Assinatura de citocinas salivares correlacionada ao controle glicêmico em adultos com diabetes tipo 2

Abstract

Type 2 diabetes is a metabolic disorder with high global prevalence. This disease is associated with a state of chronic inflammation, with an imbalance between pro- and anti-inflammatory cytokines. In recent years, the potential of saliva as a tool for monitoring this condition has been investigated. This biofluid has the ability to reflect aspects of systemic conditions, being a non invasive, cost-effective and easy collection and storage method. Therefore, the objective of this dissertation was to identify pro- and anti-inflammatory cytokines in saliva related to markers of glycemic control in adults with type 2 diabetes. A cross-sectional study was conducted with 20 individuals with type 2 diabetes (diabetes group) and 20 volunteers without diabetes (control group). Data on demographic characteristics, BMI, serum glycated hemoglobin (H1bAc) and fasting glucose (HGT) were collected. Unstimulated saliva samples were collected to quantify the concentration of IL-1β, IL-4, IL-6, IL-8, IL-10, IL-17A, IL-22, TGF-α and TNF-α. The Chi square, Mann-Whitney and Spearman correlation tests were used in the statistical analysis. The diabetes group consisted of 8 women and 12 men, with a mean age of 57.6 ± 6.8 years, while the control group consisted of 10 women and 10 men, with a mean age of 51.6 ± 12.7 years. There were no statistically significant differences between the groups for the sociodemographic variables (P > 0.05). It was observed that the diabetes group presented higher salivary levels of IL-6 (P = 0.003) and IL-10 (P = 0.021). The analysis of the correlation between cytokines and markers of glycemic control revealed that there were moderate direct correlations of HGT with salivary levels of IL-1β (rho = 0.505; P = 0.032), IL-6 (rho = 0.535; P = 0.022), IL-10 (rho = 0.525; P = 0.025), IL-22 (rho = 0.585; P = 0.011), TGF-α (rho = 0.632; P = 0.005) and TNF-α (rho = 0.624; P = 0.006). HbA1c showed correlations only for the ratios between salivary markers (IL-22/IL-4, TNF-α /IL-4 e IL-6/IL-10). The findings of this study suggest that changes in salivary cytokine levels may be related to glycemic dyscontrol in individuals with type 2 diabetes. Furthermore, it is suggested that cytokine levels respond more immediately to changes measured by HGT, while HbA1c appears to be more related to the imbalance between cytokines, which may be related to a long-term response.