Markers of Oxidative Stress in the Saliva of Type 2 Diabetic Patients

Objective: Diabetes mellitus is associated with increased prevalence of oral diseases for which reactive oxygen species have been implicated. The saliva contains protective antioxidants which statutorily curtail these destructive oxygen molecules. A functional compromise of the antioxidants may precipitate oxidative stress leading to the increased oral disease susceptibility. However, salivary markers of oxidative stress have not been sufficiently studied in the diabetics. Methods: A total of 166 adults were recruited for this study. They comprised of 95 Type 2 diabetic patients and 71 healthy non-diabetic controls. About 3 ml of unstimulated saliva samples were collected from participants and processed, levels of salivary H2O2, NO and MDA were measured using spectrophotometry method and compared between the two groups. Data was analysed using t-test, logistic regression and receiver operating characteristics (ROC) with statistical significance set at p<0.05. Results: Salivary H2O2 (p=0.024) and NO (p=0.002) were significantly higher in the diabetic patients when compared to the healthy non-diabetic control group. Binary logistic regression showed that patients with Type 2 diabetic mellitus are more likely to have elevated salivary H2O2 (OR= 1.013; p=0.025) and NO (OR=1.016; p=0.003) levels. ROC analysis showed statistically significant performance of salivary NO levels in distinguishing between T2DM patients and healthy controls. Conclusions: Higher levels of oxidative stress markers including salivary H2O2 and NO in the diabetic groups could be a pointer to the characteristic high prevalence of oral diseases in diabetes mellitus, given that oxidative stress predisposes to disease vulnerability. This calls for increased attention to oral health in diabetes management to minimise co-morbidity

Levels of Salivary Immunoglobulin A and Immunoglobulin G in Type 2 Diabetic Patients

Background: Diabetes mellitus is a chronic disorder of glucose metabolism and it is associated with a compromised oral immunity. Salivary immunoglobulins offer a comprehensive protection for the oral cavity; however, there is insufficient data regarding their levels in type 2 diabetic patients. This study aimed to measure salivary Immunoglobulin G (IgG) and Immunoglobulin A (IgA) in diabetic patients in comparison to healthy nondiabetic controls. Methods: Diabetic patients from the outpatient clinic and nondiabetic healthy members of staff, were recruited for this study. Unstimulated saliva samples were collected from all participants and levels of immunoglobulins A and G were determined using enzyme-linked immunosorbent assay techniques; the values were compared between the two groups. Results: A total of 167 participants were recruited for this study, 95 (56.9%) of them were diabetic patients, while the remaining 72 (43.1%) were healthy nondiabetic controls. The median salivary IgA was 12.57 (Interquartile range [IQR] 11.05–13.67) g/ml in the diabetics and 11.94 (IQR 10.41–13.65) µg/ml in the control group; P = 0.31 while the median salivary IgG was 32.27 (IQR 25.26–38.33) µg/ml in the diabetics and 26.26 (22.48–31.29) µg/ml in the control group; P < 0.001. Conclusion: Salivary IgG was significantly elevated in the diabetic patients, in spite of a higher prevalence of oral infections, this calls for a more stringent attention to oral hygiene in diabetic patients