Sialometric and Sialochemical Changes in Morbidly Obese Patients before and after Bariatric Surgery
Luiz CC Gambus, Aline CBR Johann, Patrícia VC Bettega, Edvaldo AR Rosa, Ivone MI Morimoto, Magda RR da Cruz, Luís S Nassif, Sérgio L Rocha, Sérgio O Ioshii, Andresa VS Vaz, Juliana AL Solyon, Francineo Moraes, Sérgio A Ignácio, Ana MTG Hardy
Bariatric surgery, Body mass index, Morbid obesity, Obesity, Saliva
Citation Information :
Gambus LC, Johann AC, Bettega PV, Rosa EA, Morimoto IM, da Cruz MR, Nassif LS, Rocha SL, Ioshii SO, Vaz AV, Solyon JA, Moraes F, Ignácio SA, Hardy AM. Sialometric and Sialochemical Changes in Morbidly Obese Patients before and after Bariatric Surgery. J Contemp Dent Pract 2018; 19 (7):756-761.
Aim: To evaluate the sialometric and sialochemical changes in morbidly obese patients before and after bariatric surgery.
Materials and methods: A total of 74 participants were divided into three groups paired by sex and age: (a) Experimental 1 (E1)—morbid obesity (n = 40)—according to the Fobi-Capella technique, corresponding to the individuals with a body mass index (BMI) of greater than 40 kg/m2 prior to bariatric surgery; (b) Experimental 2 (E2)—the same individuals after surgery; and (c) control (C) (n = 34)—individuals with a BMI of nearly 23 kg/m2. The measure of salivary flow was carried out by collecting stimulated saliva. The pH was evaluated using the pocket pH meter, while the salivary buffer capacity (SBC) was determined by the titration method. Analyses of the salivary concentration of total proteins (TPs), amylase activity, urea, calcium (Ca++), and glucose were evaluated using the calorimetric method.
Results: Group E1, as compared with group C, presented the highest pH levels (p = 0.03), amylase activity (p = 0.00), and calcium (p = 0.00). The opposite was observed for glucose (p = 0.00), TP (p = 0.04), and urea (p = 0.04). Group E2, as compared with group C, revealed higher levels of amylase (p = 0.00) and calcium (p = 0.00). The opposite was observed for SBC (p = 0.01), PT (p = 0.00), and glucose (p = 0.00). Group E1, as compared with group E2, presented higher values of SBC (p = 0.00) and urea (p = 0.00). The lowest values were found for calcium and urea (p = 0.03).
Conclusion: Both weight gain and bariatric surgery are risk factors for the oral condition, causing change in some important salivary components, such as TP, amylase, calcium, and glucose.
Clinical significance: This article is a valuable addition to the scientific literature, due to its novelty. There are no papers that show salivary alterations related to bariatric surgeries.
Gao F, Wang ZJ, Shen H, Yang SW, Nie B, Zhou YJ. Impact of obesity on mortality in patients with diabetes: meta-analysis of 20 studies including 250,016 patients. J Diabetes Investig 2018 Jan;9(1):44-54.
Campos JM. The Brazilian Society of Bariatric and Metabolic Surgery. SBCBM.prioritizes encouraging of scientific production. Arq Bras Cir Dig 2015 Dec;28(Suppl 1):1.
Brouwer CA, Gietema JA, Vonk JM, Tissing WJ, Boezen HM, Zwart N, Postma A. BMI and annual increase of BMI in longterm childhood cancer survivors; relationship to treatment. Support Care Cancer 2012 Feb;20(2):311-318.
Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, Mullany EC, Biryukov S, Abbafati C, Abera SF, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014 Aug;384(9945):766-781.
Zurawinski W, Soko.owski D, Krupa-Kotara K, Czech E, Sosada K. Evaluation of the results of treatment of morbid obesity by the endoscopic intragastric balloon implantation method. Wideochir Inne Tech Maloinwazyjne 2017 Mar;12(1): 37-48.
Lopez-Nava G, Galvao MP, Bautista-Castano I, Fernandez- Corbelle JP, Trell M, Lopez N. Endoscopic sleeve gastroplasty for obesity treatment: two years of experience. Arq Bras Cir Dig 2017 Jan-Mar;30(1):18-20.
Brazilian Bariatric and Metabolic Surgery Society. Brazilian society of bariatric surgery supports targets to contain obesity and proposes consumer alert seal. Brazil: SBCBM; 2017. [Cited 2017 May 27]. Available from: http://sbcbm.org.br/wordpre ss=surgeries+bariatrics+done+in+brazil+in+2015.
American Society for Metabolic and Bariatric Surgery. Estimate of bariatric surgery numbers, 2011-2016. Gainesville (FL): ASMBS; 2017. [Cited 2017 Mar 21]. Available from: http:// asmbs.org/resources/estimate-of-bariatric-surgery-numbers.
Dawes C. Physiological factors affecting salivary flow rate, oral sugar clearance, and the sensation of dry mouth in man. J Dent Res 1987 Feb;66(Spec No):648-653.
Mörnstad H, Von Knorring L, Forsgren L, Holmgren S. Acute effects of some different antidepressant drugs on saliva composition. Neuropsychobiology 1986;15(2):73-79.
Banderas-Tarabay JA, Gonzáles-Begne M, Sanchez-Garduno M, Millán-Cortéz E, López-Rodríguez A, Vilchis-Velázquez A. The flow and concentration of proteins in human whole saliva. Salud Publica Mex 1997 Sep-Oct;39(5):433-441.
Actis AB, Perovic NR, Defagó D, Beccacece C, Eynard AR. Acid profile of human saliva: a possible indicator of dietary fat intake. Arch Oral Biol 2005 Jan;50(1):1-6.
Pannunzio E, Amancio OM, Vitalle MS, Souza DN, Mendes FM, Nicolau J. Analysis of stimulated whole saliva in overweight and obese school children. Rev Assoc Med Bras (1992) 2010 Jan-Feb;56(1):32-36.
Castagnola M, Scarano E, Passali GC, Messana I, Cabras T, Iavarone F, Di Cintio G, Fiorita A, De Corso E, Paludetti G. Salivary biomarkers and proteomics: future diagnostic and clinical utilities Biomarkers e proteomica salivari: prospettive future cliniche e diagnostiche. Acta Otorhinolaryngol Ital 2017 Apr;37(2):94-101.
Grégio AM, Durscki JR, Lima AA, Machado MA, Ignácio SA, Azevedo LR. Association of amitriptyline and diazepam on the histomorphometry of rat parotid glands. Pharmacol Online 2006;2:96-108.
Chauhan V, Vaid M, Gupta M, Kalanuria A, Parashar A. Metabolic, renal, and nutritional consequences of bariatric surgery: implications for the clinician. South Med J 2010 Aug;103(8):775-783, quiz 784-785.
Tenovuo J. Salivary parameters of relevance for assessing caries activity in individuals and populations. Community Dent Oral Epidemiol 1997 Feb;25(1):82-86.
Krasse, B. Caries risk: a practical guide for assessment and control. Chicago (IL): Quintessence Pub Co.; 1985. p. 113.
Kobus A, Kierklo A, Zalewska A KuŸmiuk A, Szajda SD, £awicki S, Bagiñska J. Unstimulated salivary flow, pH, proteins and oral health in patients with juvenile idiopathic arthritis. BMC Oral Health 2017 Jun;17(1):94.
Bornhorst GM, Gouseti O, Wickham MS, Bakalis S. Engineering digestion: multiscale processes of food digestion. J Food Sci 2016 Mar;81(3):R534-R543.
Humphrey SP, Williamson RT. A review of saliva: Normal composition, flow, and function. J Prosthet Dent 2001 Feb;85(2):162-169.
Rohleder N, Nater UM. Determinants of salivary alfaamylase in humans and methodological considerations. Psychoneuroendocrinology 2009 May;34(4):469-485.
Edgar WM. Saliva: its secretion, composition and functions. Br Dent J 1992 Apr;172(8):305-312.
Abou Neel EA, Aljabo A, Strange A, Ibrahim S, Coathup M, Young AM, Bozec L, Mudera V. Demineralization– remineralization dynamics in teeth and bone. Int J Nanomed 2016 Sep;11:4743-4763.
Hebert SC, Brown EM, Harris HW. Role of the Ca (2+)-sensing receptor in divalent mineral ion homeostasis. J Exp Biol 1997 Jan;200(Pt 2):295-302.
Bristow SM, Gamble GD, Horne AM, Reid IR. Dietary calcium intake and rate of bone loss in men. Br J Nutr 2017 May;117(10):1432-1438.
Panchbhai AS, Degwekar SS, Bhowte RR. Estimation of salivary glucose, salivary amylase, salivary total protein and salivary flow rate in diabetics in India. J Oral Sci 2010 Sep;52(3):359-368.
Smith AE, Annesi JJ, Walsh AM Lennon V, Bell RA. Association of changes in self-efficacy, voluntary physical activity, and risk factors for type 2 diabetes in a behavioral treatment for obese preadolescents: a pilot study. J Pediatr Nurs 2010 Oct;25(5):393-399.