Publication: Evaluation of TNF-α and Il-6 in saliva among diabetic retinopathy patients
| dc.contributor.author | Ibrahim, Khairul Anwar | |
| dc.date.accessioned | 2026-04-05T00:04:43Z | |
| dc.date.available | 2026-04-05T00:04:43Z | |
| dc.date.issued | 2021 | |
| dc.description.abstract | Introduction: Diabetes retinopathy (DR) is one of the major microvascular complication of diabetes mellitus (DM). It is known as the second most common cause of blindness in Malaysia and the 5th worldwide. The burden cause by DM and blindness due to DR is high. Multifactorial etiology involves in DR pathogenesis include genetic backgrounds and environmental risk factors. Recent evidence had showed that inflammatory process plays a crucial role in the development of DR. Increase in Tumor necrosis factor alpha (TNF-α) and Interleukin 6 (IL-6) were associated with DR. Saliva protein biomarkers are a novel technique for clinical diagnosis. Thus, identification of TNF-α and IL-6 in saliva perhaps provide insight in the role of saliva as a diagnostic alternative in future. Objective: The objective of this study was to compare TNF and IL-6 level in saliva between DM patients and No DM, and also in between the different DR groups. Besides that, it also to determine the relationship between TNF-α and IL-6 level in saliva with level of HbA1c and duration of DM. Methods: A comparative cross-sectional study was conducted exclusively at a tertiary hospital in Malaysia, Hospital Universiti Sains Malaysia (USM) between January 2018 and November 2020. This study involved DM patients with DR, no DR and No DM. Unstimulated saliva samples were collected. Laboratory analysis using commercial Human TNF-α and IL-6 ELISA kit (LEGEND MAX™, BioLegend, Inc.) was performed to measure TNF-α and IL-6 levels in saliva. Statistical analysis was done using SPSS Inc. Version 26. Results: A total of 120 patients were included into the study (DM no DR: 33 patients, DM with NPDR: 30 patients, DM with PDR: 32 patients, No DM: 25 patients). There was significantly higher mean saliva IL-6 in DM group (0.033 SD 0.005 pg/ml) compared to No DM group (0.027 SD 0.001 pg/ml) after adjusted with covariates (p < 0.001). There was no significant difference of mean TNF-α in saliva between DM and No DM after adjusted with covariates. Mean IL-6 in saliva were significantly higher in NPDR (0.036 SD 0.003 pg/ml) and PDR (0.093 SD 0.023 pg/ml) compare to No DR (0.027 SD 0.001 pg/ml) (p < 0.001 and p < 0.001 respectively). Mean TNF-α in saliva were significantly higher in NPDR (0.086 SD 0.022 pg/ml) and PDR (0.093 SD 0.023 pg/ml) compare to No DR (0.049 SD 0.011 pg/ml) (p = 0.015 and p = 0.003) respectively. However, there was no significant difference of mean IL-6 and TNF-α in saliva between NPDR and PDR. The HbA1c level and duration of DM were not associated with TNF-α and IL-6 in saliva. Comorbidities and DR stages were the factors associated with TNF-α in saliva. While only DR stages was the significant factor associated with IL-6 in saliva. Conclusion: This study showed that there is significant association between TNF-α and IL-6 level in saliva among DM patients. DR pathogenesis involved multiple pathway which is mediated by inflammatory mediators. They are found to be in high concentration in the eye and systematically compare to non-DR patients. Further study with larger cohort and longer duration of follow-up needed to confirmed this finding | |
| dc.identifier.uri | https://erepo.usm.my/handle/123456789/23861 | |
| dc.language.iso | en | |
| dc.subject | - | |
| dc.title | Evaluation of TNF-α and Il-6 in saliva among diabetic retinopathy patients | |
| dc.type | Resource Types::text::thesis::master thesis | |
| dspace.entity.type | Publication | |
| oairecerif.author.affiliation | Universiti Sains Malaysia |