Stankeviciene Indre, Puriene Alina, Brukiene Vilma, Mieliauskaite Diana, Bække Synnøve, Tommeras Berit, Al-Mahdi Rania, Rimkevicius Arunas, Stangvaltaite-Mouhat Lina
Institute of Dentistry, Faculty of Medicine, Vilnius University, Vilnius, 01131, Lithuania.
Department of Experimental, Preventive and Clinical Medicine, State Research Institute Center for Innovative Medicine, Vilnius, Lithuania.
BMC Oral Health. 2025 Feb 14;25(1):239. doi: 10.1186/s12903-025-05595-1.
Dry mouth-related conditions adversely affect patients' well-being, as well as their oral and general health. There are indications that the quantitative and qualitative protein composition of saliva is disrupted in patients with xerostomia and Sjögren's syndrome. Salivary α-amylase levels positively correlate with the copy number (CN) of its coding gene, AMY1 (amylase alpha 1). This study aimed to investigate the association between intensity of xerostomia, Sjögren's syndrome, and AMY1 CN. Establishing such an association could position AMY1 CN as a potential genetic biomarker for dry mouth-related conditions, aiding in their early detection.
This cross-sectional study utilized secondary data from the main dry mouth study conducted in five public hospitals in Vilnius, the capital city of Lithuania. Based on sample size calculations for the main study, 127 patients who met the inclusion criterion of dry mouth complaints (sometimes, often, and always) were recruited. The outcomes were xerostomia intensity, assessed using a visual analogue scale (VAS), and confirmed cases of Sjögren's syndrome, assessed using the 2016 ACR/EULAR classification criteria and classified as either primary or secondary. Sociodemographic information included age and sex; self-perceived stress levels were assessed using the Perceived Stress Scale (PSS-10). During clinical examinations, unstimulated whole sialometry was performed for 15 min, and oral mucosa swabs were collected. The swabs were used to quantify AMY1 CN via droplet digital PCR (ddPCR). Data were analyzed using both univariable and multivariable regression models.
In total, 112 patients with available AMY1 CN data and recorded xerostomia intensity VAS scores were included in this study. Of these, 26 (23%) were diagnosed with Sjögren's syndrome; 9 (8%) had primary and 17 (15%) had secondary Sjögren's syndrome. According to multivariable linear regression analyses, higher AMY1 CN was associated with 0.15 lower xerostomia intensity VAS score (β =-0.15, 95% CI -0.30, -0.01). Higher AMY1 CN reduced the odds for primary Sjögren's syndrome (OR 0.52, 95% CI 0.03-0.89).
The present study indicated an inverse association between xerostomia, primary Sjögren's syndrome, and AMY1 CN. Studies validating these findings and exploring the underlying mechanisms are warranted.
口干相关病症会对患者的幸福感以及口腔和全身健康产生不利影响。有迹象表明，口干症和干燥综合征患者唾液的蛋白质定量和定性组成会受到破坏。唾液α-淀粉酶水平与其编码基因AMY1（淀粉酶α1）的拷贝数（CN）呈正相关。本研究旨在调查口干症、干燥综合征的严重程度与AMY1 CN之间的关联。建立这种关联可以将AMY1 CN定位为口干相关病症的潜在遗传生物标志物，有助于早期发现这些病症。
这项横断面研究利用了在立陶宛首都维尔纽斯的五家公立医院进行的主要口干研究的二手数据。根据主要研究的样本量计算，招募了127名符合口干主诉纳入标准（有时、经常和总是）的患者。结局指标为使用视觉模拟量表（VAS）评估的口干严重程度，以及使用2016年美国风湿病学会/欧洲抗风湿病联盟分类标准评估并分类为原发性或继发性的干燥综合征确诊病例。社会人口学信息包括年龄和性别；使用感知压力量表（PSS-10）评估自我感知压力水平。在临床检查期间，进行15分钟的非刺激性全唾液流量测定，并采集口腔黏膜拭子。使用液滴数字PCR（ddPCR）通过拭子对AMY1 CN进行定量。使用单变量和多变量回归模型分析数据。
本研究共纳入了112名有可用AMY1 CN数据且记录了口干严重程度VAS评分的患者。其中，26名（23%）被诊断为干燥综合征；9名（8%）患有原发性干燥综合征，17名（15%）患有继发性干燥综合征。根据多变量线性回归分析，较高的AMY1 CN与口干严重程度VAS评分降低0.15相关（β=-0.15，95%CI -0.30，-0.01）。较高的AMY1 CN降低了原发性干燥综合征的发病几率（OR 0.52，95%CI 0.03 - 0.89）。
本研究表明口干症、原发性干燥综合征与AMY1 CN之间存在负相关。有必要进行验证这些发现并探索潜在机制的研究。
