[Assessing of possible biomarkers (AST, CRP, and albumin) indicating the progression of periodontitis in saliva samples of type 2 diabetic patients].

Introduction: Periodontitis is one of the most common diseases affecting teeth over the age of 40 years, a process that can be exacerbated by diabetes. People with diabetes are more prone to periodontal disorders. The determination of biomarkers in saliva may be useful for evaluating abnormal periodontal processes. Objective: The main aim of this study was to identify possible biomarkers (aspartate aminotransferase [AST], C-reactive protein [CRP], and albumin) in saliva that could help assess periodontal progression in type 2 diabetic patients. Method: Patients were selected at the Department of Periodontology of the Faculty of Dentistry, University of Debrecen. Considering the study criteria, 18 diabetic and 19 non-diabetic patients were recruited with an average age of 62 ± 9 years. After anamnesis was taken, resting saliva sample was collected from each study participant, and periodontal screening test was performed. In addition to the routine laboratory tests, AST activity, CRP and albumin concentrations were determined in the saliva samples. Using ROC curve analysis, we further evaluated the diagnostic value of AST based on the area under the curve (AUC) value. Results: AST activity values measured in the saliva samples of the diabetic patients were significantly higher compared to the control group (56 [44–107] vs. 33 [14–64] U/L, P = 0.02), however, there was no significant correlation between HgbA1c values and salivary AST levels. Nevertheless, increased AST values in the saliva samples can be attributed to the presence of the combined effect of diabetes mellitus and periodontitis (n = 13), as we observed an even higher AST activity in diabetic patients who developed periodontitis (92 [55–154] vs. 48 [31–55] U/L, P = 0.019) compared with the subgroup showing milder gingivitis (n = 5). On the other hand, compared to the control group, the saliva samples of diabetic patients did not show significant differences in CRP and albumin levels, furthermore, the age did not influence AST results in diabetes mellitus (r = 0.217, P = 0.415). Finally, based on the ROC curve analysis, AST measured in saliva was able to differentiate gingivitis and periodontitis subgroups (AUC: 0.803, P = 0.005) as well as diabetic patients from controls (AUC: 0.744, P = 0.021) at a 49 U/L cut-off value. Conclusion: AST enzyme activity that can be measured in saliva can be a potential laboratory biomarker for the effective investigation of the periodontal clinical status in diabetic patients. Orv Hetil. 2025; 166(16): 613–622.