Salivary 1,25(OH)2D3 & cortisol as biomarkers of anxiety, depression, and periodontitis: a comparative cross-sectional study.

PURPOSE: This study examines the correlation between salivary levels of 1,25(OH)2D3 (calcitriol) and cortisol in healthy individuals and patients with anxiety and depression, both with and without periodontitis. The innovative evaluation of salivary 1,25(OH)2D3, which is impervious to seasonal fluctuations, could facilitate the early identification and prevention of psychiatric and oral conditions by utilizing salivary biomarkers derived from the oral environment.

METHODS

This comparative cross-sectional study involved 152 participants from the Department of Periodontology at Jinnah Medical and Dental College, Karachi, Pakistan. Anxiety and depression were evaluated with the Aga Khan University Anxiety and Depression Scale, while periodontitis was assessed via clinical attachment loss and probing pocket depth. Salivary 1,25(OH)2D3 and cortisol levels were quantified with an Enzyme-Linked-Immunosorbent-Assay (ELISA). The statistical evaluation encompassed one-way ANOVA, Kruskal-Wallis tests, post hoc comparisons, and correlation and regression analyses.

RESULTS

The mean 1,25(OH)2D3 levels were significantly lower in patients with anxiety and depression (AD) and those with both anxiety, depression, and periodontitis (ADP) (130.78 ± 8.52 pmol/L and 33.44 ± 26.17 pmol/L) compared to healthy controls (HC) (220.92 ± 11.63 pmol/L, p < 0.05), demonstrating a strong negative correlation (AD: r = -0.936, p < 0.05, ADP: r = -0.932, p < 0.05). Conversely, cortisol levels were significantly higher in case groups (AD: 6.41 ± 0.54 nmol/L, ADP: 7.8 ± 1.09 nmol/L) than in healthy controls (4.22 ± 0.61 nmol/L, p < 0.05), showing a strong positive correlation (AD: r = 0.922, p < 0.05, ADP: r = 0.496, p < 0.002). Regression analysis identified cortisol and 1,25(OH)2D3 as significant predictors of anxiety, depression, and periodontitis (p < 0.05).

CONCLUSION

Salivary 1,25(OH)2D3 and cortisol serve as potential non-invasive markers for the early detection of anxiety, depression, and periodontitis.