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. 2022 Jun 10:10:800373.
doi: 10.3389/fpubh.2022.800373. eCollection 2022.

Salivary Biomarkers as Predictors of Obesity and Intermediate Hyperglycemia in Adolescents

Hend Alqaderi  1   2   3 , Fahad Hegazi  4 , Fahd Al-Mulla  1 , Chung-Jung Chiu  5 , Alpdogan Kantarci  5 , Ebaa Al-Ozairi  1   6 , Mohamed Abu-Farha  1 , Saadoun Bin-Hasan  1   7 , Aishah Alsumait  2 , Jehad Abubaker  1 , Sriraman Devarajan  1 , J Max Goodson  5 , Hatice Hasturk  5 , Mary Tavares  3   5   8
Affiliations

Salivary Biomarkers as Predictors of Obesity and Intermediate Hyperglycemia in Adolescents

Hend Alqaderi et al. Front Public Health. .

Abstract

Introduction: Childhood obesity presents a major risk for metabolic diseases in adulthood. Noninvasive methods are needed for predicting the course of obesity in children and its complications. Using blood for longitudinal analyses of biomarkers to predict disease in children is not a convenient method. Saliva presents a noninvasive platform to detect inflammatory changes in biomarkers as possible predictive measures of future pathological events.

Objectives: The aim of this study was to evaluate the relationship between specific salivary biomarkers, obesity, and intermediate hyperglycemia in children. We also investigated the longitudinal association between the salivary biomarkers and change in Body Mass Index-for-age percentile scores (BMIz).

Methods: Data on 353 adolescents were collected from the individuals recruited for seven years in an ongoing Kuwait Healthy Life Study cohort. BMIz was measured at 10, 12, and 17 years of age. Interleukin (IL)-6, IL-8, IL-10, Leptin, C-Reactive Protein (CRP), Insulin, Vascular Endothelial Growth Factor (VEGF), and Monocyte Chemoattractant Protein-1 (MCP-1) were measured in saliva and serum. Additionally, fasting blood plasma glucose levels were recorded. Multilevel longitudinal regression modeling, mediation analyses, and logistic regression were used to determine the predictive value of salivary biomarkers in obesity and hyperglycemia.

Results: Longitudinal analyses showed that with each one-unit increase of salivary CRP and insulin, there was a 3.5 kg/m2 and 3.2 kg/m2 increase in BMIz, respectively. Comparable to serum CRP and insulin, higher salivary CRP and insulin OR 4.94 [95%CI: 1.66,14., OR 2.64 [95%CI: 1.09, 6.38], respectively) were predictive of hyperglycemia and obesity (OR 4.53 [95%CI: 2.40,8.50], OR 3.29 [95%CI: 1.82,5.97], respectively). Insulin was a strong mediator in the relationship between obesity and hyperglycemia.

Conclusion: Our findings demonstrated that salivary CRP and insulin were associated with hyperglycemia, obesity, and possibly diabetes in adolescents. Salivary biomarkers are a noninvasive approach with significant value for disease risk assessment and prevention.

Keywords: C-Reactive Protein; children; cytokines; inflammation; insulin; metabolic disease; obesity; saliva.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Scatter plot of the correlation between serum and salivary CRP biomarker levels.
Figure 2
Figure 2
Scatter plot of the correlation between serum and salivary insulin biomarker levels.
Figure 3
Figure 3
Scatter plot of the correlation between serum and salivary adiponectin biomarker levels.
Figure 4
Figure 4
Logistic analysis relating salivary levels of insulin, C-reactive protein (CRP), and adiponectin to probabilities of intermediate hyperglycemia and obesity at visit 3. Intermediate hyperglycemia was defined as hemoglobin A1c (HbA1c) between >5.6– <6.4% and obesity was defined as body mass index (BMI) > [mean+2*standard deviation (SD)]. Odds ratio (OR), 95% confidence interval (CI), and test for linear trend were calculated as per 10-time increase of salivary biomarker levels adjusted for age, sex, blood pressure, and school.
Figure 5
Figure 5
Pathway of the mediation process for Insulin in the relationship between BMIz and Intermediate hyperglycemia.
See this image and copyright information in PMC

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