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AlSufyani AA. Correlation of serum biochemical parameters and saliva pH in healthy individuals. Saudi J Biol Sci 2023; 30:103793. [PMID: 37744004 PMCID: PMC10514437 DOI: 10.1016/j.sjbs.2023.103793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 08/14/2023] [Accepted: 08/27/2023] [Indexed: 09/26/2023] Open
Abstract
Saliva has the potential to work alongside needles in standard medical diagnosis. Yet the number of studies aimed at deciphering the biochemical communication between saliva and the rest of the body's systems is still very limited. The aim of this study is to investigate the interfluid interaction between saliva and serum by determining the correlation between saliva pH and serum biochemical parameters under mild conditions. Ultimately, using saliva may provide a stress-free diagnostic tool, but more ambitiously, the pH of saliva could present a genuine cost-effective screening tool that may immensely benefit areas with limited access to health care and diagnostic labs. Saliva and blood samples were collected from 43 randomly selected children (7-12 years), living in Jeddah, free from obesity and chronic or systemic body and mouth diseases. A complete serum biochemical analysis was performed, and the salivary pH of all samples was measured immediately at the time of collection. The correlations between saliva pH and serum biochemical parameters were investigated using Univariate and multiple linear regression models. Our results showed that pH has a weak significant positive correlation with total protein and a negative weak significant correlation with urea. Weak correlations suggest the existence of more serum factors to be investigated for their effect on the pH using a stepwise multiple linear regression. The multiple linear models' calculated saliva pH values were close to the measured values, demonstrating its possible capacity to predict saliva pH using serum parameters. The regression model's successful prediction of saliva pH using serum biochemicals reflects the significant correlations between the body fluids' parameters and invites more research to elucidate these relationships.
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Affiliation(s)
- Amal A. AlSufyani
- College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
- Ministry of the National Guard - Health Affairs, Jeddah, Saudi Arabia
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Goodson JM, Hardt M, Hartman ML, Alqaderi H, Green D, Tavares M, Mutawa AS, Ariga J, Soparkar P, Behbehani J, Behbehani K. Salivary N1-Methyl-2-Pyridone-5-Carboxamide, a Biomarker for Uranium Uptake, in Kuwaiti Children Exhibiting Exceptional Weight Gain. Front Endocrinol (Lausanne) 2019; 10:382. [PMID: 31281289 PMCID: PMC6596350 DOI: 10.3389/fendo.2019.00382] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 05/28/2019] [Indexed: 12/20/2022] Open
Abstract
In a longitudinal study of 6,158 Kuwaiti children, we selected 94 for salivary metabolomic analysis who were neither obese (by waist circumference) nor metabolic syndrome (MetS) positive (<3 diagnostic features). Half (43) remained healthy for 2 years. The other half (51) were selected because they became obese and MetS positive 2 years later. In the half becoming obese, metabolomic analysis revealed that the level of salivary N1-Methyl-2-pyridone-5-carboxamide (2PY) had the highest positive association with obesity (p = 0.0003, AUC = 0.72) of 441 salivary biochemicals detected. 2PY is a recognized uremic toxin. Also, 2PY has been identified as a biomarker for uranium uptake. Considering that a relatively recent military conflict with documented uranium contamination of the area suggests that this weight gain could be a toxicological effect of long-time, low-level uranium ingestion. Comparison of salivary 2PY in samples from the USA and Kuwait found that only Kuwait samples were significantly related to obesity. Also, the geographic distribution of both reported soil radioactivity from 238U and measured salivary 2PY was highest in the area where military activity was highest. The prevalence pattern of adult diabetes in Kuwait suggests that a transient diabetogenic factor has been introduced into the Kuwaiti population. Although we did not measure uranium in our study, the presence of a salivary biomarker for uranium consumption suggests potential toxicity related to obesity in children.
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Affiliation(s)
- Jo Max Goodson
- Department of Applied Oral Sciences, The Forsyth Research Institute, Cambridge, MA, United States
- *Correspondence: Jo Max Goodson
| | - Markus Hardt
- Department of Applied Oral Sciences, The Forsyth Research Institute, Cambridge, MA, United States
| | - Mor-Li Hartman
- Department of Applied Oral Sciences, The Forsyth Research Institute, Cambridge, MA, United States
| | - Hend Alqaderi
- Department of Applied Oral Sciences, The Forsyth Research Institute, Cambridge, MA, United States
- Kuwait School Health Program, Kuwait City, Kuwait
| | - Daniel Green
- Department of Applied Oral Sciences, The Forsyth Research Institute, Cambridge, MA, United States
| | - Mary Tavares
- Department of Applied Oral Sciences, The Forsyth Research Institute, Cambridge, MA, United States
| | | | | | - Pramod Soparkar
- Department of Applied Oral Sciences, The Forsyth Research Institute, Cambridge, MA, United States
| | - Jawad Behbehani
- Faculty of Dentistry, Kuwait University, Kuwait City, Kuwait
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Nizam R, Al-Ozairi E, Goodson JM, Melhem M, Davidsson L, Alkhandari H, Al Madhoun A, Shamsah S, Qaddoumi M, Alghanim G, Alhasawi N, Abu-Farha M, Abubaker J, Shi P, Hartman ML, Tavares M, Bitar M, Ali H, Arefanian H, Devarajan S, Al-Refaei F, Alsmadi O, Tuomilehto J, Al-Mulla F. Caveolin-1 Variant Is Associated With the Metabolic Syndrome in Kuwaiti Children. Front Genet 2018; 9:689. [PMID: 30622557 PMCID: PMC6308323 DOI: 10.3389/fgene.2018.00689] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 12/11/2018] [Indexed: 12/18/2022] Open
Abstract
Caveolin-1 (CAV1) variants have been suggested to be associated with obesity and related metabolic disorders, but information based on human studies is limited. In the present study, we aimed to investigate the potential association between the CAV1 rs1997623 C/A variant and metabolic syndrome (MetS) in Kuwaiti children. DNA from saliva samples collected from 1313 Kuwaiti children (mean age: 12 years) were genotyped using the TaqMan SNP genotyping assay. The classification of MetS was based on the presence/absence of four indicators; (1) central obesity, (2) elevated systolic or diastolic blood pressure, (3) low salivary high-density lipoprotein cholesterol (HDLC), and (4) high salivary glucose. In this study, children with MetS scored ≥3, children in the intermediate metabolic group scored 1 or 2 and children without MetS scored 0. About one-third of the children were obese. A total of 246 children (18.7%) were classified as having MetS; 834 children (63.5%) were in the intermediate metabolic group, and 233 children (17.7%) had no indication of MetS. Obesity was highly prevalent in the MetS group (91.9%) while 26.8% of children were obese in the intermediate metabolic group. None of the children were obese in the group without MetS. Analysis of the CAV1 rs1997623 variant revealed a significant association of the A-allele (p = 0.01, Odds Ratio (OR) = 1.66) and the heterozygous CA-genotype (p = 0.005, OR = 1.88) with MetS. Consistently, the A-allele (p = 0.002, OR = 1.71) and CA-genotype (p = 0.005, OR = 1.70) also showed significant association with the intermediate metabolic group. Furthermore, the A-allele (p = 0.01, OR = 1.33) and the CA-genotype (p = 0.008, OR = 1.55) were associated with low levels of saliva HDLC. Individuals who were heterozygous or homozygous for the variant (CA/AA) showed significantly lower levels of high HDLC compared to those harboring the CC-genotype (p = 0.023). Our study revealed a novel association of the CAV1 rs1997623 variant with the MetS and with low saliva HDLC levels in young Kuwaiti children and indicated the need for further in-depth studies to unravel the role of CAV1 gene in the genetic etiology of MetS.
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Affiliation(s)
- Rasheeba Nizam
- Functional Genomics Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Ebaa Al-Ozairi
- Clinical Division, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Jo Max Goodson
- Applied Oral Sciences, The Forsyth Institute, Cambridge, MA, United States
| | - Motesam Melhem
- Functional Genomics Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Lena Davidsson
- Family Medicine and Pediatric Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Hessa Alkhandari
- Family Medicine and Pediatric Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Ashraf Al Madhoun
- Functional Genomics Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Sara Shamsah
- Faculty of Allied Health Sciences, Kuwait University, Kuwait City, Kuwait
| | - Malak Qaddoumi
- Functional Genomics Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Ghazi Alghanim
- Functional Genomics Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Nouf Alhasawi
- Functional Genomics Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Mohamed Abu-Farha
- Biochemistry and Molecular Biology Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Jehad Abubaker
- Biochemistry and Molecular Biology Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Ping Shi
- Applied Oral Sciences, The Forsyth Institute, Cambridge, MA, United States
| | - Mor-Li Hartman
- Applied Oral Sciences, The Forsyth Institute, Cambridge, MA, United States
| | - Mary Tavares
- Applied Oral Sciences, The Forsyth Institute, Cambridge, MA, United States
| | - Milad Bitar
- Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Hamad Ali
- Faculty of Allied Health Sciences, Kuwait University, Kuwait City, Kuwait
| | | | - Sriraman Devarajan
- National Dasman Diabetes Biobank, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Faisal Al-Refaei
- Clinical Division, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Osama Alsmadi
- Cell Therapy and Applied Genomics, King Hussein Cancer Center, Amman, Jordan
| | | | - Fahd Al-Mulla
- Functional Genomics Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
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Tiongco RE, Bituin A, Arceo E, Rivera N, Singian E. Salivary glucose as a non-invasive biomarker of type 2 diabetes mellitus. J Clin Exp Dent 2018; 10:e902-e907. [PMID: 30386523 PMCID: PMC6203925 DOI: 10.4317/jced.55009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Accepted: 08/14/2018] [Indexed: 12/20/2022] Open
Abstract
Background Every year, millions of people are diagnosed with Diabetes mellitus (DM) and the number of new and undiagnosed cases continue to rise. Diagnosis of diabetes is usually performed by blood glucose analysis after fasting for a certain period. However, this method uses an invasive technique that can cause discomfort and even trauma to some patients which could eventually lead to behavioral changes such as avoidance of healthcare and laboratory testing. Studies that explore the diagnostic value of salivary glucose are promising due to the non-invasiveness of the test procedures and its potential correlation with blood results. Material and Methods The study conducted aimed to determine if salivary glucose can be utilized as an alternative to blood glucose in the screening, diagnosis, and monitoring of type 2 diabetes mellitus (T2DM). A total of 75 participants were recruited and equally divided into 3 groups (normal fasting glucose, impaired fasting glucose, and provisional DM) based on their fasting blood glucose (FBG) level. Blood and unstimulated saliva were collected from each participant and were subjected to glucose analysis using the routine glucose oxidase-peroxidase method. Results Using Pearson's correlation and linear regression, a high degree and significant correlation was observed between blood and salivary glucose (r = 0.715, p<0.001). Further analysis showed that salivary glucose is 88.5% sensitive and 61.5% specific with a positive predictive value of 45.8%, and a negative predictive value of 97.1%. Conclusions Salivary glucose is comparable to blood glucose in diagnosing and monitoring T2DM and is considered more advantageous than blood due to its non-invasive nature. Key words:Saliva, glucose, non-invasive, diabetes.
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Affiliation(s)
- Raphael-Enrique Tiongco
- Department of Medical Technology, College of Allied Medical Professions, Angeles University Foundation, Angeles City, 2009, Philippines
| | - Aira Bituin
- Department of Medical Technology, College of Allied Medical Professions, Angeles University Foundation, Angeles City, 2009, Philippines
| | - Engracia Arceo
- Department of Medical Technology, College of Allied Medical Professions, Angeles University Foundation, Angeles City, 2009, Philippines
| | - Nicole Rivera
- Department of Medical Technology, College of Allied Medical Professions, Angeles University Foundation, Angeles City, 2009, Philippines
| | - Eloisa Singian
- Department of Medical Technology, College of Allied Medical Professions, Angeles University Foundation, Angeles City, 2009, Philippines
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Abstract
Summary
Diabetes mellitus is one of the most common chronic diseases which continue to increase in number and significance. It presents the third most prevalent condition among medically compromised patients referring for dental treatment. Diabetes mellitus has been defined as a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Hyperglycemia leads to widespread multisystem damage which has an effect on oral tissue. The present article summarizes current knowledge regarding the association between diabetes mellitus and oral and dental health.
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Capsule Prolongs Survival of Streptococcus pneumoniae during Starvation. Infect Immun 2018; 86:IAI.00802-17. [PMID: 29311231 DOI: 10.1128/iai.00802-17] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 12/21/2017] [Indexed: 12/18/2022] Open
Abstract
Person-to-person transmission of Streptococcus pneumoniae (the pneumococcus) may occur via environmental sources in close contact with carriers. Pneumococcal polysaccharide capsules, the determinant of serotype (or type), are heterogeneous in structure and amount, and these differences affect rates of transmission. In this study, we examined the contribution of capsule and its variations to the maintenance of pneumococcal viability under starvation conditions. S. pneumoniae retained its ability to colonize infant mice even after incubation for 24 h in phosphate-buffered saline at 25°C. The expression of capsule by the cps locus prolonged survival under these and other nutrient-poor conditions. Analysis of capsule-switch constructs showed that strain-to-strain differences in survival were due to capsule type rather than genetic background. The addition of glucose was sufficient to rescue the survival defect of the capsule-deficient derivative, demonstrating that in the absence of capsule, survival depends upon nutrient availability. During starvation, there was a decrease in capsule size and amount of capsular polysaccharide that was dependent on bacterial viability and the presence of the cps locus. These observations suggest that pneumococci catabolize their own capsular polysaccharide using the genes involved in its biosynthesis to maintain viability when other carbon sources are unavailable. Our findings describe a new role of the pneumococcal capsule: the prolongation of viability under nutrient-limiting conditions as would be encountered during periods when the organism is between hosts.
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Goodson JM, Hartman ML, Shi P, Hasturk H, Yaskell T, Vargas J, Song X, Cugini M, Barake R, Alsmadi O, Al-Mutawa S, Ariga J, Soparkar P, Behbehani J, Behbehani K. The salivary microbiome is altered in the presence of a high salivary glucose concentration. PLoS One 2017; 12:e0170437. [PMID: 28249034 PMCID: PMC5331956 DOI: 10.1371/journal.pone.0170437] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 01/04/2017] [Indexed: 01/30/2023] Open
Abstract
Background Type II diabetes (T2D) has been associated with changes in oral bacterial diversity and frequency. It is not known whether these changes are part of the etiology of T2D, or one of its effects. Methods We measured the glucose concentration, bacterial counts, and relative frequencies of 42 bacterial species in whole saliva samples from 8,173 Kuwaiti adolescents (mean age 10.00 ± 0.67 years) using DNA probe analysis. In addition, clinical data related to obesity, dental caries, and gingivitis were collected. Data were compared between adolescents with high salivary glucose (HSG; glucose concentration ≥ 1.0 mg/d, n = 175) and those with low salivary glucose (LSG, glucose concentration < 0.1 mg/dL n = 2,537). Results HSG was associated with dental caries and gingivitis in the study population. The overall salivary bacterial load in saliva decreased with increasing salivary glucose concentration. Under HSG conditions, the bacterial count for 35 (83%) of 42 species was significantly reduced, and relative bacterial frequencies in 27 species (64%) were altered, as compared with LSG conditions. These alterations were stronger predictors of high salivary glucose than measures of oral disease, obesity, sleep or fitness. Conclusions HSG was associated with a reduction in overall bacterial load and alterations to many relative bacterial frequencies in saliva when compared with LSG in samples from adolescents. We propose that hyperglycemia due to obesity and/or T2D results in HSG and subsequent acidification of the oral environment, leading to a generalized perturbation in the oral microbiome. This suggests a basis for the observation that hyperglycemia is associated with an increased risk of dental erosion, dental caries, and gingivitis. We conclude that HSG in adolescents may be predicted from salivary microbial diversity or frequency, and that the changes in the oral microbial composition seen in adolescents with developing metabolic disease may the consequence of hyperglycemia.
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Affiliation(s)
- J. Max Goodson
- Department of Applied Oral Sciences, the Forsyth Research Institute, Cambridge, Massachusetts, United States of America
- * E-mail:
| | - Mor-Li Hartman
- Department of Applied Oral Sciences, the Forsyth Research Institute, Cambridge, Massachusetts, United States of America
| | - Ping Shi
- Department of Applied Oral Sciences, the Forsyth Research Institute, Cambridge, Massachusetts, United States of America
| | - Hatice Hasturk
- Department of Applied Oral Sciences, the Forsyth Research Institute, Cambridge, Massachusetts, United States of America
| | - Tina Yaskell
- Department of Applied Oral Sciences, the Forsyth Research Institute, Cambridge, Massachusetts, United States of America
| | - Jorel Vargas
- Department of Applied Oral Sciences, the Forsyth Research Institute, Cambridge, Massachusetts, United States of America
| | - Xiaoqing Song
- Department of Applied Oral Sciences, the Forsyth Research Institute, Cambridge, Massachusetts, United States of America
| | - Maryann Cugini
- Department of Applied Oral Sciences, the Forsyth Research Institute, Cambridge, Massachusetts, United States of America
| | - Roula Barake
- The Dasman Diabetes Institute, Kuwait City, Kuwait
| | | | | | | | - Pramod Soparkar
- Department of Applied Oral Sciences, the Forsyth Research Institute, Cambridge, Massachusetts, United States of America
| | - Jawad Behbehani
- Kuwait University, Faculty of Dentistry, Kuwait City, Kuwait
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Hao G, Wang D, Sun Y, Yu J, Lin F, Cao H. Association of blood glucose and lipid levels with complete blood count indices to establish a regression model. Biomed Rep 2017; 6:339-345. [PMID: 28451397 DOI: 10.3892/br.2017.852] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 11/23/2016] [Indexed: 11/06/2022] Open
Abstract
Hyperglycemia and hyperlipidemia, which are usually diagnosed by analysis of blood glucose (GLU) and lipid levels, are two of the most common diseases in modern society. The purpose of the current study was to investigate the potential association between blood GLU and lipid levels with complete blood count (CBC) indices in overweight and healthy individuals and establish a regression model. There were 456 healthy and 421 overweight participants in the study. Data were collected on triglyceride (TG), total cholesterol (CHO), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), blood GLU and CBC. The distribution characteristics and differences between healthy and overweight subjects were analyzed. Subsequently, the associations between TG, CHO, HDL, LDL and GLU with CBC were analyzed using correlation analysis and multiple linear regression (MLR). Significant differences were identified between the healthy and overweight individuals in TG, CHO, HDL, LDL, GLU and in the majority of the CBC indices. The correlation analysis indicated that there were strong correlations between TG, LDL, HDL, CHO and GLU with CBC indices in the healthy and overweight subjects. The MLR demonstrated that the regression models of TG, LDL, HDL and CHO, but no GLU, were statistically significant in the two groups (P<0.001). The HDL regression model exhibited the best regression parameters; the multiple correlation coefficients (R) were 0.351 and 0.308 in the healthy and overweight subjects, respectively. In the overweight and healthy subjects, there were strong correlations between TG, LDL, HDL and CHO with CBC indices, with HDL being the most relevant to the CBC indices. The CBC demonstrated statistical significance in the diagnosis of hyperlipidemia.
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Affiliation(s)
- Guangshu Hao
- Central Laboratory, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Dan Wang
- Central Laboratory, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Yanni Sun
- Central Laboratory, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Jiong Yu
- The State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Feiyan Lin
- Central Laboratory, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China
| | - Hongcui Cao
- Central Laboratory, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325000, P.R. China.,The State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
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Hartman ML, Goodson JM, Shi P, Vargas J, Yaskell T, Stephens D, Cugini M, Hasturk H, Barake R, Alsmadi O, Al-Mutawa S, Ariga J, Soparkar P, Behbehani J, Behbehani K, Welty F. Unhealthy Phenotype as Indicated by Salivary Biomarkers: Glucose, Insulin, VEGF-A, and IL-12p70 in Obese Kuwaiti Adolescents. J Obes 2016; 2016:6860240. [PMID: 27069678 PMCID: PMC4812454 DOI: 10.1155/2016/6860240] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 02/11/2016] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Here, we investigated the relationships between obesity and the salivary concentrations of insulin, glucose, and 20 metabolic biomarkers in Kuwaiti adolescents. Previously, we have shown that certain salivary metabolic markers can act as surrogates for blood concentrations. METHODS Salivary samples of whole saliva were collected from 8,317 adolescents. Salivary glucose concentration was measured by a high-sensitivity glucose oxidase method implemented on a robotic chemical analyzer. The concentration of salivary insulin and 20 other metabolic biomarkers was assayed in 744 randomly selected saliva samples by multiplexed bead-based immunoassay. RESULTS Obesity was seen in 26.5% of the adolescents. Salivary insulin predicting hyperinsulinemia occurred in 4.3% of normal-weight adolescents, 8.3% of overweight adolescents, and 25.7% of obese adolescents (p < 0.0001). Salivary glucose predicting hyperglycemia was found in only 3% of obese children and was not predictive (p = 0.89). Elevated salivary glucose and insulin occurring together was associated with elevated vascular endothelial growth factor and reduced salivary interleukin-12. CONCLUSION Considering the surrogate nature of salivary insulin and glucose, this study suggests that elevated insulin may be a dominant sign of metabolic disease in adolescent populations. It also appears that a proangiogenic environment may accompany elevated glucose in obese adolescents.
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Affiliation(s)
- Mor-Li Hartman
- Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, MA 02142, USA
- *Mor-Li Hartman:
| | - J. Max Goodson
- Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, MA 02142, USA
| | - Ping Shi
- Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, MA 02142, USA
| | - Jorel Vargas
- Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, MA 02142, USA
| | - Tina Yaskell
- Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, MA 02142, USA
| | - Danielle Stephens
- Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, MA 02142, USA
| | - Maryann Cugini
- Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, MA 02142, USA
| | - Hatice Hasturk
- Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, MA 02142, USA
| | - Roula Barake
- Department of Nutrition, Dasman Diabetes Institute, 15462 Dasman, Kuwait
| | - Osama Alsmadi
- Genome Center, The Dasman Diabetes Institute, 15462 Dasman, Kuwait
| | | | | | - Pramod Soparkar
- Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, MA 02142, USA
| | - Jawad Behbehani
- Faculty of Dentistry, Kuwait University, 13060 Safat, Kuwait
| | | | - Francine Welty
- Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
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Shi P, Goodson JM, Hartman ML, Hasturk H, Yaskell T, Vargas J, Cugini M, Barake R, Alsmadi O, Al-Mutawa S, Ariga J, Soparkar P, Behbehani J, Behbehani K, Welty F. Continuous Metabolic Syndrome Scores for Children Using Salivary Biomarkers. PLoS One 2015; 10:e0138979. [PMID: 26418011 PMCID: PMC4587796 DOI: 10.1371/journal.pone.0138979] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 09/08/2015] [Indexed: 02/06/2023] Open
Abstract
Background Binary definitions of the metabolic syndrome based on the presence of a particular number of individual risk factors are limited, particularly in the pediatric population. To address this limitation, we aimed at constructing composite and continuous metabolic syndrome scores (cmetS) to represent an overall measure of metabolic syndrome (MetS) in a large cohort of metabolically at-risk children, focusing on the use of the usual clinical parameters (waist circumference (WC) and systolic blood pressure (SBP), supplemented with two salivary surrogate variables (glucose and high density lipoprotein cholesterol (HDLC). Two different approaches used to create the scores were evaluated in comparison. Methods Data from 8,112 Kuwaiti children (10.00 ± 0.67 years) were used to construct two cmetS for each subject. The first cmetS (cmetS-Z) was created by summing standardized residuals of each variable regressed on age and gender; and the second cmetS (cmetS-PCA) was defined as the first principal component from gender-specific principal component analysis based on the four variables. Results There was a graded relationship between both scores and the number of adverse risk factors. The areas under the curve using cmetS-Z and cmetS-PCA as predictors for severe metabolic syndrome (defined as the presence of ≥3 metabolic risk factors) were 0.935 and 0.912, respectively. cmetS-Z was positively associated with WC, SBP, and glucose, but inversely associated with HDLC. Except for the lack of association with glucose, cmetS-PCA was similar to cmetS-Z in boys, but had minimum loading on HDLC in girls. Analysis using quantile regression showed an inverse association of fitness level with cmetS-PCA (p = 0.001 for boys; p = 0.002 for girls), and comparison of cmetS-Z and cmetS-PCA suggested that WC and SBP were main contributory components. Significant alterations in the relationship between cmetS and salivary adipocytokines were demonstrated in overweight and obese children as compared to underweight and normal-weight children. Conclusion We have derived continuous summary scores for MetS from a large-scale pediatric study using two different approaches, incorporating salivary measures as surrogate for plasma measures. The derived scores were viable expressions of metabolic risk, and can be utilized to study the relationships of MetS with various aspects of the metabolic disease process.
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Affiliation(s)
- Ping Shi
- Department of Applied Oral Sciences, the Forsyth Research Institute, Cambridge, Massachusetts, United States of America
- * E-mail: (JMG); (PS)
| | - J. Max Goodson
- Department of Applied Oral Sciences, the Forsyth Research Institute, Cambridge, Massachusetts, United States of America
- * E-mail: (JMG); (PS)
| | - Mor-Li Hartman
- Department of Applied Oral Sciences, the Forsyth Research Institute, Cambridge, Massachusetts, United States of America
| | - Hatice Hasturk
- Department of Applied Oral Sciences, the Forsyth Research Institute, Cambridge, Massachusetts, United States of America
| | - Tina Yaskell
- Department of Applied Oral Sciences, the Forsyth Research Institute, Cambridge, Massachusetts, United States of America
| | - Jorel Vargas
- Department of Applied Oral Sciences, the Forsyth Research Institute, Cambridge, Massachusetts, United States of America
| | - Maryann Cugini
- Department of Applied Oral Sciences, the Forsyth Research Institute, Cambridge, Massachusetts, United States of America
| | - Roula Barake
- The Dasman Diabetes Institute, Kuwait City, Kuwait
| | | | | | | | - Pramod Soparkar
- Department of Applied Oral Sciences, the Forsyth Research Institute, Cambridge, Massachusetts, United States of America
| | - Jawad Behbehani
- Faculty of Dentistry, Kuwait University, Kuwait City, Kuwait
| | | | - Francine Welty
- Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America
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