Inflammatory biomarkers in saliva: assessing the strength of association of diabetes mellitus and periodontal status with the oral inflammatory burden
(Journal of Clinical Periodontology; doi: 10.1111/j.1600-051X.2012.01866.x)
Angela J. Yoon, Bin Cheng, Elizabeth Philipone, Ryan Turner, Ira B. Lamster
Saliva contains substances released during inflammation. Measuring them could help researchers understand gum disease, but a substance being higher in a study does not automatically make it a useful diagnostic test.
Researchers studied 192 people grouped according to type 2 diabetes status and oral health. Groups included people with different levels of periodontitis and people with no natural teeth. Saliva was tested for beta-glucuronidase, an enzyme associated with inflammatory activity, and IL-1beta, a protein involved in immune signalling.
Both diabetes and periodontitis were associated with higher beta-glucuronidase levels, with periodontal disease showing the stronger relationship. IL-1beta was mainly associated with periodontal severity rather than diabetes status. Participants without natural teeth had the lowest levels of both markers. These were measurements in saliva; they do not demonstrate that inflammation elsewhere in the body was lower.
The study suggests that oral disease makes an important contribution to inflammatory substances found in saliva. It does not show that saliva testing can replace a gum examination or guide diabetes treatment. Lower levels among people without teeth must not be interpreted as a reason to remove teeth. The purpose of periodontal care is to assess and treat disease while preserving teeth where possible.
This study provides a snapshot rather than showing what happened first. People in the comparison groups may differ in ways the researchers could not fully measure, such as other health conditions, medicines or access to care. Statistical adjustment helps, but cannot remove every difference. A relationship seen across a group is also not a forecast for one person. The findings are best viewed as a reason for further research, not proof that changing one measurement will prevent or treat another condition.
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Periodontitis is the 6th most prevalent condition globally
Periodontitis and diabetes are bidirectionally linked
Diabetic complications are increased if you have both diseases
Successful periodontal treatment can improve blood glucose control
Periodontitis is the 6th most prevalent condition globally
Periodontitis and diabetes are bidirectionally linked
Diabetic complications are increased if you have both diseases
Successful periodontal treatment can improve blood glucose control
