Salivary parameters of adults with diabetes mellitus: a systematic review and meta-analysis

Marques, Rafaella Cristhina Rego; Silva, Joana Rodrigues da; Lima, Camilla Pedrosa Vieira; Stefani, Cristine Miron; Damé‐Teixeira, Nailê

doi:10.1016/j.oooo.2022.03.001

Cited by 9 publications

(7 citation statements)

References 35 publications

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“…Most studies did not take into account confounding factors, such as salivary hypofunction and the individual’s dietary habits. There is a consensus that the combination of DM, poor glycemic control, and polypharmacy are associated with xerostomia and the hypofunction of salivary glands in T2D patients [ 12 , 35 , 36 ]. Consequently, changes in the main oral microorganisms, as detected here, can be observed between individuals with xerostomia and those with normal salivary function [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

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Enrichment of Acid-Associated Microbiota in the Saliva of Type 2 Diabetes Mellitus Adults: A Systematic Review

et al. 2023

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It could conceivably be hypothesized that a link exists between an altered microbiota due to local hyperglycemia and the increased risk of caries in diabetes mellitus (DM). This systematic review aimed to perform a cross-study comparison into the salivary microbiota of adults with type 2 diabetes mellitus (T2D) compared to adults without T2D, particularly focusing on the abundance of acid-associated bacteria. This report follows PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Studies using next-generation sequencing and other molecular techniques are included. The methodological quality of individual studies was assessed using appropriate Joanna Briggs Institute tools. The certainty of the evidence considering the effect direction was evaluated using the GRADE approach. From 2060 titles retrieved, 12 were included in the data synthesis, totalling 873 individuals with T2D and controls evaluated across the literature. Weighted averages of blood glucose levels (HbA1c—fasting blood glucose) were 8.21%—172.14 mg/dL and 5.12%—84.53 mg/dL for T2D and controls, respectively. In most studies, the relative abundance of acidogenic and aciduric bacteria was higher in diabetics when compared to their normoglycaemic controls. Whilst the evidence certainty was very low, there was a consistent Proteobacteria depletion and Firmicutes enrichment in T2D. As for the acid-associated genera, there was consistent enrichment of Lactobacillus and Veillonela for T2D. Tannerella/T. forsythia was enriched in T2D saliva, but the certainty is low. Further well-designed cohorts are needed to clarify the distribution of acid-associated microorganisms in the saliva of adults with T2D and how this can be clinically manifested (PROSPERO = CRD42021264350).

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Section: Discussionmentioning

confidence: 99%

“…Glucose transporters are found in salivary glands, which means that glucose is transported from the blood to saliva [ 11 ]. In addition, the salivary flow, which is critical to maintaining oral health, is reduced in people living with DM [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Enrichment of Acid-Associated Microbiota in the Saliva of Type 2 Diabetes Mellitus Adults: A Systematic Review

et al. 2023

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“…On the one hand, that restriction of ingestion of refined carbohydrates reduced caries in patients with T2DM. On the other hand, a high salivary glucose level ( 30 ) or hyposalivation ( 31 ) in T2DM might increase the caries risk. Therefore, it may be these contradictory associations that lead to no significant change in oral cariogenic bacteria in patients with T2DM.…”

Section: Discussionmentioning

confidence: 99%

Dysbiosis of Oral Microbiota and Metabolite Profiles Associated with Type 2 Diabetes Mellitus

Qian

Cheng

et al. 2023

Microbiol Spectr

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“…A well-established oral manifestation of DM is periodontitis, which may also impair the systemic glycaemia control [ 1 , 2 ]. A reduced salivary flow is also commonly observed in individuals suffering from this metabolic disorder [ 3 , 4 ]. The oral health is deprecated, essentially when the glycaemic levels are uncontrolled [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, individuals with uncontrolled DM frequently present ketoacidosis increasing the ketone bodies (acetone, acetoacetic acid, and β-hydroxybutyric acid) in blood and urine [ 15 ], and probably in saliva. The potentially altered pH [ 4 ] can represent a selective pressure over the diabetic oral microbiome. If the pH-balance of the microbial community is disrupted by severe environmental pressures, the microbiome may collapse into an ‘acidogenic stage’ (increase in the acidogenic microorganisms) that initiates dental caries or into an ‘’inflammatory stage” (increase of inflammophilic anaerobic microorganisms) leading to periodontitis [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Enrichment of sulphate-reducers and depletion of butyrate-producers may be hyperglycaemia signatures in the diabetic oral microbiome

Lima

Grisi

Guimarães

et al. 2022

Journal of Oral Microbiology

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Objectives This study aimed to investigate oral microbial signatures associated with hyperglycaemia, by correlating the oral microbiome with three glycaemic markers. Potential association between clinical parameters and oral bacterial taxa that could be modulating the hyperglycaemic microbiome was also explored. Methods Twenty-three individuals diagnosed with type 2 Diabetes Mellitus (T2D) and presenting periodontitis were included, as well as 25 systemically and periodontally healthy ones. Fasting blood glucose, glycated haemoglobin, salivary glucose, periodontitis classification, caries experience and activity and salivary pH were evaluated. The V4 region of the 16S rRNA gene was amplified from total salivary DNA, and amplicons were sequenced (Illumina MiSeq). Results Hyperglycaemia was correlated with proportions of Treponema, Desulfobulbus, Phocaiecola and Saccharimonadaceae. Desulfobulbus was ubiquitous and the most enriched organism in T2D individuals (log2FC = 4). The Firmicutes/Bacteroidetes ratio was higher at alkali salivary pH than acidic pH. In the network analysis, Desulfobulbus was clustered in a negative association with caries-associated and butyrate-producing bacteria. Conclusion The salivary microbiome is shaped by systemic hyperglycaemia, as well as changes in the salivary pH, which may be linked to local hyperglycaemia. The enrichment of predictive biomarkers of gut dysbiosis in the salivary microbiome can reflect its capacity for impairment of hyperglycaemia.

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Salivary parameters of adults with diabetes mellitus: a systematic review and meta-analysis

Cited by 9 publications

References 35 publications

Enrichment of Acid-Associated Microbiota in the Saliva of Type 2 Diabetes Mellitus Adults: A Systematic Review

Enrichment of Acid-Associated Microbiota in the Saliva of Type 2 Diabetes Mellitus Adults: A Systematic Review

Dysbiosis of Oral Microbiota and Metabolite Profiles Associated with Type 2 Diabetes Mellitus

Enrichment of sulphate-reducers and depletion of butyrate-producers may be hyperglycaemia signatures in the diabetic oral microbiome

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