Relationship between Salivary Alpha-2 Macroglobulin and HbA1c among Patients with Type-2 Diabetes Mellitus: A Cross-sectional Study

Abstract

Context: Type-2 diabetes mellitus (DM2) requires an adequate glycemic control to avoid diabetic complications. The best parameter available is glycosylated hemoglobin (HbA1c), as it gives us an overview of an individuals' glycemic control of the previous 4 months. Salivary biomarkers used as a diagnostic tool can indicate the control or degree of progression of diseases. Studies indicate that salivary alpha-2-macroglobulin (A2MG) levels are elevated in diabetes patients. Aims: To study the relationship of salivary A2MG with glycosylated Hba1c among patients with DM2. Settings and Design: A total of 87 patients of DM2, age 35–65 years were recruited. Materials and Methods: The routine oral cavity examination and dental check-up was done to rule out any dental disease. The patients with hepatic diseases and inflammatory diseases of oral cavity and body were excluded. The values of HbA1c were collected from the records of patients. Salivary A2MG levels were estimated by enzyme-linked immunosorbent assay. Levels of fasting and postprandial blood sugar, serum creatinine, and A2MG were compared with the HbA1c groups (<7 and ≥ 7). Statistical Analysis Used: Descriptive statistics (Software SPSS version 20.0). Nonparametric Pearson correlation test was used to assess the correlation between HbA1c and A2MG. Results: A positive correlation between salivary levels of A2MG and blood levels of HbA1c in blood was observed in this study. Results showed that there was also a significant correlation in mean values of fasting and postprandial blood sugar, serum creatinine, and salivary A2MG in diabetic subjects. Conclusion: Measurement of A2MG in saliva represents a promising noninvasive alternative method to evaluate glycemic index and consequently avoiding comorbidities.

Keywords

• Alpha 2 macroglobulin
• diabetes mellitus
• salivary biomarker