A Case-Control Study of Salivary Redox Homeostasis in Hypertensive Children. Can Salivary Uric Acid be a Marker of Hypertension?
Abstract
:1. Introduction
2. Material and Methods
2.1. Ethical Issues
2.2. Patients
2.3. Saliva Collection
2.4. Dental Examination
2.5. Blood Collection
2.6. Total Protein Assay
2.7. Redox Assays
2.8. Enzymatic and Non-Enzymatic Antioxidants
2.9. Redox Status
2.10. Oxidative Stress Products
2.11. Nitrosative Stress Products
2.12. Statistical Analysis
3. Results
3.1. Clinical Characteristics
3.2. Salivary Gland Function and Dental Examination
3.3. Enzymatic and Non-Enzymatic Antioxidants
3.4. Redox Status
3.5. Oxidative Stress Products
3.6. Nitrosative Stress
3.7. Correlations
3.8. ROC Analysis
4. Discussion
5. Conclusions
- Childhood hypertension is associated with disturbances in enzymatic and non-enzymatic antioxidant defense as well as enhanced oxidative and nitrosative damage both in the plasma/erythrocytes as well as salivary glands (NWS and SWS).
- In hypertension, the secretion of stimulated saliva decreases. Children with hypertension should receive additional dental care.
- Salivary UA may be a potential biomarker of hypertension in children. However, further studies are necessary to assess its diagnostic utility in a larger group of patients.
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Control n = 53 | Hypertension n = 53 | ||
---|---|---|---|
General Data | |||
Age (years) | 13 ± 3.1 | 13 ± 3.5 | |
Male n (%) | 28 (53%) | 28 (53%) | |
BMI (kg/m2) | 22 ± 2.6 | 26 ± 5.9 * | |
SDS BMI | 0.8 ± 0.2 | 2.4 ± 0.5 | |
Obesity n (%) | 0 (0) | 20 (38%) | |
Blood Pressure | |||
SBP (mmHg) | 106 ± 10.5 | 124 ± 12 * | |
DBP (mmHg) | 65 ± 8 | 76 ± 9.5 * | |
Blood Tests | |||
WBC (tys./μL) | 7.5 ± 0.9 | 6.8 ± 1.7 | |
RBC (tys./μL) | 4.3 ± 0.5 | 4.3 ± 0.2 | |
Hgb (g/dL) | 14 ± 0.9 | 14 ± 1.3 | |
Hct (%) | 43 ± 2.6 | 42 ± 3.7 | |
PLT (tys./μL) | 250 ± 65 | 274 ± 60 | |
sCre (mg/dL) | 0.73 ± 0.5 | 0.73 ± 0.4 | |
sUrea (mg/dL) | 15 ± 10 | 25 ± 11 | |
HDL (mg/dL) | 52 ± 10 | 48 ± 12 | |
LDL (mg/dL) | 70 ± 25 | 97 ± 24 * | |
TC (mg/dL) | 167 ± 45 | 177 ± 74 | |
TG (mg/dL) | 70 ± 38 | 122 ± 72 * | |
Glucose (mg/dL) | 82 ± 5.5 | 89 ± 7.9 | |
IL-6 (pg/mL) | 1.44 ± 0.57 | 2.49 ± 0.58 * | |
eGFR (mL/min/1.73m2) | 140 ± 29 | 118 ± 38 | |
Pharmacotherapy | |||
Hypotensive drugs | 0 per day n (%) | 0 (0) | 22 (39) |
1 per day n (%) | 0 (0) | 24 (45) | |
2 per day n (%) | 0 (0) | 7 (13) | |
Angiotensin-converting enzyme inhibitors n (%) | 0 (0) | 21 (40) | |
Angiotensin receptor blockers n (%) | 0 (0) | 5 (9) | |
Calcium channel blockers n (%) | 0 (0) | 4 (7) |
24 h SBP (mmHg) | 127 ± 11 |
24 h DBP (mmHg) | 69 ± 7.5 |
SBP daytime (mmHg) | 130 ± 11 |
DBP daytime (mmHg) | 72 ± 7.6 |
SBP nighttime (mmHg) | 117 ± 11 |
DBP nighttime (mmHg) | 72 ± 16 |
SBPL daytime (%) | 51 ± 3.7 |
DBPL daytime (%) | 19 ± 3.0 |
SBPL nighttime (%) | 47 ± 4.6 |
DBPL nighttime (%) | 20 ± 2.8 |
SBP 24 h Z-score | 0.21 ± 5.9 |
DBP 24 h Z-score | 0.25 ± 2.2 |
SBP day Z-score | 0.91 ± 2.5 |
DBP day Z-score | 136 ± 675 |
SBP night Z-score | -7 ± 20 |
DBP night Z-score | -7.9 ± 29 |
Control n = 53 | Hypertension n = 53 | |
---|---|---|
NWS flow (mL/min) | 0.47 ± 0.05 | 0.43 ± 0.05 |
SWS flow (mL/min) | 1.8 ± 0.09 | 0.89 ± 0.09 * |
TP NWS (μg/mL) | 1350 ± 185 | 1330 ± 264 |
TP SWS (μg/mL) | 1019 ± 217 | 772 ± 228 * |
α-amylase NWS (μmol/mg protein) | 0.2 ± 0.08 | 0.19 ± 0.08 |
α-amylase SWS (μmol/mg protein) | 0.28 ± 0.05 | 0.21 ± 0.08 * |
DMFT | 3.1 ± 0.1 | 3.1 ± 0.2 |
dmft | 11 ± 0.1 | 11.1 ± 0.1 |
PBI | 0 ± 0.1 | 0 ± 0.1 |
GI | 0 ± 0.1 | 0 ± 0.1 |
Pair of Variables | r | p |
---|---|---|
SWS | ||
CAT and SOD | 0.32 | 0.028 |
Saliva and blood | ||
AGE NWS and AGE plasma | 0.83 | <0.001 |
MDA NWS and MDA plasma | 0.83 | <0.001 |
Pair of Variables | r | p |
---|---|---|
NWS | ||
SOD and TOS | 0.83 | <0.001 |
MDA and SBP | 0.64 | <0.001 |
MDA and SBP | 0.49 | 0.001 |
SWS | ||
CAT and TOS | 0.75 | <0.001 |
UA and TOS | 0.62 | <0.001 |
UA and DBP | 0.8 | <0.001 |
AGE and SBP | 0.64 | <0.001 |
AGE and DBP | 0.5 | 0.001 |
MDA and SBP | 0.6 | <0.001 |
MDA and DBP | 0.31 | 0.025 |
UA and DBP | 0.8 | <0.001 |
UA and DBP 24 h Z-score | 0.35 | 0.016 |
UA and SBP 24 h Z-score | 0.41 | 0.004 |
GSH and Peroxynitrite | -0.61 | <0.001 |
Peroxynitrite and MDA | 0.61 | <0.001 |
Peroxynitrite and nitrotyrosine | 0.68 | <0.001 |
SWS flow and MDA | −0.77 | <0.001 |
SWS flow and NO | 0.56 | <0.001 |
SWS flow and peroxynitrite | −0.42 | 0.002 |
SWS flow and nitrotyrosine | −0.41 | 0.002 |
Saliva and blood | ||
AGE NWS and AGE plasma | 0.8 | <0.001 |
MDA NWS and MDA plasma | 0.89 | <0.001 |
UA SWS and IL-6 | 0.72 | <0.001 |
AUC | Confidence Intervals | p Value | Cut-off | Sensitivity (%) | Specificity (%) | |
---|---|---|---|---|---|---|
NWS | ||||||
SOD (mU/mg protein) | 0.91 | 0.86–0.96 | <0.001 | >1.65 | 77 | 83 |
CAT (nmol H2O2/min/mg protein) | 0.68 | 0.58–0.78 | 0.002 | >0.52 | 64 | 66 |
Px (mU/mg protein) | 0.55 | 0.43–0.67 | 0.406 | >0.49 | 55 | 64 |
GSH (µg/mg protein) | 0.87 | 0.80–0.94 | <0.001 | <0.43 | 79 | 79 |
UA (µg/mg protein) | 0.85 | 0.77–0.92 | <0.001 | >3.35 | 72 | 79 |
TAC (µmol/mg protein) | 0.83 | 0.74–0.92 | <0.001 | >0.59 | 77 | 82 |
TOS (nmol H2O2 equiv/mg protein) | 0.87 | 0.79–0.95 | <0.001 | >10.30 | 81 | 87 |
OSI (TOS/TAC ratio) | 0.58 | 0.47–0.68 | 0.186 | >13.45 | 57 | 55 |
AGE (AFU/mg protein) | 0.96 | 0.92–1.00 | <0.001 | >2.08 | 92 | 92 |
MDA (µmol/mg protein) | 0.79 | 0.70–0.87 | <0.001 | >101.3 | 75 | 74 |
NO (nmol/mg protein) | 0.63 | 0.52–0.73 | 0.026 | <180.6 | 62 | 58 |
Peroxynitrite (pmol/mg protein) | 0.79 | 0.69–0.89 | <0.001 | >63.47 | 75 | 77 |
Nitrotyrosine (pmol/mg protein) | 0.63 | 0.53–0.74 | 0.018 | >221.3 | 64 | 60 |
SWS | ||||||
SOD (mU/mg protein) | 0.74 | 0.65–0.84 | <0.001 | >3.72 | 74 | 70 |
CAT (nmol H2O2/min/mg protein) | 0.93 | 0.87–0.98 | <0.001 | >5.11 | 91 | 91 |
Px (mU/mg protein) | 0.79 | 0.70–0.88 | <0.001 | >0.47 | 77 | 72 |
GSH (µg/mg protein) | 0.79 | 0.70–0.88 | <0.001 | <0.70 | 70 | 70 |
UA (µg/mg protein) | 0.98 | 0.96–1.00 | <0.001 | >5.50 | 94 | 96 |
TAC (µmol/mg protein) | 0.80 | 0.71–0.88 | <0.001 | >0.82 | 74 | 75 |
TOS (nmol H2O2 equiv/mg protein) | 0.61 | 0.50–0.72 | 0.055 | >19.37 | 55 | 58 |
OSI (TOS/TAC ratio) | 0.64 | 0.53–0.74 | 0.015 | <22.30 | 58 | 55 |
AGE (AFU/mg protein) | 0.99 | 0.97–1.00 | <0.001 | >4.64 | 92 | 92 |
MDA (µmol/mg protein) | 0.80 | 0.72–0.89 | <0.001 | >68.72 | 77 | 74 |
NO (nmol/mg protein) | 0.83 | 0.75–0.91 | <0.001 | <197.7 | 74 | 77 |
Peroxynitrite (pmol/mg protein) | 0.84 | 0.76–0.92 | <0.001 | >72.86 | 83 | 79 |
Nitrotyrosine (pmol/mg protein) | 0.72 | 0.62–0.82 | 0.001 | >204.5 | 66 | 66 |
AUC | Confidence Intervals | p Value | Cut-off | Sensitivity (%) | Specificity (%) | |
---|---|---|---|---|---|---|
Erythrocytes | ||||||
SOD (mU/mg protein) | 0.89 | 0.83–0.96 | <0.001 | >0.37 | 83 | 83 |
CAT (nmol H2O2/min/mg protein) | 0.85 | 0.77–0.92 | <0.001 | >0.43 | 79 | 79 |
GPx (mU/mg protein) | 1.00 | 1.00–1.00 | <0.001 | >0.23 | 100 | 98 |
Plasma | ||||||
GSH (µg/mg protein) | 0.70 | 0.59–0.80 | 0.001 | <3.19 | 64 | 68 |
UA (µg/mg protein) | 0.68 | 0.58–0.78 | 0.002 | >0.81 | 64 | 66 |
TAC (µmol/mg protein) | 0.85 | 0.77–0.94 | <0.001 | >0.62 | 81 | 85 |
TOS (nmol H2O2 equiv/mg protein) | 0.76 | 0.67–0.86 | <0.001 | >7.95 | 77 | 74 |
OSI (TOS/TAS ratio) | 0.57 | 0.46–0.68 | 0.226 | >13.45 | 57 | 55 |
AGE (AFU/mg protein) | 1.00 | 1.00–1.00 | <0.001 | >3.96 | 98 | 100 |
MDA (µmol/mg protein) | 0.90 | 0.84–0.97 | <0.001 | >103.7 | 85 | 92 |
NO (nmol/mg protein) | 0.82 | 0.73–0.91 | <0.001 | <16.66 | 77 | 79 |
Peroxynitrite (pmol/mg protein) | 0.78 | 0.68–0.87 | <0.001 | >86.27 | 72 | 74 |
Nitrotyrosine (pmol/mg protein) | 0.67 | 0.57–0.77 | 0.003 | >166.2 | 68 | 64 |
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Maciejczyk, M.; Taranta-Janusz, K.; Wasilewska, A.; Kossakowska, A.; Zalewska, A. A Case-Control Study of Salivary Redox Homeostasis in Hypertensive Children. Can Salivary Uric Acid be a Marker of Hypertension? J. Clin. Med. 2020, 9, 837. https://doi.org/10.3390/jcm9030837
Maciejczyk M, Taranta-Janusz K, Wasilewska A, Kossakowska A, Zalewska A. A Case-Control Study of Salivary Redox Homeostasis in Hypertensive Children. Can Salivary Uric Acid be a Marker of Hypertension? Journal of Clinical Medicine. 2020; 9(3):837. https://doi.org/10.3390/jcm9030837
Chicago/Turabian StyleMaciejczyk, Mateusz, Katarzyna Taranta-Janusz, Anna Wasilewska, Agnieszka Kossakowska, and Anna Zalewska. 2020. "A Case-Control Study of Salivary Redox Homeostasis in Hypertensive Children. Can Salivary Uric Acid be a Marker of Hypertension?" Journal of Clinical Medicine 9, no. 3: 837. https://doi.org/10.3390/jcm9030837