Salivary diagnostics in diabetes and periodontitis

Background + Aims

• Periodontitis, a chronic gum disease, involves inflammation and tissue destruction. It is especially common in people living with diabetes, making diagnosis and monitoring crucial.
• Saliva contains proteins (biomarkers) that reflect gum health and inflammation. These biomarkers could provide a non-invasive tool for diagnosing gum disease in people living with diabetes.
• The study examined whether a combination of salivary biomarkers can distinguish between healthy gums and periodontitis in individuals living with type 2 diabetes (T2DM).

Materials + Methods

• This case-control study recruited adult patients. Exclusion criteria included medical conditions such as cancer, liver/kidney disease, and immunosuppression, as well as recent antibiotic use, smoking, and pregnancy.
• Included adult participants were divided into 3 groups:
  • T2DM with periodontitis (DWP, n=29)
  • T2DM without periodontitis (DWoP, n=32)
  • Non-diabetic, healthy individuals (NP, n=31)
• Participants underwent a comprehensive periodontal examination. Periodontitis was defined based on clinical attachment loss (CAL), probing depth (PD), and bleeding on probing (BOP).
• Participants provided unstimulated whole saliva samples  for biomarker analysis.
• Salivary levels of interleukin-1β (IL-1β), interleukin-6 (IL-6), macrophage inflammatory protein-1α (MIP-1α), adiponectin, resistin, and matrix metalloproteinase-8 (MMP-8) were measured using Luminex and ELISA methods.
• Statistical analysis aimed to compare biomarker levels among groups.
• The ability of biomarkers to distinguish periodontitis from healthy individuals was assessed, with accuracy, sensitivity, specificity, and predictive values calculated.
• Statistical significance was set at p<0.05.

Results

• Higher levels of IL-1β and MMP-8 were found in people living with T2DM who had periodontitis compared to those without periodontitis.
  • MMP-8 was the most reliable marker, distinguishing periodontitis in T2DM patients with high accuracy.
• Biomarker levels increased across groups 0 lowest in the NP group and highest in the DWP group.
• Combining multiple biomarkers improved the ability to detect periodontitis in T2DM patients.
• MMP-8 showed a strong correlation with periodontitis severity, including deeper pockets and moreBOP

Limitations