Salivary sialic acid as a diagnostic biomarker for periodontal health in children with type 1 diabetes mellitus: a pilot study.

Abstract

Background: Type 1 Diabetes Mellitus (T1DM) is a chronic autoimmune condition that alters salivary composition due to metabolic disturbances. Saliva provides a non-invasive means of detecting systemic changes. This pilot study compared salivary pH, sialic acid concentration, antioxidant capacity, and oral health indicators between children with and without T1DM.

Methods: A comparative cross-sectional study was conducted among 40 children aged 6-15 years (20 with T1DM, 20 healthy controls). Sociodemographic and clinical data were collected, and unstimulated saliva was analysed for pH, sialic acid, and antioxidant capacity. Oral examinations included salivary flow rate, plaque index, and gingival index. Statistical analyses were performed using the Shapiro-Wilk test. As several variables demonstrated non-normal distributions and subgroup sample sizes were small, non-parametric statistical methods were applied for between-group comparisons.

Results: Children with T1DM demonstrated significantly lower salivary pH (6.70 ± 0.93 vs. 7.65 ± 0.27) and flow rate (3.93 ± 0.99 ml vs. 6.03 ± 1.18 ml), and higher sialic acid levels (78.13 ± 49.67 µg/ml vs. 36.84 ± 17.33 µg/ml) than controls. Plaque and gingival indices were also elevated in T1DM (p < 0.01). Antioxidant capacity was slightly higher but not statistically significant. Age-based analysis showed younger diabetic children (8-10 years) had elevated sialic acid and lower antioxidants, whereas older children (11-15 years) exhibited reduced flow rates and higher plaque/gingival indices, suggesting progressive oral changes with age.

Conclusion: T1DM significantly affects salivary composition and oral health in children, with age-specific variations. Salivary biomarkers, particularly sialic acid and pH, show potential as non-invasive tools for monitoring metabolic and periodontal changes in pediatric diabetes. Larger longitudinal studies are needed to validate these findings.