Clinical Implications and Research Progress of Salivary Biomarkers for Endocrine and Metabolic Disorders.
Salivary biomarkers may provide a non-invasive method for assessing endocrine and metabolic disorders, but standardization and validation are crucial for their clinical use.
Where it sits
this study against the rest of the pasireotide corpusSummary and findings
This review evaluates the clinical translation of salivary biomarkers for endocrine and metabolic disorders. It highlights the potential of various salivary biomarkers, including late-night salivary cortisol for Cushing's syndrome and glycaemic biomarkers for diabetes monitoring. The study emphasizes the need for standardized procedures and multicenter validation.
Abstract
<h4>Aims</h4>Similar to blood, saliva contains a broad range of biomarkers and may offer a non-invasive, repeatable specimen for endocrine and metabolic assessment. This review aims to synthesise and evaluate recent advances in the clinical translation of salivary biomarkers, while providing a critical assessment of the diagnostic reliability and clinical potential of key salivary biomarkers.<h4>Materials and methods</h4>PubMed, Web of Science and ScienceDirect were searched for English-language articles published up to July 2025, with emphasis on studies from 2020 to 2025. We included articles with a focus on the clinical translation of salivary biomarkers for endocrine and metabolic disorders. The relevant studies on the physiology underlying the synthesis and transport of salivary biomarkers were also identified.<h4>Results</h4>Late-night salivary cortisol is the most clinically established marker and is guideline-endorsed for Cushing's syndrome, while salivary cortisone may improve the diagnostic accuracy. Salivary glycaemic biomarkers, such as glucose, 1,5-anhydroglucitol, fructosamine, glycated albumin and α-amylase, show potential for diabetes screening or monitoring. Salivary uric acid, inflammatory factors and adipokines may reflect hyperuricaemia, obesity and metabolic inflammation. However, most biomarkers remain exploratory and their clinical translation is limited by inconsistent collection procedures, oral disease, medication effects and analytical platforms.<h4>Conclusions</h4>Salivary biomarkers offer a promising non-invasive approach for assessment of endocrine and metabolic disorders. Standardised procedures and large-scale multicentre validation are needed to define reliable clinical cutoffs and perform comparisons with blood-based reference standards. Applications for machine learning and wearable sensing technology can further promote clinical translation.
Background
This paper addresses the clinical and biological relevance of salivary biomarkers in endocrine and metabolic disorders. Previous research has established the presence of various biomarkers in saliva, but their clinical utility remains underexplored. This study is significant as it aims to synthesize recent advances and evaluate the diagnostic reliability of these biomarkers.
Methods
The review involved a literature search of PubMed, Web of Science, and ScienceDirect for English-language articles published up to July 2025. Emphasis was placed on studies from 2020 to 2025 that focused on salivary biomarkers for endocrine and metabolic disorders. The review also included studies on the physiology of salivary biomarker synthesis and transport.
Results
The review indicates that late-night salivary cortisol is the most established marker for Cushing's syndrome. It also notes that salivary glycaemic biomarkers have potential for diabetes screening or monitoring. However, it highlights that many biomarkers are still exploratory and face challenges in clinical translation.
Interpretation
The findings suggest that while salivary biomarkers have potential, their clinical significance is limited by various confounding factors. Previous literature supports the use of late-night salivary cortisol, but the clinical relevance of other biomarkers remains uncertain. The review calls for standardized procedures and larger validation studies to enhance the reliability of these biomarkers.
Key findings
- Late-night salivary cortisol is the most clinically established marker and is guideline-endorsed for Cushing's syndrome.
- Salivary glycaemic biomarkers show potential for diabetes screening or monitoring.
- Most biomarkers remain exploratory and their clinical translation is limited by inconsistent collection procedures.
Limitations
- Most biomarkers remain exploratory.
- Clinical translation is limited by inconsistent collection procedures.
- Potential effects from oral disease and medications are not fully addressed.