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Preventive

Saliva insulin as an innovative method of risk assessment for caries, pre-diabetes and obesity: A randomized controlled trial

103 - Saliva insulin as an innovative method of risk assessment for caries, pre-diabetes and obesity: A randomized controlled trial

Friday, May 24, 2024
10:00 AM – 10:10 AM EST
Location: Exhibit Hall (back left corner of the hall, space 137)

    Presenting Author(s)

  • Mimansa Cholera, DDS, MPH (she/her/hers)

    Resident
    University of California, San Francsico
    University of California, San Francisco
    San Francisco, California, United States

    • Co-Author(s)

  • TT

    Thomas Tanbonliong, DDS

    University of California, San Francisco

    • Research Mentor(s)

  • JS

    Jodi Stookey, PhD

    MCAH Senior Epidemiologist
    San Francisco Department of Public Health
    San Francisco, California, United States

    • Program Director(s)

  • RS

    Ray Stewart, DMD, MS

    Professor
    University of California, San Francsico
    San Francisco, California, United States

Purpose: Saliva insulin is a non-invasive biomarker of carbohydrate intake and plasma insulin. If saliva insulin can reflect effects of drinking water intervention on insulin and related risk factors, it may inform drinking water intervention to prevent insulin-related conditions, including diabetes, obesity and caries.

This study tested if drinking a standard serving (500 ml) of water (W) instead of a standard serving of apple juice (AJ) or no drink (ND) acutely normalizes saliva insulin and reduces caries risk factors (improves saliva osmolality, pH, buffering capacity and immune parameters).

Methods: After baseline saliva collection, 105 pediatric patients (5-10y), attending a routine dental check-up, were randomly assigned to receive W, AJ, or ND, Weight-stratified randomization controlled for differences in insulin by weight status. Follow-up saliva was collected 45-60 minutes after drink administration.

Results: The AJ (OR, 95%CI: 0.10, 0.04-0.28) and ND (OR, 95%CI: 0.10, 0.04-0.28) groups were significantly less likely to have saliva insulin below 170 pg/mL at follow-up than the W group.

Compared to the W group, the AJ group was significantly less likely to have increased pH (OR, 95%CI: 0.09, 0.02-0.34) and buffering capacity (OR, 95%CI: 0.05, 0.03-0.08) and reduced IgA (OR, 95%CI: 0.35, 0.16-0.77). The ND group was significantly less likely to have reduced IgA (OR, 95%CI: 0.41, 0.27-0.63) and amylase (OR, 95%CI: 0.35, 0.18-0.67) than the W group.

Conclusions: Saliva insulin covaried with caries risk factors: carbohydrate intake (from apple juice), lower pH, lower buffering, higher IgA, and higher amylase. Saliva insulin was sensitive to immediate caries risk reduction by drinking water intervention in children eligible for school-based oral health screenings and public health services in San Francisco. Saliva insulin monitoring is ACTIONABLE for public health.