Salivary markers of hepato-metabolic comorbidities in pediatric obesity

Dig Liver Dis. 2019 Apr;51(4):516-523. doi: 10.1016/j.dld.2018.11.009. Epub 2018 Nov 17.


Background: The pediatric obesity epidemic calls for the noninvasive detection of individuals at higher risk of complications.

Aims: To investigate the diagnostic role of combined salivary uric acid (UA), glucose and insulin levels to screen noninvasively for metabolic syndrome (MetS) and nonalcoholic fatty liver disease.

Methods: Medical history, clinical, anthropometric, and laboratory data including serum triglyceride, glucose, insulin, HOMA, HDL-cholesterol, and UA levels of 23 obese children (15 with [St+] and 8 without [St-] ultrasonographic hepatic steatosis) and 18 normal weight controls were considered.

Results: Serum and salivary UA (p < 0.05; R2 = 0.51), insulin (p < 0.0001; R2 = 0.79), and HOMA (p < 0.0001; R2 = 0.79) levels were significantly correlated; however their values tended to be only slightly higher in the obese patients, predominately in [St+], than in the controls. Notably, UA and insulin levels in both fluids increased in parallel to the number of MetS components. After conversion of the z-logit function including salivary/anthropometric parameters in a stepwise logistic regression analysis, a factor of 0.5 allowed for predicting hepatic steatosis with high sensitivity, specificity, and total accuracy.

Conclusions: Salivary testing together with selected anthropometric parameters helps to identify noninvasively obese children with hepatic steatosis and/or having MetS components.

Keywords: Glucose; HOMA; Insulin; Metabolic syndrome; Saliva; Uric acid.

MeSH terms

  • Adolescent
  • Biomarkers / analysis*
  • Child
  • Comorbidity
  • Female
  • Glucose / analysis
  • Homeostasis
  • Humans
  • Insulin / analysis
  • Insulin Resistance
  • Logistic Models
  • Male
  • Metabolic Syndrome / diagnosis*
  • Non-alcoholic Fatty Liver Disease / diagnosis*
  • Pediatric Obesity / complications*
  • Saliva / chemistry*
  • Uric Acid / analysis


  • Biomarkers
  • Insulin
  • Uric Acid
  • Glucose