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<p>To assess salivary glutamate and opiorphin levels in subjects with Symptomatic Irreversible Pulpitis (SIP), with and without Type 2 Diabetes (T2D), and to assess their association with pain intensity using the Visual Analogue Scale (VAS). Patients experiencing SIP pain with (<i>n</i> = 25) and without (<i>n</i> = 25) type 2 diabetes along with healthy controls (<i>n</i> = 25) were recruited for this study. VAS scale was used to record the pain.3&#xa0;mL of unstimulated saliva was collected after thorough oral examination and diagnosis for irreversible pulpitis.The salivary samples were analysed for the pain markers—glutamate and opiorphin by ELISA method. The results were analysed statistically. Diagnostic performance was assessed using ROC curve analysis, and group differences were evaluated by ANOVA. Higher levels of glutamate (7.69 ± 2.07&#xa0;µg/mL; <i>p</i> &lt; 0.01) and opiorphin (3.96 ± 2.67&#xa0;ng/mL; <i>p</i> &lt; 0.05) were detected in patients with T2D and SIP, when compared with subjects without T2D. T2D + SIP and nondiabetic SIP groups showed higher opiorphin (<i>d</i> = 1.45, 95% CI [0.83–2.08]; <i>d</i> = 0.99, 95% CI [0.40–1.58]) and glutamate levels (<i>d</i> = 1.31, 95% CI [0.70–1.93]; <i>d</i> = 0.58, 95% CI [0.01–1.15]) versus healthy controls, with T2D + SIP also exceeding ND + SIP for glutamate (<i>d</i> = 1.18, 95% CI [0.58–1.78]). However, the relation between VAS score and levels of glutamate (<i>p</i> &lt; 0.05) and opiorphin (<i>p</i> &lt; 0.001) between diabetic and nondiabetic subjects with dental pain were found to be significantly different. ROC analysis revealed excellent discriminatory performance for glutamate (AUC = 0.843–0.850) across comparisons, whereas opiorphin was limited to distinguishing diabetic from nondiabetic pulpitis (AUC = 0.725). Glutamate levels correlated negatively with pain (VAS; <i>r</i> = –0.351, <i>p</i> = 0.002), while opiorphin correlated positively with pain (<i>r</i> = 0.283, <i>p</i> = 0.014). Salivary glutamate demonstrates strong potential as a diagnostic biomarker for pulpitis in both diabetic and nondiabetic individuals, while opiorphin may serve as an indicator of pain severity rather than disease differentiation.</p>

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Salivary glutamate and opiorphin as noninvasive markers of irreversible pulpitis in subjects with and without type2 diabetes

  • 期刊论文

  • 发表日期：

    2025年11月3日

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  • Aravindha Babu Narayanasamy,
  • S. Munira Banu,
  • D. Ramya,
  • R. Mathangi

摘要

To assess salivary glutamate and opiorphin levels in subjects with Symptomatic Irreversible Pulpitis (SIP), with and without Type 2 Diabetes (T2D), and to assess their association with pain intensity using the Visual Analogue Scale (VAS). Patients experiencing SIP pain with (n = 25) and without (n = 25) type 2 diabetes along with healthy controls (n = 25) were recruited for this study. VAS scale was used to record the pain.3 mL of unstimulated saliva was collected after thorough oral examination and diagnosis for irreversible pulpitis.The salivary samples were analysed for the pain markers—glutamate and opiorphin by ELISA method. The results were analysed statistically. Diagnostic performance was assessed using ROC curve analysis, and group differences were evaluated by ANOVA. Higher levels of glutamate (7.69 ± 2.07 µg/mL; p < 0.01) and opiorphin (3.96 ± 2.67 ng/mL; p < 0.05) were detected in patients with T2D and SIP, when compared with subjects without T2D. T2D + SIP and nondiabetic SIP groups showed higher opiorphin (d = 1.45, 95% CI [0.83–2.08]; d = 0.99, 95% CI [0.40–1.58]) and glutamate levels (d = 1.31, 95% CI [0.70–1.93]; d = 0.58, 95% CI [0.01–1.15]) versus healthy controls, with T2D + SIP also exceeding ND + SIP for glutamate (d = 1.18, 95% CI [0.58–1.78]). However, the relation between VAS score and levels of glutamate (p < 0.05) and opiorphin (p < 0.001) between diabetic and nondiabetic subjects with dental pain were found to be significantly different. ROC analysis revealed excellent discriminatory performance for glutamate (AUC = 0.843–0.850) across comparisons, whereas opiorphin was limited to distinguishing diabetic from nondiabetic pulpitis (AUC = 0.725). Glutamate levels correlated negatively with pain (VAS; r = –0.351, p = 0.002), while opiorphin correlated positively with pain (r = 0.283, p = 0.014). Salivary glutamate demonstrates strong potential as a diagnostic biomarker for pulpitis in both diabetic and nondiabetic individuals, while opiorphin may serve as an indicator of pain severity rather than disease differentiation.