Association between Salivary Fructosamine, Plasma Glycated Hemoglobin, and Plasma Glucose Levels among Type II Diabetes Mellitus and Nondiabetic Individuals—A Cross-sectional Study

Abstract

Objective The study was aimed to determine the association between salivary fructosamine and plasma glycated hemoglobin, plasma fasting and postprandial glucose levels among patients suffering from type II diabetes mellitus and nondiabetic healthy individuals.

Materials and Methods The cross-sectional study was conducted in a hospital setting. A total of 100 participants were included, with 50 participants in each group—group I (patients with type II diabetes mellitus) and group II (nondiabetic healthy individuals). Blood and saliva samples were collected to estimate the levels of the blood and salivary parameters. Depending upon the normality, appropriate tests were used—t-test and Mann–Whitney U test were used for continuous data. Pearson chi-square test and Fisher's exact test were used for discrete data. To test for any positive association between salivary and blood parameters, simple linear regression was carried out.

Results The study results showed that group I had significantly higher levels of salivary fructosamine when compared to group II (p < 0.001). In groups I and II a significant positive association was observed between salivary fructosamine and plasma glycated hemoglobin (group I, r-value 0.893; group II, r-value 0.307).

Conclusion The overall study results showed that salivary fructosamine levels were significantly higher in patients with diabetes when compared to nondiabetic individuals. Also, positive correlation was observed between salivary fructosamine, plasma fasting, plasma postprandial, and plasma glycated hemoglobin among both the groups.

Keywords

noninvasive - saliva - fructosamine - diabetes mellitus - glycated hemoglobin

• References

• 1 International Diabetes Federation. Diabetes Atlas. 6th ed.. Belgium: International Diabetes Federation; 2013
• 2 Yesudian CAK, Grepstad M, Visintin E, Ferrario A. The economic burden of diabetes in India: a review of the literature. Global Health 2014; 10 (80) 80
• 3 Patel P, Macerollo A. Diabetes mellitus: diagnosis and screening. Am Fam Physician 2010; 81 (07) 863-870
• 4 Subramani R, Devi U, Shankar U, Rajalakshmi R, Seshadhri Karthick. Prevalence of undiagnosed type 2 diabetes and its associated risk factors in rural population of Tamil Nadu. World J Med Sci 2014; 11 (02) 222-227
• 5 Maynard JD, Rohrscheib M, Way JF, Nguyen CM, Ediger MN. Noninvasive type 2 diabetes screening: superior sensitivity to fasting plasma glucose and A1C. Diabetes Care 2007; 30 (05) 1120-1124
• 6 World Health Organization. Screening for Type 2 Diabetes. Report of a World Health Organization and International Diabetes Federation Meeting. Geneva, Switzerland: World Health Organization; 2003. http://www.who.int/diabetes/publications/en/screening_mnc03.pdf Accessed on 01/02/2016
• 7 American Diabetes Association. Standards of medical care in diabetes 2014. Diabetes Care 2014; 37 (01) 14-80
• 8 Schwartz JG, Phillips WT, Aghebat-Khairy B. Revision of the oral glucose tolerance test: a pilot study. Clin Chem 1990; 36 (01) 125-128
• 9 Youssef D, El Abbassi A, Jordan RM, Peiris AN. Fructosamine—an underutilized tool in diabetes management: case report and literature review. Tenn Med 2008; 101 (11) 31-33
• 10 Singh R, Barden A, Mori T, Beilin L. Advanced glycation end-products: a review. Diabetologia 2001; 44 (02) 129-146
• 11 Armbruster DA. Fructosamine: structure, analysis, and clinical usefulness. Clin Chem 1987; 33 (12) 2153-2163
• 12 Bonora E, Tuomilehto J. The pros and cons of diagnosing diabetes with A1C. Diabetes Care 2011; 34 (02) (Suppl. 02) S184-S190
• 13 Mula-Abed WA, Al-Naemi AH. Performance indicators and validity of serum fructosamine assay as a diagnostic test in a screening program for diabetes mellitus. Saudi Med J 2003; 24 (05) 477-484
• 14 Sahibzada HA, Khurshid Z, Khan RS. et al. Salivary IL-8, IL-6 and TNF-α as Potential Diagnostic Biomarkers for Oral Cancer. Diagnostics (Basel) 2017; 7 (02) 2-10
• 15 Abdul RehmanS, Khurshid Z, Hussain NiaziF. et al. Role of Salivary Biomarkers in Detection of Cardiovascular Diseases (CVD) Proteomes 2017; 5 (03) 5-6
• 16 Khurshid SultanZ, Khan E. Future of oral proteomics. J Oral Res 2018; 7 (02) 42-43
• 17 Neqoro H, Morley J, Rosenthal MJ. Utility of serum fructosamine as a measure of glycaemia in young and old diabetic and non-diabetic subjects. Am J Med 1998; 85 (03) 360-364
• 18 Streckfus C, Bigler L. The use of soluble, salivary c-erbB-2 for the detection and post-operative follow-up of breast cancer in women: the results of a five-year translational research study. Adv Dent Res 2005; 18 (01) 17-24
• 19 Nakamoto I, Morimoto K, Takeshita T, Toda M. Correlation between saliva glycated and blood glycated proteins. Environ Health Prev Med 2003; 8 (03) 95-99
• 20 Khurshid Z, Zohaib S, Najeeb S, Zafar MS, Slowey PD, Almas K. Human saliva collection devices for proteomics: an update. Int J Mol Sci 2016; 17 (06) 7-10
• 21 Gröschl M, Rauh M. Influence of commercial collection devices for saliva on the reliability of salivary steroids analysis. Steroids 2006; 71 (13) (14) 1097-1100
• 22 Sannam KhanR, Khurshid Z, Akhbar S, Faraz MoinS. Advances of salivary proteomics in oral squamous cell carcinoma (OSCC) detection: an update. Proteomes 2016; 4 (04) 41
• 23 Khurshid Z, Moin SF, Khan RS, Agwan MAS, Alwadaani AH, Zafar MS. Human salivary protein extraction from RNAPro SAL, Pure SAL, and passive drooling method. Eur J Dent 2017; 11 (03) 385-389
• 24 Radha V, Mohan V. Genetic predisposition to type 2 diabetes among Asian Indians. Indian J Med Res 2007; 125 (03) 259-274
• 25 Mohan V. Why are Indians more prone to diabetes?. J Assoc Physicians India 2004; 52 (01) 468-474
• 26 Nowotny K, Jung T, Höhn A, Weber D, Grune T. Advanced glycation end products and oxidative stress in type 2 diabetes mellitus. Biomolecules 2015; 5 (01) 194-222
• 27 Campbell MJA. Glucose in the saliva of the non-diabetic and the diabetic patient. Arch Oral Biol 1965; 10 (01) 197-205
• 28 Forbat LN, Collins RE, Maskell GK, Sönksen PH. Glucose concentrations in parotid fluid and venous blood of patients attending a diabetic clinic. J R Soc Med 1981; 74 (10) 725-728
• 29 Manjrekar PA, Hedge A, Shrilaxmi D, Souza F, Kaveeshwar V, Jose A. Fructosamine in non-diabetic first degree relatives of type 2 diabetes patients: risk assessor. J Clin Diagn Res 2012; 6 (05) 770-773
• 30 Gen Z-R. et al. Measurements of salivary dructosamine and its clinical application. Shangai Medical Journal 1990; 11 (01) 628-631
• 31 Morenkova SA. [Comparative analysis of dependence of saliva sorbitol and fructosamine levels on blood glucose level in patients with diabetes]. Biomed Khim 2004; 50 (06) 612-614
• 32 Kautzky-Willer A, Brazzale AR, Moro E. et al. Influence of increasing BMI on insulin sensitivity and secretion in normotolerant men and women of a wide age span. Obesity (Silver Spring) 2012; 20 (10) 1966-1973
• 33 Kautzky-Willer A, Kosi L, Lin J, Mihaljevic R. Gender-based differences in glycaemic control and hypoglycaemia prevalence in patients with type 2 diabetes: results from patient-level pooled data of six randomized controlled trials. Diabetes Obes Metab 2015; 17 (06) 533-540
• 34 Rao PV, Laurie A, Bean ES, Roberts Jr CT, Nagalla SR. Salivary protein glycosylation as a noninvasive biomarker for assessment of glycemia. J Diabetes Sci Technol 2015; 9 (01) 97-104