Exploring the Potential Role of Salivary α-2-macroglobulin as a Non-invasive Glycemic Control Marker in Type 2 Diabetes Mellitus Patients

Aims and background: Glycemic control among type 2 diabetes mellitus (T2DM) patients is important in managing and preventing its complications.Currently, the focus is on identifying non-invasive methods for the diagnosis and screening of diabetic patients; salivary analysis has great potential for the same.Several studies have shown serum -2-macroglobulin (A2MG) to be higher in T2DM patients, but very few studies have focused on its levels in saliva.Objectives: To explore the potential role of salivary A2MG as a non-invasive glycemic control marker and its correlation with serum glycated hemoglobin (HbA1c) levels in T2DM patients and to predict the diagnostic accuracy of A2MG in assessing inadequate glycemic control.Materials and methods: A total of 93 subjects were included in this study and divided into three groups: Group I comprised 31 T2DM patients with HbA1c levels 7% (inadequate glycemic control), group II consisted of 31 T2DM patients with HbA1c levels < 7% (adequate glycemic control), and group III included 31 age-and sex-matched healthy controls, with fasting plasma glucose (FPG) < 100 mg/dL, 2-hour plasma glucose < 140 mg/dL, and HbA1c < 5.7%.All the patients underwent detailed history taking, thorough clinical and dental examination, routine laboratory investigations, and estimation of salivary A2MG.Results: There was a statistically significant difference in mean levels of salivary A2MG among the three groups (p < 0.001).Salivary A2MG was found to have a significant positive correlation with HbA1c (r = 0.923, p < 0.001).The optimum cutoff point of salivary A2MG to differentiate between groups I and III was 1512.40 ng/mL (area under the curve [AUC] = 1.0,CI = 95%, p < 0.001).Conclusion: Salivary A2MG proved to be a promising non-invasive alternative method for assessing glycemic control and consequently avoiding comorbidities in T2DM.