Physiological whole saliva is a unique body fluid constantly washing the mucous membranes of the mouth, throat, and larynx. Saliva is a clear, slightly acidic mucinous-serous secretion, composed of various electrolytes, small organic substances, proteins, peptides, and polynucleotides. There are many ways to use saliva as a biological fluid (biofluid). The significant advantages of saliva as a unique diagnostic material are its availability and the noninvasive method of collection. The aim of this review is to emphasize the diagnostic value of saliva as a research material in the configuration of its structure and secretion disorders. The data were obtained using the MEDLINE (PubMed) search engine, as well as an additional manual search. The analysis covered 77 articles selected from a group of 1986 publications and initially qualified for devising. The results were evaluated and checked for the correctness of qualifying in accordance with inclusion and exclusion criteria. The diagnostic use of saliva has attracted the attention of many researchers due to its noninvasive nature and relative simplicity of collection. In addition, it should be noted that the determination of chemical and physical saliva parameters can be effectively performed in the patient's presence in the dental office.

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A Review of Selected Studies That Determine the Physical and Chemical Properties of Saliva in the Field of Dental Treatment.

Diabetes mellitus is the most common chronic disease that affects the oral health. The aim of the study is to evaluate the dental caries, salivary flow rate, buffer capacity, and Lactobacilli in saliva in children with type 1 diabetes mellitus compared to the control group. Methods. The sample consisted of 160 children of 10 to 15 years divided into two groups: 80 children with type 1 diabetes mellitus and 80 children as a control group. Dental caries was assessed using the DMFT index for permanent dentition. Stimulated saliva was collected among all children. Salivary flow rate and buffer capacity were measured, and the colonies of Lactobacillus in saliva were determined. The observed children have answered a number of questions related to their dental visits and parents’ education. The data obtained from each group were compared statistically using the chi-square test and Mann–Whitney U-test. The significant level was set at . Results. DMFT in children with type 1 diabetes was significantly higher than that in the control group ( ). Diabetic children have a low level of stimulated salivary flow rate compared to control children (0.86 ± 0.16 and 1.10 ± 0.14). The buffer capacity showed statistically significant differences between children with type 1 diabetes and control group ( ). Also, children with type 1 diabetes had a higher count and a higher risk of Lactobacillus compared to the control group ( and ). Conclusion. The findings we obtained showed that type 1 diabetes mellitus has an important part in children’s oral health. It appears that children with type 1 diabetes are exposed to a higher risk for caries and oral health than nondiabetic children.

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The Influence of Type 1 Diabetes Mellitus on Dental Caries and Salivary Composition

Objective To perform a meta-analysis based on published studies that compared falls and bone fractures between patients with and without hyponatremia. Context There is evidence suggesting that hyponatremia is associated with an increased risk of falls and bone fractures. Design An extensive Medline, Embase and Cochrane search was performed to retrieve all studies published up to, 30 April 2017, using the following words: "hyponatremia" or "hyponatraemia" AND "falls" and "bone fractures." A meta-analysis was performed including all studies comparing falls and bone fractures in subjects with or without hyponatremia. Patients and results Of 216 retrieved articles, 15 studies satisfied inclusion criteria encompassing a total of 51 879 patients, of whom 2329 were hyponatremic. Across all studies, hyponatremia was associated with a significantly increased risk of falls (MH-OR = 2.14[1.71; 2.67]. This result was confirmed when only hospitalized patients were considered (MH-OR = 2.44 [1.97; 3.02]). A meta-regression analysis showed that the hyponatremia-related risk of falls was higher in those studies considering a lower serum [Na+ ] cut-off to define hyponatremia. Interestingly, the estimated risk of falls related to hyponatremia was already significantly higher when a serum [Na+ ] cut-off of 135 mmol/L was considered (MH-OR = 1.26[1.23;1.29]). The presence of hyponatremia was also associated with a higher risk of fractures, particularly hip fractures (MH-OR = 2.00[1.43;2.81]). Conclusions This study confirms that hyponatremia is associated with an increased risk of falls and bone fractures. The clinical, social and economic relevance of such association is strengthened by the increased incidence of hyponatremia in older people.

Hyponatremia, falls and bone fractures: A systematic review and meta-analysis.

Regarding the widespread progression of diabetes, its related complications and detrimental effects on human health, investigations on this subject seems compulsory. AMP-activated protein kinase (A...

Polyphenols targeting diabetes via the AMP-activated protein kinase pathway; future approach to drug discovery.

The original cohort study of AHAP started in 2011 on 1616 elderly residents of Amirkola, northern part of Iran near the Caspian Sea. The main goal of this study was to comprehensively evaluate the health of the elderly in the region with the emphasis on chronic diseases such as osteoporosis. The first cohort profile was published in the International Journal of Epidemiology in 2014. The phase 1 AHAP showed the elevated level of some diseases and conditions including osteoporosis, metabolic syndrome, obesity, vision problems and relatively low levels of oral health. Therefore, the second phase of this cohort started with more complete population coverage in 2016, not only to collect and record the information based on previous protocol, but also consider new areas such as nutritional status, complete eye and dental examinations and health assessment on the basis of Iranian Traditional Medicine. The new aspect of this project is to conduct clinical and laboratory examinations at the health center to extend more facilities to the elderly. In addition to serum and DNA, samples of saliva, hair and nails are collected and kept under standard conditions in the biobank of this cohort. Researchers can apply for access to data or suggest a collaborative study by submitting the proposal to AHAP committee.

Cohort Profile Update: The Amirkola Health and Ageing Project (AHAP).

BACKGROUND Diabetes mellitus is one of the most prevalent metabolic diseases, with complications such as decreased salivary flow rate and xerostomia. OBJECTIVE This study aimed to determine the salivary flow rate and xerostomia in type I and II diabetic patients in comparison with healthy controls. METHODS This case-control study was performed on diabetic patients of a private office in Babol, Iran, between May 2015 and October 2016. This study involved two study groups (type I and II diabetes, with 40 in each group) and two control groups (control I and II, with 35 in each group) which were age- and sex-matched with the related study groups. They were all selected through simple sampling. Unstimulated whole saliva was collected through Navazesh method and the salivary flow rate was measured (ml/min). Xerostomia was evaluated via Fox's test. Moreover, the patients' data were recorded including age, sex, disease duration, type of diabetes, fasting blood glucose (FBG) and HbA1C. The obtained data were statistically analyzed by using SPSS version 17. Independent-samples t-test, Chi-square, Pearson correlation and multiple comparison post-hoc tests were employed as appropriated. p<0.05 was considered significant. RESULTS The mean salivary flow rate in type I diabetics (0.35±0.11 ml/min) was lower than that in control I (0.50±0.07 ml/min) (p=0.01). The same difference was observed between type II diabetics (0.37±0.13 ml/min) and control II groups (0.47±0.11 ml/min) (p=0.01). No significant difference was observed in the salivary flow rate between type I and II diabetics (p=0.345). Furthermore, xerostomia was higher in type I (2.70±2.50, 1.17±1.60) and II (2.65±2.20-1.62±1.50) diabetics compared with the related control groups (p=0.01), (p=0.02). CONCLUSION Type I, II diabetic patients revealed lower salivary flow rate and higher xerostomia compared with healthy controls. The salivary flow rate and xerostomia had inverse correlation.

Salivary flow rate and xerostomia in patients with type I and II diabetes mellitus.

Background: Type 2 diabetes (T2DM) is an endocrine disease caused by inadequate secretion or improper utilization of insulin. Studies have shown that AMP-activated protein kinase (AMPK) dysregulation is contributed to the development of T2DM. Urtica dioica (UD) may have anti-hypoglycemic activities in T2DM patients. However, the underlying mechanism is remained unclear. The aim of this study was to assess the UD eect on serum levels of glucose, glycated hemoglobin (HbA1c), insulin concentration, and AMPK levels in in diabetic patients. Objectives: This study aimed to determine the e(U+FB00)ect of Urtica Dioica hydro-alcoholic extract on glycemic index and AMPK levels in diabetic patients. Methods: This randomized single-blind clinical trial was conducted in the endocrinology clinic of Rohani hospital (Babol. Iran). Convenience sampling and simple random allocation were used in the study. Sixty diabetic patients were randomly divided into the two drug and control groups. The drug group received 20 mg/kg/d of hydro-alcoholic UD extract three times for 8 weeks and control group received placebo. Fasting blood glucose (FBG), HbA1c, insulin and AMPK were measured and compared at the beginning and end of the study. Results: FBG levels of the drug group were significantly decreased compared with the placebo group (P = 0.032). Quantitative in- sulin sensitivity check index (QUICKI) increased significantly in drug group compared with the other group (P < 0.001). The insulin and AMPK levels in the drug group after taking UD extract increased by 62.5% and 8.0, respectively. However, there was no significant changes compared with the placebo group (P = 0.222 and P = 0, respectively). Conclusions: According to the results, UD is able to decrease glucose level and improve insulin release in T2DM. In addition, as UD is able to induce a small increase in AMPK activity, it is possible that the anti-hyperglycemic eect of UD is mediated by insulin secretion and the possible changes in AMPK levels.

The Effect of Urtica dioica Hydro-Alcoholic Extract on Glycemic Index and AMP-Activated Protein Kinase Levels in Diabetic Patients: A Randomized Single-Blind Clinical Trial

Background Hyponatremia (HN) can be associated with osteoporosis, falls and bone fractures in the elderly. Recent researches demonstrated different results about the correlation of HN with bone mineral density and bone fractures. Methods This analytic research came from the AHAP project in northern IRAN. All people aged 60 years and over were included in the study. Individuals with severe comorbidities and then who had concurrent conditions which could have impact on bone mineral densities (BMD) such as long-term use of steroids, calcium and/or vitamin D supplements, bisphosphonates, calcitonin, thiazides and hormonal medications were excluded. Results One thousand and one hundred and thirteen older persons entered in the study. More than 10 percent of the participants had HN (serum Na+ level ≤ 137mEq/L). No significant difference has been observed between hyponatremic and nonhyponatremic individuals about their balance abilities; bone mineral density; incidence of falls and/or bone fracture during the previous 6 months; dependency in activities of daily living; and osteoporosis. Conclusion HN was not a prevalent problem in older adults who met the inclusion criteria of this research. No significant difference has been observed between HN and bone mineral density and falls in the elderly.

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Hyponatremia, bone mineral density and falls in the elderly; Results from AHAP study.

BACKGROUND AND OBJECTIVE: Several studies have indicated that serum uric acid increases in patients with pre-diabetes and the early of type 2 diabetes mellitus. As diabetes continues and blood sugar goes uncontrolled, the level of serum uric acid drops again. This study aimed to determine the relationship between serum uric acid and blood sugar levels in the elderly, diabetic patients of Amirkola city. METHODS: This cross-sectional study was a part of Amirkola Health and Ageing Project (AHAP). Blood samples were obtained from all the patients in order to measure the Fasting Blood Sugar (FBS) and blood uric acid levels. Afterwards, the relationship between the serum uric acid and Blood Glucose was evaluated. FINDINGS: Of the 1525 older people aged 60 and over, 351(23) were known to have type 2 diabetes and 116 people was diagnosed as diabetes mellitus based on the measurements of FBS. Data analysis revealed an inverse relationship between FBS and serum uric acid level (p=0.012, r=-0.054) and age (p=0.001, r=-0.090) whereas there was a direct relationship between FBS and Body Mass Index (BMI) (p=0.001, r=0.115). CONCLUSION: According to the findings of this study, FBSis inversely correlated with the serum uric acid and age whereas there is a direct correlation between BMI and FBS. © 2015, Journal of Babol University of Medical Sciences. All right reserved.

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The relationship between serum uric acid and blood sugar levels in the elderly diabetic patients of amirkola city

1. Department of Internal Medicine, Babol University of Medical Sciences, Babol, Iran. 2. Department of Internal Medicine, Babol University of Medical Sciences, Babol, Iran. 3. Cellular and Molecular Biology Research Center, Student Research committee, School of Medicine, Babol University of Medical Sciences, Babol, Iran. 4. Department of Community Medicine, Social Determinants of Health (SDH) Research Centre, Babol University of Medical Sciences, Babol, Iran. 5. Department of Radiology, Babol University of Medical Sciences, Babol, Iran. 6. Social Determinants of Health (SDH) Research Centre, Babol University of Medical Sciences, Babol, Iran.

Ali Mirzapour

Papers

Salivary flow rate and xerostomia in patients with type I and II diabetes mellitus.

The Effect of Urtica dioica Hydro-Alcoholic Extract on Glycemic Index and AMP-Activated Protein Kinase Levels in Diabetic Patients: A Randomized Single-Blind Clinical Trial

Hyponatremia, bone mineral density and falls in the elderly; Results from AHAP study.

The relationship between serum uric acid and blood sugar levels in the elderly diabetic patients of amirkola city

Correlation between Thyroid Function and Bone Mineral Density in Elderly People