Frontiers in dental medicine · 2026
Salivary biomarker profiling in prediabetes-associated periodontitis: role of adiponectin, resistin, and total matrix metalloproteinase-8.
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Thomas Julie Toby, Joseph Betsy, Varghese Sajit, Thomas Nebu George, S Kavya, Thomas Toby, Sorsa Timo, Anil Sukumaran, Waltimo Tuomas
Аннотация
AIM: This study evaluated the diagnostic potential of salivary total matrix metalloproteinase-8 (tMMP-8), adiponectin, and resistin in prediabetic adults with and without periodontitis and examined their associations with systemic and periodontal parameters.
MATERIALS AND METHODS: Systemically healthy and prediabetic adults, categorized by periodontal status, underwent clinical, anthropometric, and metabolic assessments. A total of 84 adults aged 25-55 years were enrolled and stratified into four groups: prediabetes with periodontitis (PreDM-PD, n = 24), prediabetes with periodontal health (PreDM-PH, n = 19), systemically healthy with periodontitis (SH-PD, n = 22), and systemically and periodontally healthy controls (SH-PH, n = 19). Unstimulated saliva was collected to quantify tMMP-8, adiponectin, and resistin by sandwich ELISA. Statistical analyses included group comparisons (one-way ANOVA with Bonferroni post-hoc correction; Kruskal-Wallis with Dunn's test for non-normally distributed variables), correlation analysis of biomarkers with systemic and periodontal measures, and principal component analysis (PCA) to define a composite inflammatory profile.
RESULTS: Participants with periodontitis had significantly higher periodontal parameters (p < 0.001). Salivary tMMP-8 was elevated in prediabetic individuals with periodontitis compared to other groups (p < 0.001), whereas adiponectin was lower in prediabetic groups versus controls (p < 0.01). tMMP-8 correlated positively with BMI, HbA1c, probing pocket depth (PPD), and clinical attachment loss (CAL). Adiponectin inversely correlated with HbA1c, PPD, CAL, and bleeding on probing. Resistin showed a weak positive correlation with CAL. PCA revealed an inflammatory profile (high tMMP-8, low adiponectin) explaining 37.1% of variance (KMO = 0.58; Bartlett's χ² = 22.86, p < 0.001), effectively distinguishing prediabetic with periodontitis from healthy controls (AUC = 0.925, p < 0.001; sensitivity 87.5%, specificity 89.5%, Youden J = 0.77) and showing acceptable accuracy in periodontal health. Between-group differences for tMMP-8, adiponectin, PPD, CAL and BoP remained statistically significant after adjustment for age (ANCOVA, all p < 0.01).
CONCLUSION: Salivary tMMP-8 and adiponectin composite profiles outperform single markers, supporting their use in non-invasive periodontal risk screening in metabolically vulnerable adults. Elevated tMMP-8 links periodontal and metabolic inflammation in prediabetes.
MATERIALS AND METHODS: Systemically healthy and prediabetic adults, categorized by periodontal status, underwent clinical, anthropometric, and metabolic assessments. A total of 84 adults aged 25-55 years were enrolled and stratified into four groups: prediabetes with periodontitis (PreDM-PD, n = 24), prediabetes with periodontal health (PreDM-PH, n = 19), systemically healthy with periodontitis (SH-PD, n = 22), and systemically and periodontally healthy controls (SH-PH, n = 19). Unstimulated saliva was collected to quantify tMMP-8, adiponectin, and resistin by sandwich ELISA. Statistical analyses included group comparisons (one-way ANOVA with Bonferroni post-hoc correction; Kruskal-Wallis with Dunn's test for non-normally distributed variables), correlation analysis of biomarkers with systemic and periodontal measures, and principal component analysis (PCA) to define a composite inflammatory profile.
RESULTS: Participants with periodontitis had significantly higher periodontal parameters (p < 0.001). Salivary tMMP-8 was elevated in prediabetic individuals with periodontitis compared to other groups (p < 0.001), whereas adiponectin was lower in prediabetic groups versus controls (p < 0.01). tMMP-8 correlated positively with BMI, HbA1c, probing pocket depth (PPD), and clinical attachment loss (CAL). Adiponectin inversely correlated with HbA1c, PPD, CAL, and bleeding on probing. Resistin showed a weak positive correlation with CAL. PCA revealed an inflammatory profile (high tMMP-8, low adiponectin) explaining 37.1% of variance (KMO = 0.58; Bartlett's χ² = 22.86, p < 0.001), effectively distinguishing prediabetic with periodontitis from healthy controls (AUC = 0.925, p < 0.001; sensitivity 87.5%, specificity 89.5%, Youden J = 0.77) and showing acceptable accuracy in periodontal health. Between-group differences for tMMP-8, adiponectin, PPD, CAL and BoP remained statistically significant after adjustment for age (ANCOVA, all p < 0.01).
CONCLUSION: Salivary tMMP-8 and adiponectin composite profiles outperform single markers, supporting their use in non-invasive periodontal risk screening in metabolically vulnerable adults. Elevated tMMP-8 links periodontal and metabolic inflammation in prediabetes.