Bilancio Giancarlo, Cavallo Pierpaolo, Lombardi Cinzia, Guarino Ermanno, Cozza Vincenzo, Giordano Francesco, Palladino Giuseppe, Cirillo Massimo
Department "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy.
Nephrology Clinic, University Hospital, Salerno, Italy.
J Clin Lab Anal. 2018 Sep;32(7):e22449. doi: 10.1002/jcla.22449. Epub 2018 Mar 30.
Phosphorus and urea are measurable in saliva. Measurements of saliva phosphorus (S-Pho) and saliva urea (S-Urea) could be useful because of low invasivity. Data are limited to saliva tests methodology and to correlations between plasma and saliva compositions. S-Pho and S-Urea were investigated focusing on blind duplicates, differences between collection sites, differences between collection times, freezing-thawing effects, and plasma-saliva correlations.
Tests were performed using fresh saliva collected by synthetic swap early morning after overnight fast (standard). Methodology was investigated in fifteen healthy volunteers. Plasma-saliva correlations were investigated in thirty nephropathic outpatients.
S-Pho and S-Urea in all measurements ranged above detection limits (0.3 mmol/L). In healthy volunteers, S-Pho and S-Urea were similar in duplicates (results for S-Pho and S-Urea: % difference between samples ≤ 4.85%; R between samples ≥ .976, P < .001), in samples from different mouth sites (≤4.24%; R ≥ .887, P < .001), and in samples of different days (≤5.61%; R ≥ .606, P < .01) but, compared to standard, were substantially lower in after-breakfast samples (-28.0% and -21.3%; R ≥ .786, P < .001) and slightly lower in frozen-thawed samples (-12.4% and -5.92%; R ≥ .742, P < .001). In nephropathic patients, S-Pho was higher than but correlated with plasma phosphorus (saliva/plasma ratio 4.80; R = .686, P < .001), whereas S-Urea and plasma urea were similar and correlated with each other (saliva/plasma ratio 0.96; R = .944, P < .001). Post-dialysis changes in S-Pho and S-Urea paralleled post-dialysis changes in plasma phosphorus and urea.
S-Pho and S-Urea reflect plasma phosphorus and plasma urea. Early morning fasting fresh samples are advisable because collection time and freezing-thawing affect saliva tests.
唾液中可检测到磷和尿素。由于侵入性低，唾液磷（S-Pho）和唾液尿素（S-Urea）的检测可能有用。现有数据仅限于唾液检测方法以及血浆与唾液成分之间的相关性。对S-Pho和S-Urea进行了研究，重点关注盲法重复检测、采集部位差异、采集时间差异、冻融效应以及血浆-唾液相关性。
使用过夜禁食后清晨通过合成拭子采集的新鲜唾液进行检测（标准方法）。在15名健康志愿者中研究了检测方法。在30名肾病门诊患者中研究了血浆-唾液相关性。
所有测量中的S-Pho和S-Urea均高于检测限（0.3 mmol/L）。在健康志愿者中，S-Pho和S-Urea在重复检测中相似（S-Pho和S-Urea的结果：样本间百分比差异≤4.85%；样本间R≥0.976，P<0.001），在不同口腔部位的样本中相似（≤4.24%；R≥0.887，P<0.001），在不同日期的样本中相似（≤5.61%；R≥0.606，P<0.01），但与标准样本相比，早餐后样本中的含量显著降低（-28.0%和-21.3%；R≥0.786，P<0.001），冻融样本中的含量略有降低（-12.4%和-5.92%；R≥0.742，P<0.001）。在肾病患者中，S-Pho高于血浆磷但与之相关（唾液/血浆比值为4.80；R = 0.686，P<0.001），而S-Urea与血浆尿素相似且相互相关（唾液/血浆比值为0.96；R = 0.944，P<0.001）。透析后S-Pho和S-Urea的变化与血浆磷和尿素的透析后变化平行。
S-Pho和S-Urea反映血浆磷和血浆尿素。建议采集清晨空腹新鲜样本，因为采集时间和冻融会影响唾液检测。
