Differential Associations for Salivary Sodium, Potassium, Calcium, and Phosphate Levels with Carotid Intima Media Thickness, Heart Rate, and Arterial Stiffness.

Carlos Labat,Simon N Thornton,Silke Thul,Athanase Benetos,Mohamed Temmar,John Pirault,Magnus Bäck

doi:10.1155/2018/3152146

Abstract

Salivary biomarkers may offer a noninvasive and easy sampling alternative in cardiovascular risk evaluation. The aim of the present study was to establish associations of salivary potassium, sodium, calcium, and phosphate levels with the cardiovascular phenotype determined by carotid ultrasound and carotid-femoral pulse wave velocity and to identify possible covariates for these associations. N = 241 samples of nonstimulated whole buccal saliva were obtained from subjects with (n = 143; 59%) or without (n = 98; 41%) hypertension. The potassium concentrations were 10-fold higher in saliva compared with plasma, whereas sodium concentrations exhibited the reverse relation between saliva and blood. There were no significant correlations between the levels of sodium, potassium, or calcium in saliva and plasma. All salivary electrolytes, except sodium, were significantly associated with age. In age-adjusted analyses, salivary potassium was significantly associated with carotid artery intima media thickness (cIMT) and carotid-femoral pulse wave velocity, and these associations were at the limit of significance in multivariate analyses including prevalent cardiovascular disease and risk factors. Body mass index was a significant confounder for salivary potassium. Salivary phosphate was significantly associated with cIMT in the multivariate analysis. Salivary potassium, calcium, and phosphate levels were significantly associated with heart rate in the univariate age-adjusted as well as in two different multivariate models, whereas no significant associations between sodium and heart rate were observed. In conclusion, the differential association of salivary electrolytes with cardiovascular phenotypes indicates that these electrolytes should be further studied for their predictive value as noninvasive biomarkers for cardiovascular risk evaluation.

Highlights

IntroductionThe simple and noninvasive sampling procedure for saliva, together with the development of easy-to-use point of care analysis methods, may change the landscape of medical diagnostics and facilitate patient evaluation by telemedicine
Saliva is gaining renewed interest for its diagnostic value
In multivariate analysis adjusted for age and including prevalent cardiovascular disease and risk factors, we found HR to be a major determinant for salivary ion levels and we identified salivary phosphate levels as an independent predictor of carotid artery intima media thickness (cIMT)

Summary

Introduction

The simple and noninvasive sampling procedure for saliva, together with the development of easy-to-use point of care analysis methods, may change the landscape of medical diagnostics and facilitate patient evaluation by telemedicine. Since salivary CRP correlates strongly with circulating levels [1], the use of venipuncture can be avoided, permitting the patients to sample saliva themselves for infectious and inflammatory disease diagnosis. Low levels of CRP, measured by high-sensitivity CRP assays, are indicative of low-grade chronic inflammation, which can be associated with an increased cardiovascular risk [2]. Such CRP alteration within the lower normal range can be detected in saliva.

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