysis. Additionally, we performed a correlation analysis comparing the Saxon test with other diagnostic methods.

RESULTS

In 57.6% patients, the Saxon test score was more than 2.00 g/2 min, which is considered negative for hyposalivation. Multiple regression analysis revealed that the age and sex of patients significantly influenced test scores. The mean Saxon test score was less than 2.00 g/2 min in older patients and women. Moreover, the test showed a significant correlation with other methods used to measure salivary flow.

CONCLUSION

The Saxon test is useful not only for patients with SS but also for patients without SS.

Effect of Saliva Collection Methods on the Detection of Periodontium-Related Genetic and Epigenetic Biomarkers-A Pilot Study

Different collection methods may influence the ability to detect and quantify biomarker levels in saliva, particularly in the expression of DNA/RNA methylation regulators of several inflammations and tissue turnover markers. This pilot study recruited five participants and unstimulated saliva were collected by either spitting or drooling, and the relative preference for each method was evaluated using a visual analogue scale. Subsequently, total RNA, gDNA and proteins were isolated using the Trizol method. Thereafter, a systematic evaluation was carried out on the potential effects of different saliva collection methods on periodontium-associated genes, DNA/RNA epigenetic factors and periodontium-related DNA methylation levels. The quantity and quality of DNA and RNA were comparable from different collection methods. Periodontium-related genes, DNA/RNA methylation epigenetic factors and periodontium-associated DNA methylation could be detected in the saliva sample, with a similar expression for both methods. The methylation of tumour necrosis factor-alpha gene promoter from drooling method showed a significant positive correlation (TNF α, r = 0.9) with clinical parameter (bleeding on probing-BOP). In conclusion, the method of saliva collection has a minimal impact on detecting periodontium-related genetic and epigenetic regulators in saliva. The pilot data shows that TNF α methylation may be correlated with clinical parameters.

An updated review on pathophysiology and management of burning mouth syndrome with endocrinological, psychological and neuropathic perspectives

Burning mouth syndrome (BMS) is a chronic oro-facial pain disorder of unknown cause. It is more common in peri- and post-menopausal women, and sex hormone dysregulation is believed to be an important causative factor. Psychosocial events often trigger or exacerbate symptoms, and persons with BMS appear to be predisposed towards anxiety and depression. Atrophy of small nerve fibres in the tongue epithelium has been reported, and potential neuropathic mechanisms for BMS are now widely investigated. Historically, BMS was thought to comprise endocrinological, psychosocial and neuropathic components. Neuroprotective steroids and glial cell line-derived neurotrophic factor family ligands may have pivotal roles in the peripheral mechanisms associated with atrophy of small nerve fibres. Denervation of chorda tympani nerve fibres that innervate fungiform buds leads to alternative trigeminal innervation, which results in dysgeusia and burning pain when eating hot foods. With regard to the central mechanism of BMS, depletion of neuroprotective steroids alters the brain network-related mood and pain modulation. Peripheral mechanistic studies support the use of topical clonazepam and capsaicin for the management of BMS, and some evidence supports the use of cognitive behavioural therapy. Hormone replacement therapy may address the causes of BMS, although adverse effects prevent its use as a first-line treatment. Selective serotonin reuptake inhibitors (SSRIs) and serotonin and noradrenaline reuptake inhibitors (SNRIs) may have important benefits, and well-designed controlled studies are expected. Other treatment options to be investigated include brain stimulation and TSPO (translocator protein 18 kDa) ligands.

Evaluation of salivary cortisol levels in relation to dento-maxillary prosthesis adjustment

PURPOSE

The purpose of this study was to investigate the influence of dento-maxillary prosthesis adjustment procedure on levels of salivary cortisol.

METHODS

Nine participants (six men, three women, mean age 65.9 years) took part in this study. Saliva samples were collected before and after dento-maxillary prosthesis adjustment during the four different visits. Free cortisol levels were determined using a salivary cortisol immunoassay kit (expanded-range high-sensitivity salivary cortisol enzyme immunoassay kit, Salimetrics). Besides, original self-report sheets, a 35-item food intake questionnaire, the University of Washington Quality of Life (UW-QOL) questionnaire version 4, and the Geriatric Oral Health Assessment Index (GOHAI) questionnaire were also administered. The changes of salivary cortisol levels were analyzed using 2-level multilevel linear regression, with adjustment for age, sex, and time. Wilcoxon signed-rank test was used to compare scores of the food intake questionnaire, UW-QOL questionnaire, and GOHAI questionnaire.

RESULTS

Salivary cortisol levels decreased significantly after carrying out the dento-maxillary prosthesis adjustment procedure. During the third adjustment, the salivary cortisol levels were significantly low. In addition, salivary cortisol levels of participants aged 70 years and over were significantly higher than other aged groups. The total scores for grade III-V of the food intake questionnaire increased significantly. Other questionnaires had a trend toward increasing scores, yet the differences were not significant.

CONCLUSIONS

Within the limitations of this study, the results suggest that a reduction in symptoms of discomfort may have an influence on the decrease of salivary cortisol levels in dento-maxillary prosthesis wearers.

Antiseptic mouthwashes could worsen xerostomia in patients taking polypharmacy

OBJECTIVE

Polypharmacy is a common cause of xerostomia. This study aimed to investigate whether xerostomia could be an adverse drug event of mouthwashes, when they are used for longer than 2 weeks by patients taking polypharmacy.

MATERIALS AND METHODS

This cross-sectional observational study included 120 hospitalized patients (60 middle-aged and 60 elderly patients), taking polypharmacy (≥4 drugs daily) and at risk of drug-induced xerostomia. Xerostomia was assessed by questioning participants.

RESULTS

A total of 62.5% of patients complained of xerostomia. In the middle-aged group (mean age=44.0 (8.7) years; 35.0% women) xerostomia seemed independently associated to mouthwashes, at the limit of significance (OR=5.00, 95% CI=0.99-25.3, p=0.052). Active principles in mouthwashes were mainly quaternary ammonium compounds (91.9%). Mouthwashes may disturb the healthy balance of the biofilm moisturizing the oral mucosa. The biofilm contains mucins, salivary glycoproteins with oligosaccharides side chains able to sequester water and endogenous bacteria surrounded by a glycocalyx. Oral bacteria are fully susceptible to quaternary ammonium (chlorhexidine, hexetidine, cetylpyridinium chloride) and to other antiseptics used in mouthwashes, such as betain, resorcin, triclosan, essential oils and alcohol. However, caregivers currently recommend such dental plaque control products to patients suffering from xerostomia in order to reduce the risk of caries and periodontitis.

CONCLUSION

This study is the first report that use of antiseptic mouthwashes for more than 2 weeks could worsen xerostomia in patients taking polypharmacy. Oral care protocols should avoid this iatrogenic practice, particularly when xerostomia alters the quality-of-life and worsens malnutrition.

The influence of hormone replacement therapy on the salivary flow of post-menopausal women

The aim of this study is to investigate the influence of hormone therapy on salivary flow in menopausal women. It is a case-control study involving 86 post-menopausal women. The case group consisted of 47 women undergoing estroprogestative or estrogen hormone replacement therapy (HRT), and the control group consisted of 39 women who did not receive any HRT. All patients were submitted to a standard questionnaire, followed by total stimulated sialometry and determination of body mass index (BMI). The salivary flow was classified as follows: normal (1.0-3.0 mL/min), low (0.7-1.0 mL/min), and hyposalivation (<0.7 mL/min). The results were analyzed statistically by the chi-square test, logistic regression model, and linear regression (p < 0.05). The HRT group presented an association of protection, even after adjusting the analysis, for low salivary flow (Adjusted OR = 0.22; 95% CI = 0.05-0.88; p = 0.034), and hyposalivation (Adjusted OR = 0.30; 95% CI = 0.10-0.92; p = 0.036). The results suggest that estroprogestative therapy (β = + 0.53; p = 0.022) has greater influence on the increase of salivary flow than estrogen therapy (β = +0.35; p = 0.137). The study concludes stating salivary flow was influenced by HRT on the post-menopausal women studied.

Unstimulated whole saliva cortisol levels during Ramadan in Iranian Muslims

AIMS

Ramadan is a great opportunity for scientific research due to its peculiar nature. This study was designed to investigate whether morning saliva cortisol pick can change during and after Ramadan compared to before it.

MATERIALS AND METHODS

A total of 30 healthy volunteer men (aged between 30 and 76 years) were asked to participate in a cross-sectional study between August 12 and September 10, 2010. Saliva was collected 2 weeks before the beginning of Ramadan (BR), during the first week (R1), middle (R2), the last week (R3) of Ramadan and 3 weeks after Ramadan (AR). Cortisol concentration was analyzed by ELISA. Statistical analysis of one-way repeated measures analysis of variance (ANOVA) was used.

RESULTS

The mean unstimulated saliva cortisol concentration and its output were significantly higher in the BR than during and after Ramadan.

CONCLUSION

Mean saliva cortisol concentration and its output tended to be lower during and 3 weeks after Ramadan.

CLINICAL SIGNIFICANCE

Cortisol as a stress hormone seems to be low during Ramadan.

Oral health and menopause: a comprehensive review on current knowledge and associated dental management

The menopause is physiological changes in women that give rise to adaptive changes at both systemic and oral level. As we all begin to reach an older age, dental health and hygiene becomes a major concern. The dentist is often the first person to appreciate numerous changes that are experienced throughout the body during menopause. The teeth and gums are extremely susceptible to any hormonal changes that take place just before menopause and readily decrease body's ability to fight off minor infections or maintain a healthy balance of useful and harmful bacteria within the oral environment. This review aimed to develop better understanding for major oro-dental complications observed in women during menopause, and schematic approach towards the different dental management protocols used during these periods. Various internets based popular search engines were used to explore related data from literature, which includes PubMed, PubMed Central, Cochrane, Google, Medknow, Ebsco, Science Direct, and IndMed. Upon compilation of relevant data, it was observed that periodontal health is most severely affected (up to 60%) followed by dry mouth (25%) and burning mouth (glossodynia; 15%) which, in turn, may increase the occurrence of oral mucosal and dental diseases, such as candidiasis. Though, the usage of hormone replacement therapy is effective but it does not necessarily prevent or help women with oral symptoms. Therefore, well controlled long-term randomized studies are needed to establish more authentic clinical guidelines for successful management of such conditions.

Unstimulated whole saliva 25-hydroxycholecalciferol in patients with xerostomia in menopausal women

BACKGROUND AND AIM

The aim of this study was to compare unstimulated whole saliva 25-hydroxycholecalciferol (25(OH)D) in menopausal women with and without oral dryness (OD) feeling, and evaluate the relationship between saliva 25(OH)D and severity of OD feeling.

METHODS

A case-control study was carried out on 70 selected menopausal women aged 41-77 years with or without OD feeling (35 as case and 35 as control) conducted at the Clinic of Oral Medicine, Tehran University of Medical Sciences. Unstimulated saliva samples were obtained by expectoration. Xerostomia inventory (XI) score was used as an index of OD feeling severity. The saliva 25(OH)D concentration was measured by ELISA. Statistical analysis of Student's t test and Spearman correlation was used.

RESULTS

The mean saliva 25(OH)D level was significantly higher in the case group (897.1 ± 128.9 pg/ml), compared with control (156.7 ± 43.4 pg/ml; P < 0.05). XI score correlated significantly with saliva 25(OH)D concentration (r = 0.457, P < 0.001).

CONCLUSIONS

It seems that the level of salivary 25(OH)D concentration may be higher in menopausal women with OD feeling than in the control group, and there is a positive correlation between OD feeling severity and unstimulated whole saliva 25(OH)D.

Salivary flow, testosterone, and femur bone mineral density in menopausal women with oral dryness feeling

OBJECTIVES

We compared salivary flow, serum and saliva testosterone, and femur bone mineral density (BMD) of menopausal women with or without xerostomia.

STUDY DESIGN

A case/control study was performed on 60 selected menopausal women with or without xerostomia. BMD and testosterone concentration were measured by a dual-energy x-ray absorptiometry system and enzyme-linked immunosorbent assay method, respectively.

RESULTS

Multinomial logistic regression demonstrated that low saliva flow rate (odds ratio [OR] = 22.8, 95% confidence interval [CI]: 5.4, 96.8), low femur BMD (OR = 6.0, CI: 1.8, 20.0), high stimulated saliva testosterone (OR = 5.2, CI: 2.0, 18.9), high unstimulated saliva testosterone (OR = 3.8, 95% CI: 1.6, 12.3), and high serum testosterone (OR = 2.7, CI: 1.1, 7.2) were associated with an increased risk of xerostomia in menopausal women.

CONCLUSIONS

High serum and salivary testosterone and low femur BMD and saliva flow were associated with xerostomia. Of these factors, low salivary flow seems to be the most important element in the perception of dry mouth.

The impact of saliva collection and processing methods on CRP, IgE, and Myoglobin immunoassays

BACKGROUND

Owing to its ease of collection, saliva is potentially the sample of choice in diagnosis. Salivary biomolecules have provided a porthole in surveying a person's health and well-being. Our study aims were (1) to demonstrate the effects of pre-analytical steps, collection and pre-processing techniques on salivary protein detection and (2) to establish an indication of salivary reference intervals for 3 biomolecules of clinical interest.

METHODS

Saliva samples were collected from participants (n = 25, ages 20-35 years) using the following methods: no stimulation (resting/unstimulated), mechanical, and acid stimulation. The saliva was prepared for analysis by: unprocessed, post standard centrifugation in a container without any additives, and centrifugation using Centrifugal Filter Unit (Amicon® Ultra-0.5). AlphaLisa® assays were used to measure the levels of C-Reactive Protein (CRP), Immunoglobin (IgE) and myoglobin in saliva samples.

RESULTS

Saliva flow rates were lowest with the resting/drooling collection method. The lowest total protein concentration was with acid stimulation. Unstimulated and mechanically stimulated collections produced no effect on the CRP and IgE levels while myoglobin levels were highest with the unstimulated collection. Acid stimulation had a negative impact on the measured concentrations of IgE and myoglobin (except for CRP levels).

CONCLUSION

Mechanical stimulation was the most viable option for collecting saliva without affecting the levels of CRP and myoglobin. The processing methods had an adverse effect on the concentration of total protein as well as on CRP and IgE concentrations.

Saliva-based creatine kinase MB measurement as a potential point-of-care testing for detection of myocardial infarction

Myocardial infarction (MI) is the main cause of death all over the world. Biomarkers of cardiac necrosis are of great importance in the diagnosis of MI. The aim of this study was to determine probable changes of creatine kinase MB isoform (CK-MB) levels in saliva of patients with acute MI. A case-control study was carried out on 30 patients with acute MI who were hospitalized in Kamkar-Arabnia Hospital of Qom City and 30 healthy control subjects. CK-MB levels were measured by immunoinhibition assay in saliva and serum of patients and healthy individuals. Statistical analysis of the Student's t test and Pearson correlation coefficient was used. CK-MB levels showed a significant elevation in saliva and serum of patients with acute MI compared to healthy controls. Furthermore, there was a strong correlation between salivary levels of CK-MB and its serum values. Subsequent to an acute MI, there is a rise in salivary levels of CK-MB just as what occurs in the serum. Moreover, salivary levels of CK-MB reflect well its serum values. It seems that cardiac biomarker CK-MB is measurable in the saliva of patients with acute MI. Salivary CK-MB may serve as an easy-to-use diagnostic tool for point-of-care testing of acute MI.

Unstimulated whole saliva parathyroid hormone in postmenopausal women with xerostomia

OBJECTIVE

The aim of this study was to evaluate the correlation of xerostomia severity with unstimulated saliva parathyroid hormone (PTH) and to compare unstimulated whole saliva PTH between postmenopausal women with/without xerostomia.

METHODS

A case-control study was carried out in 60 (30 as case and 30 as control) selected postmenopausal women with/ without xerostomia conducted at the Clinic of Oral Medicine, Tehran University of Medical Sciences. Xerostomia inventory (XI) score was also used as an index of xerostomia severity. PTH concentration was analyzed by enzyme-linked immunosorbent assay (ELISA). Statistical analysis of Student's t-test and Spearman correlation was used.

RESULTS

The mean unstimulated saliva PTH concentration was significantly higher but flow rate was lower in the case group compared with control. XI score correlated significantly with saliva PTH (r = 0.688, p = 0.001) and flow rate (r = - 0.529, p = 0.001).

CONCLUSION

Xerostomia severity correlated positively with unstimulated whole saliva PTH and negatively with saliva flow rate in this group of postmenopausal women. Thus, salivary flow rate and PTH levels appear associated with xerostomia and menopause.

CLINICAL SIGNIFICANCE

Salivary PTH level appears to be associated with xerostomia and menopause.