Observational Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 26, 2025; 13(21): 105911
Published online Jul 26, 2025. doi: 10.12998/wjcc.v13.i21.105911
Low salivary uric acid levels are independently associated with periodontitis
Leonardo Lorente, Esther Hernández Marrero, Pedro Abreu-Gonzalez, Angel Daniel Lorente Martín, Agustín F González-Rivero, María José Marrero González, Carmen Hernández Marrero, Olga Hernández Marrero, Alejandro Jiménez, Cándido Manuel Hernández Padilla
Leonardo Lorente, Intensive Care Unit, Hospital Universitario de Canarias, La Laguna 38320, Spain
Esther Hernández Marrero, María José Marrero González, Carmen Hernández Marrero, Olga Hernández Marrero, Cándido Manuel Hernández Padilla, Department of Periodontal, Clínica Dental Cándido, La Laguna 38204, Spain
Pedro Abreu-Gonzalez, Department of Basic Medical Sciences, University of La Laguna, La Laguna 38320, Spain
Angel Daniel Lorente Martín, Department of Odontology, CEU San Pablo University, Madrid 28660, Spain
Agustín F González-Rivero, Department of Laboratory, Hospital Universitario de Canarias, La Laguna 38320, Spain
Alejandro Jiménez, Research Unit, Hospital Universitario de Canarias, La Laguna 38320, Spain
Author contributions: Lorente L conceived, designed and coordinated the study, participated in acquisition and interpretation of data, and drafted the manuscript; Hernández Marrero E, Lorente Martín AD, González-Rivero AF, Marrero González MJ, Hernández Marrero C, Hernández Marrero O, Hernández Padilla CM participated in acquisition of data; Abreu-Gonzalez P participated in salivary levels determinations; Jiménez A participated in the interpretation of data. All authors revised the manuscript critically for important intellectual content and made the final approval of the version to be published.
Institutional review board statement: This study was initiated after obtaining approval from the Clinical Research Ethics Committee of the Hospital Universitario de Canarias.
Informed consent statement: Prior to inclusion, all participants provided written informed consent.
Conflict-of-interest statement: There are no conflicts of interest to declare.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement- checklist of items.
Data sharing statement: There are no data declare.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Leonardo Lorente, MD, PhD, Intensive Care Unit, Hospital Universitario de Canarias, Ofra s/n, La Laguna 38320, Spain. lorentemartin@msn.com
Received: February 10, 2025
Revised: March 13, 2025
Accepted: March 20, 2025
Published online: July 26, 2025
Processing time: 76 Days and 15.3 Hours
Abstract
BACKGROUND

Lower salivary uric acid concentrations, the most abundant antioxidant agent in saliva, have been observed in patients with periodontitis compared to individuals with periodontal health. However, the independent association of salivary uric acid levels with periodontitis, accounting for other risk factors, as well as its association with periodontitis severity, has not been investigated.

AIM

To the independent association of salivary uric acid levels with periodontitis and the association of salivary uric acid levels with the severity of periodontitis.

METHODS

This observational and prospective study measured salivary uric acid levels in subjects with periodontitis (characterized by periodontal loss of tissue) and in subjects without periodontitis (periodontal health or localized gingivitis in < 30% of sites). Multivariate regression analysis was performed to determine independent factors associated with periodontitis. Spearman’s rho correlation coefficient was used to assess the relationship between salivary uric acid levels and periodontitis severity. A receiver operating characteristic analysis was carried out to evaluate the diagnostic performance of salivary uric acid levels in periodontitis, reporting the area under curve (AUC) and its 95%CI.

RESULTS

We included 121 subjects, 61 of them with periodontitis and 60 without periodontitis (39 with periodontal health and 21 with local gingivitis). Subjects with periodontitis compared to those without periodontitis were older (P < 0.001), had higher salivary uric acid levels (P = 0.002), higher rate of arterial hypertension history (P = 0.001) and higher rate of never-smoker history (P < 0.001). The AUC for periodontitis diagnosis by salivary uric acid levels was 66% (95%CI: 57%-75%; P < 0.001) and the better cut-off point was 111 nmol/mL. Multiple logistic regression analysis showed an independent association of salivary uric acid levels < 111 nmol/mL (OR = 6.14; 95%CI: 2.015-18.721; P = 0.001) with periodontitis after controlling for age, never-smoker history and arterial hypertension. A negative correlation of salivary uric acid levels and periodontitis severity was observed (rho = -0.32; P < 0.001).

CONCLUSION

The two novel findings of our research were, first, that low salivary uric acid concentrations are independently associated with periodontitis, even after accounting for established risk factors. Second, salivary uric acid levels show a negative correlation with periodontitis severity.

Keywords: Oxidation; Salivary; Uric acid; Periodontitis; Gingivitis

Core Tip: Lower salivary uric acid concentrations, the most abundant antioxidant agent in saliva, have been observed in patients with periodontitis compared to individuals with periodontal health. The two novel findings of our research were, first, that low salivary uric acid concentrations are independently associated with periodontitis, even after accounting for established risk factors. Second, salivary uric acid levels show a negative correlation with periodontitis severity.