Association of salivary alpha-2-macroglobulin with glycemia and glycated hemoglobin in type 2 diabetes mellitus: a systematic review and meta-analysis study

Abstract BACKGROUND: Chronically elevated alpha-2-macroglobulin (A2MG) in the blood has been correlated with diabetes and the HbA1c profile; however, no systematic review has been conducted to evaluate the association of A2MG salivary levels and glycemia or HbA1c levels in diabetes mellitus type 2 (DM2) patients. OBJECTIVE: To evaluate whether A2MG salivary levels are related to the glycemia or HbA1c levels in DM2 patients. DESIGN AND SETTING: Systematic review developed at Universidade Federal de Uberlândia (UFU), Brazil. METHODS: Eight databases were used as research sources. The eligibility criteria included studies that reported data regarding mean salivary A2MG and the correlation between glycemia and/or HbA1c levels of DM2 subjects (uncontrolled and well-controlled) and non-diabetic subjects. The risk of bias of the studies selected was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools for use in JBI systematic reviews. Pooled correlation coefficients were estimated using the Hunter-Schmidt method. Study estimates were weighted according to their sample size, and heterogeneity was calculated using the chi-square statistic. RESULTS: Four studies on DM2 patients were included in this systematic review after careful analysis of 1482 studies. Three studies compared A2MG with HbA1c and glycemia. Overall, the correlation between A2MG and HbA1c was strong (r = 0.838). In contrast, the correlation between A2MG and glycemia was low (r = 0.354). CONCLUSION: The strong association between HbA1C and salivary A2MG suggests that this salivary protein has the potential to be a surrogate for HbA1C, if corroboratory further evidence is obtained through large-scale studies.

Association of salivary alpha-2-macroglobulin with glycemia and glycated hemoglobin in type 2 diabetes mellitus: a systematic review and meta-analysis study.

BACKGROUND: Chronically elevated alpha-2-macroglobulin (A2MG) in the blood has been correlated with diabetes and the HbA1c profile; however, no systematic review has been conducted to evaluate the association of A2MG salivary levels and glycemia or HbA1c levels in diabetes mellitus type 2 (DM2) patients. OBJECTIVE: To evaluate whether A2MG salivary levels are related to the glycemia or HbA1c levels in DM2 patients. DESIGN AND SETTING: Systematic review developed at Universidade Federal de Uberlândia (UFU), Brazil. METHODS: Eight databases were used as research sources. The eligibility criteria included studies that reported data regarding mean salivary A2MG and the correlation between glycemia and/or HbA1c levels of DM2 subjects (uncontrolled and well-controlled) and non-diabetic subjects. The risk of bias of the studies selected was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools for use in JBI systematic reviews. Pooled correlation coefficients were estimated using the Hunter-Schmidt method. Study estimates were weighted according to their sample size, and heterogeneity was calculated using the chi-square statistic. RESULTS: Four studies on DM2 patients were included in this systematic review after careful analysis of 1482 studies. Three studies compared A2MG with HbA1c and glycemia. Overall, the correlation between A2MG and HbA1c was strong (r = 0.838). In contrast, the correlation between A2MG and glycemia was low (r = 0.354). CONCLUSION: The strong association between HbA1C and salivary A2MG suggests that this salivary protein has the potential to be a surrogate for HbA1C, if corroboratory further evidence is obtained through large-scale studies.

Activity of in vitro forms of dentifrices containing the hydroalcoholic extract of the ripe fruit of Eugenia uniflora L. (Surinam cherry) on cariogenic bacteria.

The aim of this study was to evaluate the in vitro activity of dentifrices containing the hydroalcoholic extract of the ripe fruit of Eugenia uniflora L. (Surinam cherry) on Streptococcus oralis (ATCC 10557) and Lactobacillus casei (ATCC 7469). Five dentifrices were used: D1: containing hydroalcoholic extract of Eugenia uniflora L.; D2: containing fluoride and hydroalcoholic extract of Eugenia uniflora L.; D3: containing triclosan and hydroalcoholic extract of Eugenia uniflora L; D4: containing triclosan, fluoride and hydroalcoholic extract of Eugenia uniflora L.; D5: positive control (Colgate Total 12). To determine the antibacterial activity, the technique used was the minimum inhibitory concentration by the diffusion method in solid culture medium. At the concentration 0.05 g/mL, the best results were achieved with D1 (18 mm) and D4 (24 mm) on L.casei, and with D3 (19 mm) on S. oralis. The dentifrices D3 and D4 were found to have greater activity on the Streptococcus oralis, while D4 and D1 were found to have greater activity on Lactobaccilus casei. It is concluded that dentifrices with Eugenia uniflora L. have antimicrobial activity, suggesting that clinical trials should be conducted.

Avaliação in vivo de dentifrício contendo extrato da Eugenia uniflora L. (Pitanga) sobre indicadores de saúde bucal / In vivo evaluation of a dentifrice containing Eugenia uniflora L. extract, on the oral health indicators

Objetivo: Avaliar in vivo o efeito do uso de um dentifrício contendo o extrato hidroalcoólico do fruto maduro da Eugenia uniflora L. (Pitanga) sobre indicadores de saúde bucal. Método: Foi realizado um ensaio clínico aleatório, com uma amostra de 40 universitários de 21 a 24 anos de idade, de ambos os gêneros. Os participantes foram divididos em dois grupos: G1- 20 universitários que utilizaram o dentifrício a base do extrato hidroalcoólico do fruto maduro da Eugenia uniflora L. (Pitanga) a 3%; e G2 - 20 universitários que utilizaram dentifrício da Colgate Total 12® (grupo controle). Os participantes usaram os dentifrícios durante 22 dias consecutivos, tendo sido mensurados os índices de acúmulo de biofilme (IHO-S), doença gengival (ISG) e contagem de S. mutans salivar, nos tempos (t1) antes do uso, (t2) 15 dias de uso e (t3) 22 dias de uso dos produtos. Os dados foram analisados através do teste estatístico de t de Student. Resultados: As médias encontradas em t1, t2 e t3 para o G1 foram, respectivamente, IHO-S: 0,75/ 0,55/ 0,47; ISG: 2,96/ 1,86/ 1,35; UFC/mL: 1,69 x 104 / 1,45 x 104 / 1,33 x 104; para G2: IHO-S: 0,61/ 0,52/ 0,42; ISG: 1,94/ 1,62/ 1,20; UFC/mL: 1,84 x 104 / 1,47 x 104 / 1,36 x 104. Observou-se redução estatisticamente significante entre os tempos t1 e t3 em ambos os grupo para os índices IHO-S, ISG e UFC/mL pelo teste t Student (p<0,01). Ao comparar os grupos G1 e G2, constatou-se diferença estatística apenas para o ISG (p<0,01). Conclusão: O dentifrício contendo o extrato hidroalcoólico do fruto maduro da Eugenia uniflora L. (Pitanga) possui eficácia semelhante ao dentifrício da Colgate Total 12® (grupo controle).

Objective: To assess in vivo the effect of using a dentifrice containing hydroalcoholic extract of the ripe fruit of Eugenia uniflora L. on the oral health indicators. Method: A random clinical trial was performed with 40 male and female undergraduate dental students aged 21 to 24 years. The students were assigned to two groups: G1 - 20 students that used the dentifrice containing 3% hydroalcoholic extract of the ripe fruit of Eugenia uniflora L., and G2 - 20 students that used Colgate Total 12® dentifrice (control group). The participants used the dentifrices during 22 consecutive days and the following indicators were measured at t1 (before the use of dentifrice), t2 (after 15 days of use) and t3 (after 22 days of use): biofilm accumulation (OHI-S), gingival disease (GBI) and salivary S. mutans count (cfu/mL). Data were analyzed by the Student's t-test. Results: Means at t1, t2 and t3 for G1 were, respectively: OHI-S: 0.75/ 0.55/ 0.47; GBI: 2.96/ 1.86/ 1.35; cfu/mL: 1.69 x 104 / 1.45 x 104 / 1.33 x 104; for G2 were: OHI-S: 0.61/ 0.52/ 0.42; GBI: 1.94/ 1.62/ 1.20; cfu/mL: 1.84 x 104 / 1.47 x 104 / 1.36 x 104. There was a statistically significant decrease of OHI-S, GBI and cfu/mL from t1 to t3 for both groups (p<0.01). Comparing the groups, there was statistically significant difference only for GBI (p<0.01). Conclusion: The dentifrice containing hydroalcoholic extract of the ripe fruit of Eugenia uniflora L. presented similar efficacy to that of Colgate Total 12® dentifrice (control group).