Association of salivary gland hypofunction with diabetes mellitus and drugs among the elderly in Karachi, Pakistan

Lone, Muneeb Ahmed; Shaikh, Sameer; Lone, Maham Muneeb; Afaq, Ashar; Lone, Mohid Abrar

doi:10.1111/jicd.12209

Cited by 7 publications

(12 citation statements)

References 25 publications

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“…Hahnel et al 4 investigated the impact of salivary flow on the oral health-related quality of life using the Geriatric Oral Health Assessment Index (GOHAI). 25 The results showed an important difference between patients with or without hyposalivation in the GOHAI item "swallow without problems. "…”

Section: Results Of the Individual Studiesmentioning

confidence: 93%

“…Therefore, this systematic review and meta‐analysis searched the available evidence on the prevalence of hyposalivation in older adults (≤60 years old). Because an association between Sjogren syndrome, diabetes, and radiotherapy with reduced salivary flow have been clearly demonstrated due to direct or indirect effects on salivary gland structure and/or function, 6,28‐31 we did not consider studies that included elderly individuals with a history of these conditions in this review.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of hyposalivation in older people: A systematic review and meta‐analysis

et al. 2020

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Background: The proportion of elders is increasing worldwide, and hyposalivation has been associated with the ageing process. Therefore, there has been growing interest in the frequency of hyposalivation in older people since it can cause transient or permanent problems that could affect oral health. Objective: To determine the prevalence of hyposalivation in older people (aged ≥ 60 years). Methods: The review was registered at Prospero-International Prospective Register of Systematic Reviews under number CRD42018106322. The search was performed in six electronic databases (Embase, LILACS, Medline, PubMed, Web of Science and Abstracts in Social Gerodontology) and grey literature (Google Scholar) for articles published up to February 2019. The methodology of selected studies was evaluated using the Meta-Analysis of Statistics Assessment and Review (MAStARI) risk of bias checklist. Meta-analyses were performed using Medcalc and Stata 15. Results: Thirteen studies totalising 3,885 individuals (≥60 years) were included in this systematic review. The meta-analysis showed an overall hyposalivation prevalence of 33.37% (95% confidence interval [CI] 23.90-43.57, P < .0001, n = 3,447). The prevalence of hyposalivation for unstimulated and stimulated methods was 33.39% (95% CI 21.08-46.96, P < .0001, n = 2,425 individuals) and 30.47% (95% CI 22.53-39.04, P < .0001, n = 1,495 individuals), respectively. Most of the studies were evaluated as low risk of bias. Some study limitations were related to the observational studies potential risk of bias, and different criteria to measure saliva flow rate. Conclusion: This study suggests that the overall prevalence of hyposalivation in older people is 33.37%. When considering stimulated methods, the prevalence of hyposalivation was slightly lower (30.47%).

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Section: Results Of the Individual Studiesmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Prevalence of hyposalivation in older people: A systematic review and meta‐analysis

et al. 2020

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“…Out of 421, 228 were selected as control group and 193 were selected as cases. Saliva sampling: Saliva was collected using the spitting technique as described by Muneed Ahmed et al in 2011 16 . To reduce the impact of diurnal fluctuation on the amount and quality of saliva, samples were taken between 10 and 12 hours.…”

Section: Inclusion and Exclusion Criteriamentioning

confidence: 99%

Clinical Oral Findings and Salivary Analysis of Patients with and without Diabetes Mellitus

Ahmad¹,

Maqbool²,

Siddique³

et al. 2023

PJMHS

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Background: The salivary composition in diabetic patients varies depending on the type of saliva examined (whole or parotid, resting or stimulated) and the choice of participants insulin-dependent diabetes mellitus (IDDM) or non-insulin-dependent diabetes mellitus (NIDDM) patients, or a heterogeneous population with various additional systemic diseases or treatments. In Pakistan there is very few studies done on the clinical significance of saliva amongst diabetic patients. Objective: Clinical oral findings and salivary analysis of patients with and without diabetes mellitus Study Design: Case-control study Study Setting: This study was conducted at Department of Oral Biology Akhtar Saeed Medical and Dental College, Lahore from September 2022 to February 2023. Methodology: Out of 421 participants 228 were healthy taken as control and 193 were diabetic patients taken as cases were enrolled in this study. The questionnaire was made to describe the demographic variables age, gender, weight and height for BMI, educational status, socioeconomic status, marital status, and ethnicity. The biochemical parameters were estimated in saliva, collected from diabetic and non-diabetic participants. The 5ml saliva was collected from case and control participants in container and aliquoted at -800C. The samples were thawed at the time of estimation. The salivary biochemical parameters including glucose (mg/dl), insulin (IU/ml), creatinine (umol/L), urea (mml/L), albumin (md/dl), Lactoferrin (ug/ml) and IgA (mg/dl) were done in the lab and estimated through Randox kit according to the manufacturer protocol. The statistical analysis was done by using SPSS version 20. Results: The research included 421 participants in which 294 men (69.8% of the total) and 127 women (30.2% of the total). The average age was 26.4±5.1 years (range: 16.0 to 48.0) of both groups enrolled participants. While the mean of BMI was 23.4±4.5 Kg/m2 (range: 15.10 to 41.90). In this study very low- income status (73.9%) and high frequency of married with 84.6% were enrolled. Diabetics also had considerably higher levels of creatinine, urea, lactoferrin and IgA in the saliva of diabetic patients (p=0.0001). However, albumin was significantly low in diabetic saliva as compared to healthy participants (p=0.015). Practical implication: Studies towards the effects of diabetes mellitus (DM) on oral health has been conducted, but it is not yet known how common oral manifestations of the disease are or how widespread these effects are, especially in Pakistan. The purpose of this research was to compare the effects of diabetes on the dental health and salivary evaluation of people with and without the disease. Conclusion: New information on salivary parameters and oral results on Pakistani population with and without diabetes was presented in this research. The major results showed that those with diabetes had a decreased salivary flow rate, an increase in salivary glucose, and an increase in urea, creatinine, lactoferrin and IgA concentrations. However, the albumin is low in concentration. The results showed that the clinical significance of saliva amongst diabetic patients and can be used as diagnostic marker. Keyword: Saliva, biochemical parameters, diabetes mellitus, glucose, urea, Albumin

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“…The causes of hyposalivation and xerostomia range from momentary factors, such as stress and anxiety [10][11][12] , to autoimmune diseases and chronic conditions, such as rheumatoid arthritis 13 , Parkinson's disease 13,14 , Sj€ ogren's syndrome 10,15,16 and diabetes mellitus [17][18][19][20][21] . The two conditions may also be found in patients requiring treatment for head and neck cancer 3,6,13,14,21 and those with diseases specific to the salivary glands 1,19 .…”

Section: Introductionmentioning

confidence: 99%

“…Hyposalivation is diagnosed using sialometry, which consists of collecting saliva to measure the amount of secretion produced per minute 12,18 . The diagnosis of hyposalivation is necessary, because this condition can exert a negative impact on activities of daily living and quality of life 3,13,17,23 .…”

Section: Introductionmentioning

confidence: 99%

Accuracy of a questionnaire on xerostomia as a screening tool for hyposalivation

Carvalho

Santos

Bernardino

et al. 2020

International Dental Journal

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Objective: Determine the accuracy of a questionnaire on xerostomia as a screening tool for hyposalivation. Methods: A total of 402 adults awaiting dental care at a public healthcare service answered an eight-item questionnaire addressing xerostomia and were submitted to stimulated sialometry, with ≤ 0.7 mL/min considered indicative of hyposalivation. Reproducibility and internal consistency of the questionnaire were evaluated. The correlation between the score and salivary flow was investigated. The total score was also compared between groups with and without hyposalivation and diagnostic precision measures were calculated. Results: Hyposalivation was identified in 162 participants (40.3%) and a total of 229 (57.0%) answered affirmatively to at least one question. The responses to each question revealed variable reproducibility (j = 0.450-0.785) and satisfactory internal consistency (Cronbach's a = 0.70). Individuals with a larger number of positive answers had lower salivary flow (Spearman's q = À0.193; P < 0.001). The mean number of positive answers was greater in the group with a clinical diagnosis of hyposalivation compared to those without low salivary flow. The sensitivity of the screening tool was 64.8%, with an area under the ROC curve of 0.60 (95% confidence interval: 0.547-0.645; P < 0.001). Conclusion: The questionnaire proved to be useful for the epidemiological screening of individuals with possible hyposalivation.

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Association of salivary gland hypofunction with diabetes mellitus and drugs among the elderly in Karachi, Pakistan

Abstract: In the present study, the majority of elderly participants whose presenting complaint was oral dryness was found to have objective evidence of SGH, with a statistically-significant association with DM and drugs.

Cited by 7 publications

References 25 publications

Prevalence of hyposalivation in older people: A systematic review and meta‐analysis

Prevalence of hyposalivation in older people: A systematic review and meta‐analysis

Clinical Oral Findings and Salivary Analysis of Patients with and without Diabetes Mellitus

Accuracy of a questionnaire on xerostomia as a screening tool for hyposalivation

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