A Pilot Study of the Role of Salivary Biomarkers in the Diagnosis of PCOS in Adolescents Across Different Body Weight Categories.

Background/Objectives: Polycystic ovary syndrome (PCOS) is a complex endocrine disorder affecting reproductive, metabolic, and inflammatory processes in women of reproductive age. This study explored the diagnostic potential of salivary cytokines, uric acid, and testosterone in distinguishing PCOS patients from healthy controls, as well as to examine their associations with hormonal and metabolic profiles within the PCOS group. Methods: Forty-one adolescent girls with PCOS and thirty healthy controls participated in the study. The PCOS group included both normal-weight and overweight individuals, allowing evaluation of salivary biomarkers across different nutritional statuses. Salivary levels of TNF-α, IL-6, IL-1β, testosterone, and uric acid were measured and compared between the groups. A receiver operating characteristic (ROC) analysis was performed to assess the diagnostic value of each biomarker. Results: Salivary TNF-α, IL-6, and IL-1β showed high diagnostic accuracy (AUC = 0.921, 0.891, and 0.870, respectively), supporting their potential as non-invasive biomarkers. The diagnostic accuracy of salivary cytokines and testosterone remained high even in normal-weight participants, suggesting that low-grade inflammation and hormonal disturbances in PCOS are not limited to excess body weight. Salivary testosterone was strongly associated with hyperandrogenism, while uric acid correlated with the cortisol/DHEA-S ratio, indicating possible links to metabolic stress. Conclusions: In conclusion, salivary assays may offer a valuable, non-invasive tool for the early diagnosis of PCOS in adolescents, including normal-weight girls. This approach could facilitate the timely detection of inflammatory and hormonal imbalances, supporting earlier interventions and more personalized care.