title: Unhealthy Phenotype as Indicated by Salivary Biomarkers: Glucose, Insulin, VEGF-A, and IL-12p70 in Obese Kuwaiti Adolescents.
abstract: OBJECTIVE
  Here, we investigated the relationships between obesity and the salivary concentrations of insulin, glucose, and 20 metabolic biomarkers in Kuwaiti adolescents. Previously, we have shown that certain salivary metabolic markers can act as surrogates for blood concentrations.
  
  
  METHODS
  Salivary samples of whole saliva were collected from 8,317 adolescents. Salivary glucose concentration was measured by a high-sensitivity glucose oxidase method implemented on a robotic chemical analyzer. The concentration of salivary insulin and 20 other metabolic biomarkers was assayed in 744 randomly selected saliva samples by multiplexed bead-based immunoassay.
  
  
  RESULTS
  Obesity was seen in 26.5% of the adolescents. Salivary insulin predicting hyperinsulinemia occurred in 4.3% of normal-weight adolescents, 8.3% of overweight adolescents, and 25.7% of obese adolescents (p < 0.0001). Salivary glucose predicting hyperglycemia was found in only 3% of obese children and was not predictive (p = 0.89). Elevated salivary glucose and insulin occurring together was associated with elevated vascular endothelial growth factor and reduced salivary interleukin-12.
  
  
  CONCLUSIONS
  Considering the surrogate nature of salivary insulin and glucose, this study suggests that elevated insulin may be a dominant sign of metabolic disease in adolescent populations. It also appears that a proangiogenic environment may accompany elevated glucose in obese adolescents.
authors.affiliation: Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, MA 02142, USA.
authors.forename: Mor-Li
authors.initials: ML
authors.lastname: Hartman
authors.affiliation: Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, MA 02142, USA.
authors.forename: J Max
authors.initials: JM
authors.lastname: Goodson
authors.affiliation: Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, MA 02142, USA.
authors.forename: Ping
authors.initials: P
authors.lastname: Shi
authors.affiliation: Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, MA 02142, USA.
authors.forename: Jorel
authors.initials: J
authors.lastname: Vargas
authors.affiliation: Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, MA 02142, USA.
authors.forename: Tina
authors.initials: T
authors.lastname: Yaskell
authors.affiliation: Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, MA 02142, USA.
authors.forename: Danielle
authors.initials: D
authors.lastname: Stephens
authors.affiliation: Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, MA 02142, USA.
authors.forename: Maryann
authors.initials: M
authors.lastname: Cugini
authors.affiliation: Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, MA 02142, USA.
authors.forename: Hatice
authors.initials: H
authors.lastname: Hasturk
authors.affiliation: Department of Nutrition, Dasman Diabetes Institute, 15462 Dasman, Kuwait.
authors.forename: Roula
authors.initials: R
authors.lastname: Barake
authors.affiliation: Genome Center, The Dasman Diabetes Institute, 15462 Dasman, Kuwait.
authors.forename: Osama
authors.initials: O
authors.lastname: Alsmadi
authors.affiliation: Ministry of Health, 13001 Safat, Kuwait.
authors.forename: Sabiha
authors.initials: S
authors.lastname: Al-Mutawa
authors.affiliation: Ministry of Health, 13001 Safat, Kuwait.
authors.forename: Jitendra
authors.initials: J
authors.lastname: Ariga
authors.affiliation: Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, MA 02142, USA.
authors.forename: Pramod
authors.initials: P
authors.lastname: Soparkar
authors.affiliation: Faculty of Dentistry, Kuwait University, 13060 Safat, Kuwait.
authors.forename: Jawad
authors.initials: J
authors.lastname: Behbehani
authors.affiliation: Dasman Diabetes Institute, 15462 Dasman, Kuwait.
authors.forename: Kazem
authors.initials: K
authors.lastname: Behbehani
authors.affiliation: Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
authors.forename: Francine
authors.initials: F
authors.lastname: Welty
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000378:metabolism; D005260:Female; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D007328:Insulin; D007333:Insulin Resistance; D018664:Interleukin-12 / Q000378:metabolism*; D007730:Kuwait / Q000453:epidemiology; D008297:Male; D063766:Pediatric Obesity / Q000453:epidemiology / Q000378:metabolism* / Q000503:physiopathology; D010641:Phenotype; D011237:Predictive Value of Tests; D012307:Risk Factors; D012463:Saliva / Q000378:metabolism*; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D007328:Insulin; D042461:Vascular Endothelial Growth Factor A; D018664:Interleukin-12; D005947:Glucose