Estimation of Salivary Glucose, Calcium, Phosphorus, Alkaline Phosphatase, and Immunoglobulin A among Diabetic and Nondiabetic Children: A Case-Control Study

Abstract

Introduction: Saliva is vital for oral health and helps to maintain oral homeostasis. It may show qualitative and quantitative variations owing to any changes in the systemic health. Diabetes mellitus (DM) is a metabolic disease and the individuals may be at higher risk for oral health problems.

Objective: The study was aimed to estimate the levels of various salivary components among diabetic and nondiabetic children with similar caries status and also to analyze possible association between caries status and possible caries determinants in the saliva of diabetic children.

Materials and methods: A total of 70 children in the age group of 6 to 13 years with minimal dental caries (Decayed, Missing and Filled Teeth index (DMFT/dmft >1 and <5)) were selected. Group I comprised of type I diabetic children and on medication for diabetes and group II included healthy nondiabetic children. Salivary samples were collected from the participants by passive drool method and estimation of all salivary parameters was done using autoanalyzer.

Results: Statistical analyses were done using Student's t-test and results are presented as mean ± standard deviation (SD). There was a highly significant difference in mean glucose value between diabetic and nondiabetic children. Levels of salivary calcium, phosphorus, and salivary immunoglobulin A (s-IgA) did not show any significant difference between the two groups. There was also a statistically significant difference in the alkaline phosphatase (AP) levels, which was found to be higher in diabetics.

Conclusion: An elevation in the levels of salivary glucose and AP was evident in diabetic children, which can be a risk marker for dental caries. There was no correlation in the levels of salivary calcium, phosphorus, and s-IgA levels among diabetic and healthy children.

Clinical significance: The salivary factors evaluated in the study may prove to be useful measures of caries experience in diabetic children.How to cite this article: Uppu K, Sahana S, Madu GP, Vasa AAK, Nalluri S, Raghavendra KJ. Estimation of Salivary Glucose, Calcium, Phosphorus, Alkaline Phosphatase, and Immunoglobulin A among Diabetic and Nondiabetic Children: A Case-Control Study. Int J Clin Pediatr Dent 2018;11(2):71-78.

Keywords: Alkaline phosphatase; Calcium; Nondiabetic healthy children; Phosphorus; Salivary glucose; Type I diabetic children.; s-IgA.

Fig. 1:

Armamentarium used for the study

Fig. 2:

Examination of participants

Fig. 3:

Saliva collection (passive drool method)

Fig. 4:

Portable icebox for saliva storage

Fig. 5:

Micropipettes for dilution of saliva

Fig. 6:

Chemwell autoanalyzer (Awareness tech, USA)

Fig. 7:

Calbiotech ELISA kit

Fig. 8:

Reagents used for the study

Graph 1:

Mean salivary glucose levels in two groups

Graph 2:

Mean salivary calcium levels in two groups

Graph 3:

Mean salivary phosphate levels in two groups

Graph 4:

Mean salivary AP levels in two groups

Graph 5:

Mean s-IgA levels in two groups