Association between metabolic and hormonal profile, proinflammatory cytokines in saliva and gingival health in adolescent females with polycystic ovary syndrome

Abstract

Background Research studies indicate that polycystic ovary syndrome (PCOS) may increase susceptibility to periodontal disease. The mechanisms that link both conditions are not entirely understood. Thus, the study aimed to investigate the impact of hormonal and metabolic disturbances on the gingival health and salivary levels of tumor necrosis factor (TNF-α), interleukin 1β (IL1-β), and interleukin 6 (IL-6) in adolescent girls with PCOS. Methods Thirty-one patients with PCOS and twenty-eight healthy age-mates (as the control group) were enrolled in the study. Individuals with PCOS underwent blood tests for the determination of hormonal and metabolic parameters. Saliva samples were collected to measure salivary testosterone and proinflammatory cytokines in both studied groups. Calibrated dentist assessed oral hygiene and gingival health of all subjects. Results Salivary testosterone was significantly higher in the study group (p = 0.0007). The groups did not differ significantly concerning periodontal parameters. Patients with PCOS revealed higher levels of salivary cytokines (p < 0.0001). Gingival index (GI) and the percentage of sites bleeding upon probing (BOP%) were positively correlated with the plaque index (PI) in both groups (rs ≥ 0.60, p < 0.001), and negatively correlated with salivary testosterone level in the PCOS group (rs = − 0.44, p = 0.0138 and rs = − 0.37, p = 0.0424, respectively). BOP% was also positively correlated with body mass index (BMI) in the control group (rs = 0.40, p = 0.0368) and index of insulin resistance (HOMA-IR) in the study group (rs = 0.48, p = 0.0068). Salivary testosterone was positively correlated with TNF-α in the control group (rs = 0.41, p = 0.0321), while in the study group, total testosterone (TT) was positively correlated with IL-6 (rs = 0.37, p = 0.0400) and free androgen index (FAI) with TNF-α (rs = 0.36, p = 0.0491). Conclusions Gingival health of the examined population was associated primarily with oral hygiene and, to a lesser extent, with the hormonal and metabolic profile. Despite similar periodontal parameters in the both studied groups, patients with PCOS revealed significantly higher levels of proinflammatory cytokines in saliva, which might be the manifestation of the systemic low-grade inflammation associated with PCOS.

Dietary and Physical Activity Habits in Adolescent Girls with Polycystic Ovary Syndrome (PCOS)-HAstudy

“…Components of metabolic syndrome and hormonal disturbances are associated with the increased risk of cardiovascular disease, infertility, endometrial cancer and may affect the composition of the oral and gut microbiome [3,6]. Due to chronic low-grade inflammation in the body, females with PCOS have increased levels of proinflammatory mediators and oxidative stress markers in the body fluids [4,5,7]. The causes of PCOS are not clearly understood; however, numerous studies have shown that environmental/lifestyle factors may modulate the secretion of hormones and affect the metabolic profile of the patients with endocrinopathy [8][9][10][11][12].…”

Evaluation of the Salivary Matrix Metalloproteinase-9 in Women With Polycystic Ovaries Syndrome and Gingival Inflammation: A Case-Control Study

“…(2021) concluded that young women with PCOS and good oral health maintenance do not vary from healthy controls concerning gingival indices [21].…”

“…Per the present study, systematic reviews by Márquez-Arrico et al and Kellesarians et al have confirmed that a positive association between periodontal pathologies and PCOS, particularly gingivitis and chronic periodontitis [ 19 , 20 ]. Likewise, Wendland et al (2021) concluded that young women with PCOS and good oral health maintenance do not vary from healthy controls concerning gingival indices [ 21 ].…”

Association of Macronutrients Composition, Physical Activity and Serum Androgen Concentration in Young Women with Polycystic Ovary Syndrome

“…Total testosterone (tT), dehydroepiandrosterone-sulfate (DHEA-S), sex hormone binding globulin (SHBG) were measured by the electrochemiluminescence (ECLIA) immunoassay method (Elecsys; Roche Diagnostics GmbH, Mannheim, Germany) according to the manufacturer’s instructions. The free testosterone (fT) was calculated from tT and SHBG levels using the online fT calculator available on the ISSAM website ( (accessed on 17 October 2021), as described previously [ 32 , 33 , 34 ]. Serum concentrations of androstenedione (A) were measured by using the DRG Androstenedione ELISA kit (enzyme linked immunosorbent assay).…”