Abstract
BackgroundType 1 diabetes (T1D) is an autoimmune disease resulting in the targeted destruction of pancreatic β-cells and permanent loss of insulin production. Proper glucose management results in better clinical outcomes for T1D and provides a strong rationale to identify non-invasive biomarkers indicative or predictive of glycemic control. Therefore, we investigated the association of salivary inflammation with HbA1c in a T1D cohort.MethodsUnstimulated saliva was collected from 144 subjects with T1D at the USF Diabetes Center. BMI, duration of diabetes, and HbA1c were recorded during clinical visit. Levels of interleukin (IL)-1β, -6, -8, -10, IFN-γ, TNF-α, MMP-3, -8, and -9 were measured using multiplexing immunoassay analysis. To account for smoking status, salivary cotinine levels were also determined.ResultsMultiple linear (HbA1c) and logistic (self-reported gingival condition) regression analyses were performed to examine the relationships between the Principal Component Analysis (PCA) components and HbA1c and gingival condition (adjusted for age, duration of diabetes, BMI, and sex; model for HbA1c also adjusted for gingival condition and model for gingival condition also adjusted for HbA1c). PCA components 1 (MMP-8 and MMP-9) and 3 (TNF-α) were significantly associated with HbA1c (β = 0.28 ±0.14, p = 0.045; β = 0.31 ±0.14, p = 0.029), while PCA component 2 (IL-6, IL-1β, and IL-8) was significantly associated with gingival condition (OR 1.60 95% CI 1.09–2.34, p = 0.016). In general, increased salivary inflammatory burden is associated with decreased glycemic control and self-reported gingival condition.ConclusionsThe saliva may represent a useful reservoir of novel noninvasive inflammatory biomarkers predictive of the progression and control of T1D.
Highlights
Periodontitis impacts as much as 47% of the U.S population and is a significant cause for tooth loss in adults [1]
Multiple linear (HbA1c) and logistic regression analyses were performed to examine the relationships between the Principal Component Analysis (PCA) components and HbA1c and gingival condition
PCA components 1 (MMP-8 and matrix metalloproteinase (MMP)-9) and 3 (TNF-α) were significantly associated with HbA1c (β = 0.28 ±0.14, p = 0.045; β = 0.31 ±0.14, p = 0.029), while PCA component 2 (IL-6, IL-1β, and IL-8) was significantly associated with gingival condition
Summary
Periodontitis impacts as much as 47% of the U.S population and is a significant cause for tooth loss in adults [1]. This destructive process is driven by bacterial infections that colonize the tooth root surface [2] Due to this pathogenic event, immunological mediators are activated and various metabolic byproducts such as cytokines, chemokines and tissue-destructive enzymes such as matrix-metalloproteinases (MMPs) are released [3]. The overall suspected relationship between periodontal disease and glycemic control provides a strong rationale for our central hypothesis that increased inflammatory burden and quantitative biomarkers of periodontal disease will be associated with decreased glycemic control. To our knowledge, this has never been evaluated in a T1D cohort. We investigated the association of salivary inflammation with HbA1c in a T1D cohort.
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