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ORIGINAL ARTICLE
Year : 2019  |  Volume : 31  |  Issue : 2  |  Page : 155-163

Salivary α2-macroglobulin as a marker for glycemic control in patients with type 2 diabetes mellitus


1 Department of Internal Medicine, Zagazig University, Zagazig, Egypt
2 Department of Clinical Pathology, Zagazig University, Zagazig, Egypt

Correspondence Address:
Ayman Abd-Elrahman Mohamed Nsr-Allah
Department of Internal Medicine, Zagazig University, Zagazig, 44519
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ejim.ejim_117_18

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Introduction Panic from needle and the cost can discourage some diabetic patients from monitoring their blood glucose levels in a regular manner, so there is a critical need to find a new cost-effective, painless, and sensitive glucose-detection method. Many studies have found that α2-macroglobulin (A2MG) concentrations are increased in the blood of both type 1 and type 2 diabetic patients. Aim The aim of the article is to study the salivary A2MG value as a marker for glycemic control in patients with type 2 diabetes mellitus (DM). Patients and methods A total of 60 patients were included and divided into three groups. Group 1 included patients with type 2 DM with glycosylated hemoglobin (HbA1c) levels more than or equal to 7% (inadequate glycemic control). Group 2 included patients with type 2 DM with HbA1c levels less than 7% (adequate glycemic control). Group 3 included healthy persons (control group). All patients were subjected to the following: thorough history taking, full physical examination, and laboratory investigations, including fasting blood glucose, cholesterol, triglycerides, HbA1c, and salivary A2MG. Results There were statistical significant relations between salivary A2MG and both BMI and duration of diabetes (P<0.05) in type 2 uncontrolled diabetes group but not in controlled group (P>0.05). There were statistically significant positive correlations between levels of salivary A2MG and HbA1c, cholesterol, triglycerides, fasting blood sugar, duration of DM, BMI, and age. The best cutoff value of salivary A2MG as a predictor of bad glycemic control, in relation to HbA1c, was more than or equal to 645 ng/ml, with area under the receiver operating characteristic curve of 0.92, sensitivity of 91.7%, specificity of 90%, and P value of less than 0.001. Conclusion and recommendation With the advantages of rapid, accessible, sensitive, cost-effective, and noninvasive method, salivary A2MG is a promising biological marker for glycemic control in patients with type 2 DM.


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