Salivary and gingival crevicular fluid biomarkers of periodontal health and/or obesity among children and adolescents: A systematic review and meta-analysis

Abstract

Objectives: To investigate the association of salivary and gingival crevicular fluid (GCF) biomarkers with periodontal status and obesity in children and adolescents.

Data/sources: A literature search up to July 2023 was conducted through PubMed, Web of Science, Embase, ProQuest Medical Database, ProQuest SciTech Premium Collection, and the Cochrane Library. Observational studies comparing salivary and GCF biomarkers in children and adolescents with compromised periodontal status and/or obesity were included for data extraction. A meta-analysis was performed to estimate the overall standardised mean difference.

Study selection: Fifteen observational studies met the inclusion criteria and were included in this systematic review. Meta-analysis was only applicable in synthesising the dyadic relationship between GCF biomarkers and obesity. The results demonstrated that children and adolescents with obesity had significantly higher GCF levels of tumour necrosis factor-alpha (SMD:0.56; 95% CI:0.07, 1.04), adiponectin (SMD:0.33; 95% CI:0.06, 0.60), leptin (SMD:0.52; 95% CI:0.15, 0.90), and interleukin-1 beta (SMD:0.71; 95% CI:0.44, 0.99) than those with normal weight.

Conclusion: To date, no study has well addressed the triadic association between salivary or GCF biomarkers, periodontal status, and obesity among children and adolescents. Further in-depth, high-quality studies are required to investigate these associations.

Clinical significance: Periodontal disease and obesity are growing public health crises worldwide. Their relationship has been intensively studied. Investigating the salivary or GCF biomarkers alterations could help better understand the relationship between periodontal disease and obesity, which would assist in tailoring future oral health promotion programs.

Keywords: Biomarker; Gingival crevicular fluid; Meta-analysis; Obesity; Saliva; Systematic review.

Fig. 1

Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) flow diagram of the study selection process.

Fig. 2

Differences in the gingival crevicular fluid level of tumour necrosis factor-α (A), resistin (B), adiponectin (C), and leptin (D) between children and adolescents with normal weight and obesity. Standardised mean differences and the 95% confidence intervals were indicated by the diamonds in the forest plots.

Fig. 3

Differences in the gingival crevicular fluid levels of interleukin-1β (A), interleukin-8 (B), and plasminogen activator inhibitor-1 (C) between children and adolescents with normal weight and obesity. Standardised mean differences and the 95% confidence intervals were indicated by the diamonds in the forest plots.