Salivary cortisol, dehydroepiandrosterone, and chromogranin A levels in patients with gingivitis and periodontitis and a novel biomarker for psychological stress

Abstract

IntroductionThis study aimed to investigate the neuroendocrine responses based on cortisol, dehydroepiandrosterone (DHEA), cortisol/DHEA ratio, and chromogranin A levels, which reflect the activity of the hypothalamic-pituitary-adrenal axis, according to the presence or absence of psychological stress in patients with gingivitis and periodontitis compared to that in healthy controls.MethodsIn total, 117 patients (60 women, mean age: 36.29 ± 19.03 years) participated in this case-control study, comprising 32 healthy controls, 49 patients with gingivitis, and 36 patients with periodontitis. We investigated the presence of psychological stress and salivary characteristics, and analyzed the stress-related biomarkers of cortisol, DHEA, cortisol/DHEA ratio, and chromogranin A in the stimulated saliva.ResultsSalivary cortisol and chromogranin A levels increased with the severity of periodontal disease; their levels were the highest in the periodontitis group and were significantly higher in the following descending order: periodontitis, gingivitis, and healthy control groups (all values of p < 0.001). Additionally, the DHEA levels and cortisol/DHEA ratio were higher in the periodontitis group than those in the healthy control group (all values of p < 0.001). A multivariate logistic regression analysis revealed that the factors predicting above-average cortisol levels were periodontitis (odds ratio [OR] = 256.829; p < 0.001), women (OR = 6.365; p = 0.004), and psychological stress (OR = 6.036; p = 0.007); those predicting above-average cortisol/DHEA ratios were periodontitis (OR = 11.436; p < 0.001), psychological stress (OR = 3.977; p = 0.003), and women (OR = 2.890; p = 0.026). Thus, periodontitis and psychological stress were significant and strong predictors of above-average cortisol levels and cortisol/DHEA ratios. In the gingivitis group, salivary cortisol levels (r = 0.381, p = 0.007) and cortisol/DHEA ratios (r = 0.479, p < 0.001) were correlated with the presence of psychological stress. In the periodontitis group, increased cortisol/DHEA ratios (r = 0.412, p = 0.013) and lowered salivary buffer capacities (r = -0.334, p = 0.047) were correlated with the presence of psychological stress.ConclusionPeriodontitis is a multifactorial disease resulting in inflammatory tissue destruction, which differs from gingivitis and a healthy state. Differences in stress-related neuroendocrine markers were revealed based on the severity of periodontal disease. The biomarkers that could be classified according to disease severity were salivary cortisol and chromogranin A levels. Above-average cortisol levels and cortisol/DHEA ratios are significant predictors of psychological stress in patients with gingivitis and periodontitis.

White Isthmus Transcriptome Analysis Reveals the Mechanism of Translucent Eggshell Formation

“…The PIGR gene is responsible for the transport of polymeric IgA across various mucosal epithelial layers [39]. Chromogranin A is known to be a protein encoded by the CHGA gene in humans; it is a member of the granin family of neuroendocrine secretory proteins and is found in the secretory vesicles of neurons and endocrine cells [40].…”

Prediction of xerostomia in elderly based on clinical characteristics and salivary flow rate with machine learning

“…Only the UFR was a significant predictor of xerostomia. The UFR is measured while the patient is at rest, whereas the SFR is measured by spitting out whole saliva while chewing gum to promote saliva production or discharge from the salivary glands to the oral cavity 31 , 42 . In patients with Sjögren syndrome, 58% had xerostomia, defined by a UFR < 0.1 mL/min, and a UFR < 0.1 mL/min was highly specific for xerostomia 43 .…”

“…Stimulated whole saliva was collected for the next 5 min while chewing 1 g of gum base, after a 2-min pre-stimulation period to remove saliva retained in the ducts. The UFR and SFR were expressed as mL/min 30 , 31 .…”

Investigation of periodontitis, halitosis, xerostomia, and serological characteristics of patients with osteoarthritis and rheumatoid arthritis and identification of new biomarkers

“…When there was a disagreement, a unified consensus was reached through discussions. The measurement of parameters related to periodontal disease and diagnosis, including gingivitis and periodontitis, were in accordance to our previously described methods 26 .…”