Advances in Environmental Biology, 10(10) October 2016, Pages: 79-96

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Investigation of Some Biochemical Changes

hanges inSera and
beseIndividuals: ACaseControl
ontrol Study
Saliva of Adult Obese
1Abdulkadir
1Emad

Mohammed Noori Jassim,

Jassim 1Mustafa Taha Mohammed, 2FarisAbdulkareem
Abdulkareem Khazaal,
Mahmoud Eltayef Almayaa,
Almayaa 3Safanah Ahmed Farhan

Department of Chemistry, College of Science, Al-Mustansiriyah

Al
University, Baghdad, Iraq.
Al-kindy Obesity Research and Therapy Center,
enter, Al-kindy College of Medicine, University of Baghdad, Baghdad, Iraq.
3
Polymer Research Center,
enter, College of Science, Al-Mustansiriyah
Al
University, Baghdad, Iraq.
2

Address For Correspondence:

Abdulkadir Mohammed Noori Jassim,Department of Chemistry, College of Science, Al-Mustansiriyah
Al Mustansiriyah University, Iraq
E-mail: kadirchem@yahoo.com, kadirchem@uomustansiriyah.edu.iq,Web site: www.uomustansiriyah.edu.iq
This work is licensed under the Creative Commons Attribution International License (CC BY).
http://creativecommons.org/licenses/by/4.0/

Received 28 August 2016; Accepted 18 October 2016; Available online 22 October 2016

ABSTRACT
Obesity is a rapidly growing epidemic worldwide which influenced by genetic, environmental factors. The beginning of obesity is due
mainly to low energy expenditure (such as that from exercise) put together with high caloric intake. In our case-control
case
study, serum and
saliva of 22 obese and 22 healthy donorswho matched with the case group in respect of age and gender were gathered and analyzed,
analyz
to
evaluate the relationship between the physicochemical properties changes in serum and saliva of obese individuals and the control group
such as Body Mass Index (BMI), saliva pH,
H, Salivary Flow Rate (SFR), total protein, Albumin, Globulin, lipid profile, Inorganic
Phosphorous, Iron, Magnesium, Calcium and Copper. Serum and saliva samples obtained from AL-kindy
kindy Hospital (in Baghdad) and
compared with control group. The data was analyzed using independent t-test
t
by SPSS program. Our results demonstrated that serum levels
of total protein were non-significantly
significantly decreased, while in saliva of obese were non-significantly
non significantly increased (except in female increased
significantly)) as compared with control subjects. In albumin and globulin, non-significantly
significantly decreased in serum, while they were nonnon
significantly increased in saliva (except in globulin of female, increased significantly). In lipid profile, the level had shown increased values
in serum (except in HDL-C, decreased)) and in saliva the values were decreased. The serum inorganic phosphorous non-significantly
increased (except in male decreased),
), while it was highly significant increased in saliva. The serum level of iron significantly decreased
(except in male, non-significantly decreased), while it was non-significant decreased in saliva (except in total,
al, significantly decreased). In
magnesium, no change was seen in serum as compared to saliva which showed significantly increased in total and non-significantly
non
increased in male and female. The calcium level was highly significantly increased in both serum and saliva, but the level of copper showed
non-significantly
significantly increased (except in female increased significantly), while that in saliva showed highly significantly decreased.
decrease The
correlation between different parameters in serum and saliva has been studied. In Conclusion, Our results revealed that the TC, LDL-C, Fe,
Ca levels in serum may be an early biomarker root of the obesity. Furthermore, the results revealed that the human
hum salivary TG, VLDL,
inorganic P, Ca, Cu levels may be an early biomarker of the obesity. The diagnostic importance lies in fact that the salivary level of these
metals could provide a noninvasive predictive marker in the development of obesity.

KEYWORDS: Saliva,Lipid profile,Obesity

,Obesity, trace elements.
INTRODUCTION
Medically defined, obesity
sity is a physiological dysfunction in humans with environmental, genetic and
endocrinological causes [1]. It's widely prevalent and over 1.5 billion adults worldwide are classified as either
overweight or obese, with rates keep continuing to increase [2]. Imbalance between taking more food and
consuming calorie leads to overweight and obesity[3].
obesity
In obese people the metabolic disturbances are
decompensate. Overweight is a preclinical condition, obesity is the clinically manifested metabolic disorder,
including mineral imbalances [4]. Obesity classification depends on the body mass index (BMI), that equal to
weight (kg) divided
vided by the square of height (m)
( [5]. Although, significant of underlying molecularmechanisms

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Advances in Environmental Biology, 10(10) October 2016, Pages: 79-96

of adipose tissue remodeling and eventual development of obesity, potentialfactors that might serve as a
biomarker to monitor evolvement of obesity is not yet clearlyidentified. Earlier studies have found that the
composition of salivary bacteria changes inoverweight women [6].Women seem to be more at risk for toxic
metal exposure than that for men and at the same time more vulnerable to micronutrient deficiency[7].Saliva
contains mainly (98%) water, electrolytes, antibacterial constituents, mucus and various enzymes. It is well
known that the composition of saliva depends on a number of factors related to physiological, environmental,
pathological factors, and the humoral agents [8]. It is well known that saliva could offer an excellent alternative
to serum as a biological test analyzed for diagnostic purposes. This would be of great importance in biomedical
test, because it is offering a cost-effective approach for screening of grate populations, easy to collect, and
represent an alternative for patients whose blood is difficult to obtain or when compliance is a problem which
can be repeated frequently [8, 9].
Human saliva reflects the bodys health and approximately 20-30% of proteins found in human blood are
also present in saliva, highlighting the diagnostic prospect of the saliva [10]. The oral cavity, proteins, especially
albumin, areconsidered as a serum ultra-filtrate to our mouth. Proteinsin saliva have been shown to be
increasedin medically compromised patients whosegeneral conditions get worse[11].The group of analysis
which includes: Total Cholesterol (TC), Triglycerides (TG), Highdensity lipoprotein-Cholesterol (HDL-C),
Lowdensity lipoprotein-Cholesterol (LDL-C) and Very low-density lipoprotein-Cholesterol (VLDL-C) are done
in serum. Similar biochemical tests can be done with other biological fluids mainly saliva because lipids are
secreted in saliva. Therefore, saliva can be used for the estimate of lipid profile[12].
The clinical importance and evaluation of trace elements remain controversial and many questions still
remain unanswered. The essential trace elementsare of great value in regulation of normal metabolism in our
body, as they interact with many enzymes and hormones [13].The aim of this study was to analyze BMI,
salivary pH, unstimulated SFR, in a group of healthy subjects, as well as their relationshipwith age and gender,
together with obesity. Furthermore, the aim was to assess the relationship between the concentrations of proteins
(total protein, Albumin, Globulin), lipidprofile and trace elements concentrations (P, Fe, Mg, Ca and Cu), in
both serum and saliva of obese as compared with control subjects. Of even greater interest, and the topic of
future research, is the possibility of using saliva samples as a diagnostic and prognostic marker of systemic
diseases, including obesity.
MATERIALS AND METHODS
1.Subjects:
The subjects were selected in this study from the reviewer attending to Al-kindy obesity research and
therapy centerin Al-kindy Hospital in Baghdad city. The obese diagnosed as having acute or chronic diseases of
the oral mucosa or salivary glands,diabetes mellitus, hepatitis, respiratory or hepatic failurewere excluded. The
samples were collected during 11-2014 till 1-2015.A total of 22obese were compared to control subjects of 22
healthy individuals who matched for age and gender (Table 1).
Table1: The all information of obese and controlindividuals.
No.
Total (Serum & Saliva)
Groups
Samples
Control

22

44

Obese

22

44

Gender

No.

Age Range (year)

Male
Female
Male
Female

11
11
11
11

18-38
19-38
19-39
18-39

2. Samples Collection:
Blood samples (5) ml were collected from the obese and healthy donors. Blood samples were centrifuged at
(1500g) for10 min. after blood coagulation, serum thus sectioned into three eppendorf tubes and frozen at -20
C until used. Saliva secretion was performed without any stimulusin the morning (9-11h). All subjects refrained
from drinking, eating andsmoking for a minimum of 2 h before saliva collection. Before sampling, each subject
was rinsed their mouths several times and gargle with plain water, waiting fora minimum of2 min before saliva
collection(for water clearance). Unstimulated saliva was collected in sterilized clear graduated test tube. Saliva
was collected for 5 min. under resting condition. Salivary flow rate was calculated as volume collected (ml)
divided by the time required (min) for the collectionand was then measure to determine salivary pH by using a
pH meter.To diminish the error probability, each sample was analyzed three times,and the mean value was
assumed to be the real one. Then centrifuged at (1500 g) for 10 min., the supernatant was kept frozen at -20C
until the time of assay. The samples (serum and saliva) were not thawed and refrozen before using [14].

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Advances in Environmental Biology, 10(10) October 2016, Pages: 79-96

3. Estimation of BMI:
Body Mass Index (BMI) is equal to a person's weight divided by height square. It is Estimationas:
BMI = (Weight in kilograms / Height in meters2)
Then participants were categorized.Equal or less than 18.5 (Kg/m2) indicate to underweight, between 18.524.9 indicated to normal weight, 25-29.9 is overweight, while Equal or more than 30 is obese[15].
4. Ethics:
Informed parental consent was obtained to be eligible to enrollment for the study, which was done
accordingto the rules of the Local Ethics Committee of Chemistry Department, College of Science, AlMustansiriyah University, Iraq.
5. Statistical analysis:
The results were expressed as mean standard deviation (SD) values. Students t- test was used to compare
the mean values between the groups. Statistical analysis was performed with SPSS version 22.0 software. The
Pearson's Correlation test was used to perform the correlations between studied markers. Differences were
considered significant at a probability level of p0.05.
6. Biochemical Test:
Serum and salivary protein kit estimation were done based on the Biuret method (BioSystems, Spain).
Protein formsa colored complex with cupric ions in alkaline medium. Basedon this principle, serum or salivary
protein estimation were done bymixing undiluted samples with the reagentand measuring the color ofproduct
using a colorimeter at 546 nm [11]. Serum and salivary albumin were estimated using the Bromocresol
greenmethod (albumin colorimetric test) by using (Linear Chemicals, Spain). The reaction betweenalbumin in
serum or saliva(the volume of saliva used in test sample was doubled than in serum, then the results divided by
two)and the dye Bromocresol green produces change in color, which is proportional to thealbumin levels in the
samples. They were estimated using acolorimeter at 630 nm [11]. The estimation of serum and salivary globulin
weredone by the subtractingalbuminconcentration from the total proteins.
Enzymatic methods were used to measure the concentration of some components of lipid profile in serum
and saliva[16]. In TC the Oxidase/Peroxidase method was used;inTG the GPO-Peroxidase method was used and
HDL-C the Phosphotungstate/Mg-Cholesterol method was used. All kits were supplied by (BioSystems, Spain).
Level of LDL-C was calculated indirectly by the method of Friedwald and Levy method [17], while VLDL-C
estimated as TG divided by 2.2.
The trace elementlevelsfor serum and saliva were measured by commercially available kitsbased on
colorimetricroutine methods.For inorganic phosphorus the phosphomolybdate method was used, in iron the
Cetyltrimethylammonium-bromide with lipid clearing factor method was used, for magnesium the photometric
test with lipid clearing factor method was used. All these kits were supplied by (Human, Germany). The
methylthymol blue method was used in calcium which supplied by (BioSystems, Spain). Furthermore, DibromPAESA method was used to measured copper which supplied by(spectrum, Egypt).The volume of saliva used in
test sample (in some tests) was doubled than in serum, and then divided the results by this value.
RESULTS AND DISCUSSION
Diagnosis Tests Can be defined as the assessment of risk factors related to the diseases.The clinical
characteristics and biochemical parameters of the study subjects are presented in Table 2. The age, age range
and gender were illustrated for obese and control in Table 2. The mean age of obese was not statically
significant (p=0.071) as compared with control (Figure 1). The obesity and control groups showed highly
significant differences in terms of BMI (p=0.000) (Table 2, Figure 1).
Table 2: Serum and salivary parameters characteristics of obese and control subjects.
Obese subject
Control subject
(MeanSD)
(MeanSD)
Total No.
22 serum (11M, 11F)
22 serum (11M, 11F)
22 saliva (11M, 11F)
22 saliva (11M, 11F)
Age (year)
28.4548.500 (Range 18-39)
24.5005.289 (Range 18-38)
T 38.6306.391
T 23.2112.850
M 37.0216.083
M 22.5183.048
BMI (Kg/m2)
F 40.2426.564
F 23.9052.599
T 7.0210.205
T 7.2050.408
pH
Saliva
M 7.0670.207
M 7.4110.459
F 6.9750.202
F 6.999 0.213
SFR
T 0.5290.261
T 0.4960.291
(ml/min)
Saliva
M 0.4540.219
M 0.5350.344
F 0.6050.287
F 0.4580.239

p-Value
0.071
0.000**
0.000**
0.000**
0.065
0.034*
0.785
0.697
0.517
0.209

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Advances in Environmental Biology, 10(10) October 2016, Pages: 79-96

Serum
Total Protein
(g/L)
Saliva

Serum
Albumin
(g/L)
Saliva

Serum
Globulin
(g/L)
Saliva

Serum
Triglyceride
(mmol/L)
Saliva

Serum
Cholesterol
(mmol/L)
Saliva

Serum
HDL-C
(mmol/L)
Saliva

Serum
LDL-C
(mmol/L)
Saliva

Serum
VLDL-C
(mmol/L)
Saliva

Inorganic
Phosphorous
(mmol/L)

Serum

Saliva

Serum
Iron
(mmol/L)
Saliva

Serum
Magnesium
(mmol/L)
Saliva

Serum
Calcium
(mmol/L)
Saliva

T 74.85418.388
M 79.23220.335
F 69.97515.625
T 9.1001.773
M 9.1271.977
F 9.1731.636
T 36.67916.033
M 37.48418.787
F 35.87513.619
T 3.7920.217
M 3.7290.174
F 3.8550.245
T 38.16819.546
M 42.22923.943
F 34.10713.885
T 5.3431.772
M 5.3692.003
F 5.3171.607
T 2.2171.566
M 2.3491.495
F 2.0841.696
T 0.0740.030
M 0.0730.027
F 0.0740.034
T 5.9871.804
M 6.1871.852
F 5.7871.821
T 0.2120.083
M 0.1960.076
F 0.2280.090
T 0.9850.349
M 0.9190.306
F 1.0500.391
T 0.0980.022
M 0.0980.026
F 0.0970.019
T 3.6011.628
M 3.7341.798
F 3.4681.517
T 0.0890.078
M 0.0870.084
F 0.0920.076
T 1.0080.712
M 1.0670.679
F 0.9480.770
T 0.0400.029
M 0.0420.037
F 0.0380.021
T 1.5930.599
M 1.6750.390
F 1.5090.766
T 5.2280.208
M 5.1770.284
F 5.2790.063
T 0.0170.011
M 0.0210.010
F 0.0140.010
T 0.00540.0002
M 0.00550.0001
F 0.00550.0002
T 0.6450.197
M 0.6640.222
F 0.6260.176
T 1.0510.305
M 1.1300.297
F 0.9720.307
T 3.3180.469
M 3.3990.162
F 3.2370.649
T 3.3080.702
M 3.4780.435
F 3.1370.884
T 0.0110.005

T 79.56214.329
M 79.74218.675
F 79.8829.065
T 8.4691.687
M 9.1062.138
F 7.8320.719
T 37.70411.354
M 35.05411.444
F 40.35511.148
T 3.4920.695
M 3.3480.952
F 3.6450.249
T 44.83921.792
M 55.40524.603
F 34.27412.099
T 4.5341.887
M 5.0632.571
F 4.0050.505
T 1.3540.867
M 1.7091.075
F 0.9980.378
T 0.1430.100
M 0.1120.091
F 0.1750.103
T 4.2781.059
M 4.0170.995
F 4.5391.103
T 0.2970.136
M 0.2650.121
F 0.3280.148
T 1.3740.571
M 1.3850.696
F 1.3630.447
T 0.1160.033
M 0.1090.028
F 0.1230.037
T 2.6791.125
M 2.3221.113
F 3.0351.067
T 0.1290.096
M 0.1180.075
F 0.1390.116
T 0.6160.394
M 0.7780.488
F 0.4550.172
T 0.0730.052
M 0.0670.059
F 0.0790.047
T 1.5290.549
M 1.7270.598
F 1.3300.433
T 4.6440.306
M 4.6550.272
F 4.6330.351
T 0.0250.011
M 0.0260.012
F 0.0230.010
T 0.00570.0004
M 0.00560.0003
F 0.00580.0004
T 0.6420.126
M 0.6110.094
F 0.6720.151
T 0.7820.406
M 0.8810.409
F 0.6820.395
T 1.9790.510
M 2.1260.406
F 1.8330.579
T 0.7580.136
M 0.7740.165
F 0.7420.105
T 0.0080.011

0.349
0.954
0.084
0.233
0.929
0.022*
0.808
0.718
0.409
0.064
0.206
0.060
0.291
0.218
0.976
0.150
0.758
0.018*
0.029*
0.262
0.051
0.003*
0.199
0.006*
0.000**
0.003*
0.046*
0.017*
0.125
0.070
0.009*
0.056
0.096
0.035*
0.363
0.051
0.034*
0.038*
0.447
0.143
0.369
0.268
0.029*
0.265
0.051
0.014*
0.260
0.014*
0.714
0.812
0.507
0.000**
0.000**
0.000**
0.034*
0.315
0.043*
0.021*
0.240
0.051
0.952
0.477
0.512
0.017*
0.118
0.069
0.000**
0.000**
0.000**
0.000**
0.000**
0.000**
0.302

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Advances in Environmental Biology, 10(10) October 2016, Pages: 79-96

Copper
(mmol/L)

Serum

M 0.0120.006
F 0.0100.005
T 0.000470.00027
Saliva
M 0.000430.00025
F 0.000520.00029
**Highly Significant p0.0001, *Significant p0.05, T: Total, M: Male, F: Female

M 0.0110.015
F 0.0040.003
T 0.003450.00267
M 0.002530.00225
F 0.004370.00284

0.879
0.001*
0.000**
0.006*
0.000**

The present study showed that no differences were found in salivary pH of both total and female (p=0.065,
0.785), respectively, but it was decreasedsignificantly (p=0.034) in obese as compared to control subjects (Table
2, Figure 1). Different findings which have been published by Pannunzio et al., [18] who shows that the pH
values were increased in obese than in control group. In literature results are conflicting with respect to pH of
saliva. Different factors such as collection methods and determination, geographic location, diet and ages, can
influence results [18]. Normal pH of saliva is from 6 to 7, and varies in accordance with the salivary flow from
5.3 to 7.8. There are different sources of hydrogen ions in oral fluids: secretion by the salivary glands in the
form of inorganic and organic acids, production by the oral macrobiotic or acquisition through foods [11].
Our results indicated that the unstimulated SFR for the obese was slightly increased in both total and
female(p=0.697, 0.209), while it slightly decreased as compared to healthy control (p=0.517). Our results
demonstrated that saliva levels of SFR were non-significantly increased in total and female, while it decreased
in male of obese as compared with control subjects. The work of Poweret al.[19] did not show any variation in
salivation patterns between obese and non-obese subjects, while other authors found that in young obese people
salivary secretion was higher than in the control subjects [20]. In addition, previous literature [21] shows that the
healthy female have a lower SFR than male which concordant with our study. Previous study shows that the
concentration of various components of saliva was markedly affected by variations in flow rate [22]. For
instance, as the flow rate of the parotid gland increases above the unstimulated rate, pH increases but phosphate,
calcium, potassium and protein decrease in adults. At higher flow rates, pH, phosphate and protein decrease, and
potassium remains the same in adults[22].Furthermore, a study [23] showed that the SFR significantly increased
in obese, more than that of non-obese group, which explained that the salivary glands in obese subjects are more
larger in size and may continuously stimulated by long term chewing process could lead to an elevated flow
rate.
Our results demonstrated that the serum levels of total proteins were non-significantly decreased in total,
male, female (p=0.349, 0.954, 0.084), respectively, while in saliva of obese were non-significantly increased in
total, male (p=0.233, 0.929), respectively, except in female which was found to be higher significantly
(p=0.022) as compared with control subjects.Our finding agree with Pannunzio, et al. [18] which indicated that
the protein content in saliva for obese children showed ahigher value than the control and overweight children
(p= 0.003). Also, the results in agreement with Al-Juboury , et al. [23] which showed a significant high value of
total protein in saliva e of obese than normal weightsubjects. The high protein level in the saliva contributes to
major adherence of S. mutans, the first inhabitant of dental plaque[18].
Disagreement to our finding has been published by Riaz , et al.[24] which showed that the total protein was
higher in obese diabetes than healthy control group (p 0.05).
On the other hand, albumin and globulin were non-significantly decreased in serum,In contrast to the above,
they were non-significantly increased in saliva except in globulin of female, which increased significantly
(p=0.01) (Table 2, Figure 1).Generally, the major factors affecting the level of proteinand composition of whole
saliva are the SFR,protein contributions of the glandular saliva and proteins of crevicular fluid. So, the elevated
levels of protein are most likely due to increase synthesis and secretion by the individualglandular saliva.In
addition, the rise in salivary albumin also plays a role in the rise of totalproteins [11].
In lipid profile, significant higher TG in total (p=0.029) was observed,while it was non-significant
increasedin male, female (p=0.262, 0.051) for serum,compared to non obese group. On the contrary, obese
group had significant lowersaliva triglyceride in total, female (p=0.003, 0.006), respectively, while it was nonsignificant decreased in male (p=0.199) (Table 2, Figure 1).
Our results demonstrated that the serum levels of TC were significantly increased in total, male, female
(p=0.000, 0.003, 0.046), respectively, while in saliva of obese were significantly decreased in total, (p=0.017,),
and non-significantly decreased in both male and female (p=0.125, 0.070), respectively, compared to control
group(Table 2, Figure 1).
The results agree withKhan and Khaleel [25], which show the significant higher TG, TC were observed for
serum obese male as compared to non obese group. Also, Murtadha and Sarhat[26] exhibited significant
(p>0.0001) elevation of TG, TC in over weight and obese female groups compared with normal weight group.
Furthermore, Zakyet al. [27] showed increased serum value with significant difference between obese male and
female as compared to non obese group in TG, while they were increased non-significantly in TC.In both serum
and saliva, significant decreased HDL-C level in total (p=0.009, 0.035), respectively, were observed, while they
were non-significant decreased in male, female of serum (p=0.056, 0.096), and saliva(p=0.363, 0.051),
respectively, compared to control group.Khan and Khaleel [25], Murtadha and Sarhat[26],Zaky et al. [27],noted

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that the HDL-C were significantlylower in serum of obese group compared with the control group, in agreement
with our results.
Our work demonstrated that the serum levels of LDL-C were significantly increased in total, male
(p=0.034, 0.038), respectively and non-significantly increased in female (p=0. 447), while in saliva of obese
were non-significantly decreased in total, male and female (p=0.143, 0.369, 0.268), respectively, compared to
control group. In agreement to our results,Murtadha and Sarhat[26], Zaky et al. [27], showed that the LDL-C
were significantly higher in serum of obese group compared with the control group,
Also,the serum levels of VLDL-C were significantly increased in total (p=0.029) and non-significantly
increased in male and female (p=0. 265,0.051),respectively, while in saliva of obese were significantly
decreased in totaland female (p=0.014, 0.014), respectively, and non-significantly decreased male (p=0.260).
Murtadha and Sarhat[26], indicated that the VLDL-C were significantly higher in serum of obese group
compared with the control, in agreement with our results.
It is well-known that the elevated in triglyceride stores is associated with a linear elevated in the production
of cholesterol which in turn is associated with elevated secretion of cholesterol in bile and elevated risk of the
development of gall bladder diseases and gallstone formation [28].Increased TG levels in obese impaired
lipolysis, which reduced the HDL-C levels. Cardiovascular risk factor reports in obese individuals have recently
indicated a remarkable number of metabolic abnormalities that embrace differences in lipids, blood pressure,
insulin, glycemia, and hematologic function [25].
In our body, lipids are important for physiological and pathological processes. In human health and disease
condition, a diagnosis test of lipid profile is very important. Some of the studies reported the important
information about salivary organic products (lipids, carbohydrates and proteins), but least information is
described about lipid components. Among numerous studies on saliva, some of the works related to the salivary
lipid profile fraction and the information are often incomplete[10]. Malgorzata et al. [29],reviewedabout the
diagnostic use of lipid profile, its correlation with systemic diseases, and information about the levels and types
of lipids in pathological and physiological condition of saliva. It is reported that lipids present in the saliva are
important elements. Increased lipid in serum increases the level of salivary lipid. In the course of systemic
disease, saliva undergoes to change in their component. In the diagnosis of certain diseases, changes in the
salivary lipid profile helps to detect the fluctuations in our body non-invasively [29]. The whole saliva contains
2-3 g/ml of total lipid which consisted of TC, TG and fatty acids. Some investigatorbelieved that the lipids in
saliva are diffused directly from blood (serum) and they are glandular in origin. The role and diffusion of
salivary lipids in oral health have probably not studied [10]. Karjalainenet al. [30]estimated the salivary
cholesterol in healthy control adults and they showed that serum level is reflected by salivary levels to some
extent. Lipids present in saliva do not float (stay on the surface) like blood plasma lipoproteins. Therefore, their
aggregation state is different from lipids in blood or lymph. The free fatty acids and partial glycerides level was
high in saliva [31].
Chemical composition of trace elements of serum and saliva in the obese and control groups are presented
in (Table 2, Figure 1). Minerals and Trace elements influence the pathogenesis of obesity and their
complications, mainly through their involvement in inflammation and peroxidation. The metabolic disturbances
in obese people are decompensated. Even though, overweight is a preclinical condition, obesity is the clinically
manifested metabolic disorder, including mineral imbalances [4]. The present study showed that the serum
inorganic phosphorous non-significantly increased in total and female (p=0.714, 0.507), respectively, while it
was decreased in male (p=0.812). On the other hand, they were highly significant increased (p0.000) in
saliva.Adverse effects of phosphate metabolism have not been studied in details in obesity persons, especially
because of such an association was thought to be uncommon. Nevertheless, in some animal models of obesity,
serum phosphate levels were noted to be higher than the non-obese subjects. Hartmanet al. [6] showed that there
was a significant increased of salivary phosphate content in obese compared to normal weight, while plasma
phosphate was not found to be elevated in obese, in agreement to our results. Data in recent years showed that
metabolism of phosphate may be associated with the rotation of lipid in adipocytes[32]. A significant increase
has been observed in phosphate content of saliva in obese children as compared with normal weight children.
Interestingly, no significant difference of phosphate level was seen in the plasma between the two groups of
children, which confirm the results of our study. The reason for the elevated of salivary phosphate level is not
fully understood. It is well-known that the type II sodium-phosphate cotransporters (Na/Pi-2b) and type III
sodium phosphate cotransporters, PiT1 and PiT2, which are involved in phosphate resorption happen in the
kidney, which are also present in the salivary glands. This may be connected with independent phosphate
metabolism in salivary glands with local regulation [6].Different findings to our finding have been published by
Pannunzio E,et al.[18], who indicated that the phosphorous values in saliva were lower in overweight and obese
than in control groups.Our study suggests that the inorganic phosphorous level in saliva may be an early
biomarker ofthe root of the obesity. The diagnostic importance lies in the fact that the inorganic phosphorousin
saliva could provide a noninvasive predictive marker in the development of the obesity.More studies will be
required to understand the mechanism of salivary inorganic phosphorousaccumulation level in obesity.

85

Abdulkadir Mohammed Noori Jassim et al, 2016

Advances in Environmental Biology, 10(10) October 2016, Pages: 79-96

The serum level of Fedecreased significantly in total and female (p=0.714, 0.507), respectively,while it was
non-significantly decreasedin male (p=0.315). In saliva, Fe was non-significantly decreased in male and female
(p=0.240, 0.051), respectively, while in total, it was significantly decreased (p=0.021) (Table 2, Figure 1). In
agreement to our data, Yerlikayaet al. [4]reported that the level of Fe was significantly lower in the non diabetic
obese women than those of the healthy group.In our study, significantly decreased serum Fe levels in obese
women than those of the healthy group were in agreement with the findings of other investigation[33].Dambal et
al.[34] reported that the mean serum iron levels in obese individuals were significantly decreased in overweight
and obese individuals than those in the control group (p<0.0001), which confirm the results of our study.
Also,Azab et al.[35] who indicated that, Compared to the control group, serum Fe level was significantly lower
(p<0.01) in the obese children.
The trace elements and minerals affect the pathogenesis of obesity andtheir complications, mainly due their
involvementin inflammation and peroxidation. Women seemed to be at higher risk for toxic metal exposurethan
men and also more vulnerable tomicronutrient deficiency. The clinical importance and evaluation of trace
elements in different diseasesincluding remain controversial and many questionsstill unanswered [4].However,
the pathophysiological mechanisms leading to hypoferremia among obese individuals are, unknown. Proposed
mechanisms are:
(i)A n iron-poor food intake; (ii) An impairment of intestinal iron uptake and iron release from
storesbecause of an overexpression of hepcidin (Theliver derived peptide hormone hepcidin is the primary
regulator of iron hemostasis; whichis both an inhibitor of intestinal iron absorption as well as macrophage iron
release)and (iii) Inadequate iron bioavailability because of inflammation(18, 34).
Our study confirms that the Mg hadslightly changein serum of total, male and female (p=0.952, 0.477,
512), respectivelyas compared to saliva which showed significantly increased in total (p=0.017) and nonsignificantly increased in male and female(p=0.118, 0.069), respectively(Table 2, Figure 1). Celik et al. [36]
reported that the mean Serum levels of Mg were significantly lower in the obese group than controls (p =
0.014), which disagreement to our data. Also, serum Mg levels were found to be significantly lower in obese
children (p<0.01) than in the healthy children[37]. Our data confirm that the level of Mg in saliva higher than
that in serum as shown by previous study [38] that saliva is a hypotonic fluid compared to serum, some
components are found in lower level like (Mg, Na, Cl), or higher level like (K, Ca, HCO3, PO4) or similar (uric
acid, urea).The exact mechanism of hypomagnesaemia in obese persons is unclear but may beregarding to
eating habits; as increased intake of carbonated soft drinks, which are rich in phosphorousand thereby interfere
with absorption of magnesium, or excess intake of caffeine resultingin elevated magnesium excretion. Another
mechanism may be excess intake ofdairy products with high content of Ca and or fat thus interfere with its
absorption [39].
In the current study results revealed that calcium the Ca level was highly significantly increased in both
serum and saliva (p0.000) (Table 2, Figure 1). Same findings which have been published by Pannunzioet
al.[18] who indicated that the Ca values were higher in overweight and obese than in control groups.Also, Yas
et al.[40] calcium level was significantly elevated among obese compared with non-obese. However, the
salivary Ca binds to protein, citrate, phosphate and lactate and only half is found in free form. The degree of
bonded Ca depends on the salivary pH [18]. The buffers in saliva maintain the oral pH at about 7.00 to prevent
Ca loss from the teeth because at this pH, the saliva is saturated with Ca[41]. Elevated Ca concentration among
obese in our study probably related to the fact that obese individuals experience metabolic and hormonal
disturbances like increase the parathyroid hormone release, which maybe leads to increased releasing of Ca
from bone and reduction in losing ofCa from kidneys, so that the blood Ca level rises, so as salivary Ca level
since saliva is considered as a mirror of serum contents [40].
As shown in the present study, the level of Cu non-significantly increased in total and male (p=0.302,
0.879), respectively, while in female increased significantly (p=00.1). Furthermore,the saliva showed highly
significantly decreased (p0.000) (Table 2, Figure 1).Our results were similar to Yerlikayaet al.[4] who showed
that the level of Cu was significantly higher in the non diabetic obese women than those of the healthy group.
Also,previous study on obese subjects indicated that serum Cu level was significantly higher in obese group
than control (p< 0.001)[42],higher serum Cu level was also shown by other investigator [43]. Our results agree
withDambal et al. [34]who showed that serum copper levels were significantly increased in obese individuals
when compared to controls (p<0.0003).Furthermore,Azabet al. [35] compared to the control group, serum Cu
level was significantly higher (p<0.01) in the obese children, in agreement with our results. The Cu is a
component of effective antioxidant enzymes that act as protect agent against the action of free radicals in our
body. Also, an imbalance in themetabolism of Cu might trigger hypercholesterolemiaand disturbance in
oxidative stress[35]. So, our results suggest that excess weight associated with lipid metabolismdisorders might
predispose to changes in Cu levels in serum and saliva, indicating a possible mechanismof this trace element,
contributing to peroxidation or acting asan antioxidant. Also, other mechanism for Cu elevation in obese
patients was it thought to be due to pro-inflammatory cytokines released from adipose tissue as IL-1 enhance
intra-cellular Zn accumulation with intra-cellular Cu efflux, and when releasedto blood it binds to

86

Abdulkadir Mohammed Noori Jassim et al, 2016

Advances in Environmental Biology, 10(10) October 2016, Pages: 79-96

Ceruloplasmin. High serum Cu and low serum Zn were associated with increased cardiovascular mortality [44].
The imbalance in Cu level often results in a reduced desire for protein (especially animal protein). Also, high
tissue Cu aggravatesobesity. It is always associated
ass
with high serum leptin [13]. On the other hand, Clouetet al.
[45] clarify that, similarto iron, Cumay
may also have an indirect impact on ATP production and fatty acid oxidation
in mitochondria, which helping the bodys
body s metabolism to break down fattyacids and reduce fat.
7.6
Total
Male
Female

40
30
20

7.2
7

10

6.8

6.6

groups

groups

80
Total
Male
Female

0.6
0.4
0.2
0

Total Protein (g/L)

SFR (ml/min)

0.8

Total
Male
Female

60
40
20
0

groups

groups

50

60
Total
Male
Female

40
30
20
10
0

Globulin (g/L)

Albumin (g/L)

Total
Male
Female

7.4

pH

BMI (Kg/m)

50

Total
Male
Female

40
20
0

groups

groups

87

Abdulkadir Mohammed Noori Jassim et al, 2016

2.5
2

Total
Male
Female

1.5
1
0.5
0

Cholesterol (mmol/L)

Triglyceridde (mmol/L)

Advances in Environmental Biology, 10(10) October 2016, Pages: 79-96

8
6
4
2
0

groups

groups
4
Total
Male
Female

1
0.5

LDL-C (mmol/L)

HDL-C (mmol/L)

1.5

Total
Male
Female

2
1
0

groups

1.5
Total
Male
Female

1
0.5
0

Inorganic -P (mmol/L)

groups
VLDL-C (mmol/L)

Total
Male
Female

2
0

groups

groups
0.03
0.025
0.02
0.015
0.01
0.005
0

Total
Male
Female

Total
Male
Female

Magnesium (mmol/L)

Iron (mmol/L)

1.5
Total
Male
Female

0.5

groups

groups

88

Abdulkadir Mohammed Noori Jassim et al, 2016

0.015

Copper (mmol/L)

Calcium (mmol/L)

Advances in Environmental Biology, 10(10) October 2016, Pages: 79-96

Total
Male
Female

3
2

Total
Male
Female

0.01

0.005

1
0

groups

groups

Fig. 1: Comparison of the variables in serum and saliva among obese and control subjects
The correlation study between serum and saliva levels in different parameters were shown in Table 3.
Table 3: Correlation between differentparameters in serum and saliva of obese subjects
Total
Parameters
SFR
Protein
Albumin
BMI
pH
(ml/min)
(g/L)
(g/L)
2
(Kg/m )

BMI
(Kg/m2)

S
pH

SFR
(ml/min)

Total
Protein
(g/L)

T
M
F
T
M
F
T
M
F

T
M
F

T
M
F

T
M
F

T
M
F

r
--

p
--

--

--

.05
.12
5
.10
0
.05
0
.12
5
.10
0
.05
.28
3
.04
1
.05
4
.28
3
.04
1
.32
.30
8
.24

.82
.71
4
.76
9

--

--

.82
5
.71
4
.76
9

--

--

.81
.39
9
.90
4

-.60*
-.28
-.82*

.00
3
.39
.00
2

--

--

.81
3
.39
9
.90
4

.60**
-.287
.825*
*

.00
3
.39
3
.00
2

--

--

.13
.35
7
.46
5

-.07
-.192
-.097

.72
.57
2
.77
7

.07
.222
.124

.74
.51
2
.71
7

--

--

Globulin
(g/L)

Triglyceri
de
(mmol/L)

Cholester
ol
(mmol/L)

89

Abdulkadir Mohammed Noori Jassim et al, 2016

Advances in Environmental Biology, 10(10) October 2016, Pages: 79-96

Albumin
(g/L)

Globulin
(g/L)

S
Triglyceri
de
(mmol/L)

S
Cholester
ol
(mmol/L)

S
HDL-C
(mmol/L

6
T .04
M 2
F .02
4
.04
3
T M .43
F *
.43
2
.45
5
T .30
M 7
F .16
7
.30
7
T .04
M .07
F 8
.16
9

.13
.35
7
.46
5

-.033
-.294
.311

.88
5
.38
1
.35
2
.83
.70
2
.32
0

-.219
-.447
-.068

.04
.18
5
.16
0

-.04
.131
-.331

.16
5
.62
3
.35
8
.83
.81
9
.62
0

-.320
-.336
-.231

.14
7
.31
2
.49
4
.87
.43
1
.52
4

.025
-.021
-.094

T M .01
F 6
.02
6
.00
3
T .03
M F .26
9
.33
0

.94
3
.93
9
.99
4

.012
-.264
.357

.95
8
.43
3
.28
1

.87
.42
4
.32
2

.43*
.475
.382

T .02
M 1
F .21
3
.19
2

.92
5
.53
0
.57
2

T M .08
F .13
4
.01
2
T .05
M 0
F .29
1
.22
7
T .31
M .29
F 1
.41

.32
6
.16
8
.84
3
.23
.73
9
.10
7

--

--

.36
.25
5
.55
6

.09
.44
9
.07
6

--

--

.91
2
.95
2
.78
3
.50
.76
9
.27
3

.35
2
.58
1
.18
5
.64
**
.65
*
.58
0

.10
8
.06
1
.58
5
.00
1
.03
0
.06
1

--

--

.02
.06
8
.28
4

--

--

-.261
-.502
-.064

.24
0
.11
6
.85
1

.98
**
.98
**
.98
**

.00
0
.00
0
.00
0

.48
*
.56
9
.35
5
.21
8
.47
1
.03
9

.33
1
.14
4
.90
9

--

--

.04
.14
0
.24
6

-.31
-.092
-.441

.15
.78
7
.17
4

.37
.79
9
.21
7

.23
.51
5
.10
8

.30
.10
5
.75
1

--

--

.05
5
.87
5
.01
0

.368
.030
.596

.09
2
.92
9
.05
3

.32
6
.43
2
.58
2

.04
9
.15
2
.00
2

.82
7
.65
5
.99
6

.30
1
.40
5
.56
7

--

--

.70
.69
4
.97
3

.16
.278
.000

.46
.40
8
.99
9

-.02
.299
-.220

.90
.37
2
.51
5

.01
.05
8
.26
1

.44
*
.71
*
.06
7

.03
.01
3
.84
5

.37
.47
9
.34
9
.23
1
.28
0
.19
4
.10
.06
4
.35
1

.08
.13
6
.29
2

-.415
-.054
.734*

.19
.08
7
.40
5
.22
0
.26
5
.18
7
.49
*
.58
6
.37
1

.64
.85
2
.29
0

.25
.25
5
.23
4

.26
.45
0
.48
8

--

--

.82
5
.38
5
.50
1

-.053
.245
-.229

.81
5
.46
8
.49
9

.079
.158
-.062

.72
5
.64
2
.85
5

.83
0
.04
3
.10
9

.30
0
.30
8
.60
1

.17
4
.35
6
.05
1

.66
9
.05
0
.18
5

.28
0
.24
2
.31
3

.20
6
.47
4
.34
8

--

--

.15
.38
6
.20

-.19
-.201
-.208

.39
.55
4
.53

-.08
-.265
.131

.72
.43
1
.70

.02
.03
9
.43

.23
.33

.29
.31
0
.97

.00
1
.00
3

.17
.28

.44
.40
3
.89

.32
.09
6
.69

.14
.77
8
.01

-.03
-.265
.216

.26
.114
.512

-.14
.101
-.363

.04
9
.61
*
.51
0
.49
*
.62
*

.09
6
.60
2
.43
2
.65
**
.79
**

90

Abdulkadir Mohammed Noori Jassim et al, 2016

Advances in Environmental Biology, 10(10) October 2016, Pages: 79-96
5

LDL-C
(mmol/L)

VLDL-C
(mmol/L)

Inorganic
Phosphor
ous
(mmol/L)

Iron
(mmol/L)

.26
1

8
.01
2
.09
9
.37
9
.17
5

.30
6

.36
0

1
.04
3
.32
8
.40
5
.27
2

.66
2
.25
0
.60
6

.03
9
.23
2
.29
9

.86
4
.49
1
.37
2

.13
6
.21
7
.41
8

.44
*
.30
2
.67
*

.03
9
.36
7
.02
3

.10
.00
7
.22
0
.11
9
.18
6
.06
3

.65
.98
4
.51
5

.88
**
.89
**
.87
**

.00
0
.00
0
.00
0

.59
7
.58
3
.85
4

.79
**
.67
*
.94
**

.00
0
.02
3
.00
0

.08
.13
6
.29
2

1.0
**
1.0
**
1.0
**

.00
0
.00
0
.00
0

.25
.25
5
.23
3

.26
.45
0
.49
0

.35
8
.62
9
.35
1

.15
2
.34
0
.87
**

.49
9
.30
6
.00
0

.07
2
.04
2
.29
8

.74
9
.90
3
.37
4

.71
.54
5
.86
9

.27
.40
6
.24
6
.16
9
.21
9
.25
5
.04
.25
4
.25
6

.11
.21
5
.46
5

.05
.35
0
.01
6

.80
.29
2
.96
3

.45
3
.51
8
.44
9

.06
9
.24
7
.19
1

.76
1
.46
4
.57
3

.84
.45
1
.44
8

.14
.10
7
.11
2

.52
.75
5
.74
3

.67
3
.87
1
.58

.01
4
.01
8
.03

.95
0
.95
7
.91

T M .29
F 0
.41
8
.14
6
T M .22
F .15
0
.27
7
T .07
M 3
F .14
7
.28
7
T .03
M F .26
9
.33
0

.19
1
.20
1
.66
8

-.332
-.584
-.015

.13
1
.05
9
.96
5

.117
.437
-.187

.60
5
.17
9
.58
1

.05
1
.26
7
.31
9

.82
3
.42
7
.33
8

.32
.66
1
.41
0

.05
.185
-.133

.79
.58
7
.69
6

.13
.446
-.077

.55
.16
9
.82
2

.46
*
.39
4
.57
7

.02
.23
0
.06
3

.47
*
.67
*
.13
9

.02
.02
3
.68
4

.05
.19
4
.51
3

.81
.56
7
.10
7

.74
6
.66
6
.39
3

.227
.562
-.122

.30
9
.07
2
.72
1

-.082
-.097
-.101

.71
7
.77
7
.76
8

.45
5
.62
8
.04
5

.04
.14
0
.24
6

-.31
-.092
-.441

.15
.78
7
.17
4

T M .03
F 4
.06
7
.06
9

.88
2
.84
4
.84
0

-.210
-.086
-.525

.34
8
.80
2..
09
7

.121
.092
.260

.59
1
.78
7
.44
1

.47
0
.40
4
.96
5

T M .22
F .63
*
.60
*

.30
.03
6
.04
7

.10
-.166
.208

.64
.62
6
.53
8

-.01
.283
-.069

.94
.40
0
.84
0

.16
3
.28
0
.01
5
.10
.06
1
.22
5

.11
8
.17
6
.52
6
.37
.47
9
.35
0
.20
6
.16
4
.31
2
.08
.20
5
.05
6

.60
2
.60
4
.09
6

.43*
.475
.382

.32
4
.09
2
.67
*
.23
.51
5
.11
0

.14
1
.78
8
.02
3

.87
.42
4
.32
2

.16
8
.16
5
.61
*
.19
.08
7
.40
6
.21
3
.17
1
.30
6
.17
.18
3
.14
5

T .33
M 1
F .47
4
.18
6

.13
2
.14
1
.58
3

.153
.181
.644*

.49
6
.59
5
.03
2

-.46*
.82**
-.581

.02
8
.00
2
.06
1

.45
*
.55
2
.32
2

.03
3
.07
8
.33
5

.18
5
.27
3
.19
7

.41
1
.41
7
.56
2

.44
*
.54
1
.36
0

.03
9
.08
6
.27
7

T M .19
F .03
3
.25
1

.38
.92
4
.45
6

.009
-.124
-.039

.96
.71
6
.91
0

-.03
.146
.034

.87
.66
9
.92
1

.94
.74
2
.66
4

.20
.17
5
.24
3

.35
.60
7
.47
2

.83
9
.13
7
.16

.116
-.116
.274

.60
7
.73
4
.41

-.036
.236
-.160

.87
2
.48
5
.63

.17
5
.45
1
.26

.28
0
.51
8
.20

.20
6
.10
2
.53

.18
.23
3
.40
5
.26
0
.18
8
.34

.41
.49
0
.21
7

T .04
M 6
F .47
8

.01
.11
3
.14
8
.30
0
.25
4
.36

.37
.79
9
.21
6

.34
0
.61
5
.36
0

.43
.59
0
.67
0

.30
.10
5
.74
9

.65
.85
7
.50
5

.24
3
.58
0
.30

.09
5
.05
6

91

Abdulkadir Mohammed Noori Jassim et al, 2016

Advances in Environmental Biology, 10(10) October 2016, Pages: 79-96
.44
7

Magnesiu
m
(mmol/L)

Calcium
(mmol/L)

Copper
(mmol/L)

.18
5
.06
.13
1
.30
2

.77
.70
0
.36
6

.18
.30
6
.00
9

.41
.36
0
.97
8

T M .31
F .21
7
.41
7
T .06
M 0
F .39
1
.08
9

.14
.52
2
.20
2

-.17
-.105
-.338

.43
.75
8
.31
0

.0008
-.320
.354

.97
.33
8
.28
6

.62
**
.74
**
.43
6

.00
02
.00
9
.18
0

.48
*
.32
6
.75
**

.02
.32
7
.00
8

.19
.37
3
.24
6

.39
.25
9
.46
6

.79
2
.23
4
.79
4

.203
.484
-.179

.36
6
.13
2
.59
9

.263
.263
.454

.23
7
.43
4
.16
0

.01
4
.49
3
.57
0

.95
0
.12
3
.06
7

.16
9
.08
2
.90
2

.00
3
.48
0
.57
6

.99
0
.13
5
.06
4

.17
9
.04
2
.30
1

.42
5
.90
2
.36
9

.03
4
.12
7
.13
7

.88
1
.71
0
.68
7

T M .33
F .41
8
.32
7

.13
.20
1
.32
6

.284
-.085
.396

.20
1
.80
5
.22
8

-.46*
.304
-.63*

.02
8
.36
3
.03
8

.07
3
.49
9
.37
8

.74
6
.11
8
.25
1

.29
7
.87
7
.20
6

.12
2
.46
7
.02
0

.58
8
.14
8
.95
4

.22
7.28
7
.36
0

.30
9
.39
1
.27
7

.18
0
.01
4
.23
8

.42
2
.96
8
.48
2

T .22
M 0
F .18
9
.37
6

.32
4
.57
8
.25
5

-.148
-.529
-.081

.51
0
.09
4
.81
4

.076
.402
.076

.73
7
.22
0
.82
5

.13
4
.37
4
.03
9

.55
1
.25
8
.90
9

.30
4
.54
7
.04
2
.23
3
.05
3
.41
4
.25
4
.30
1
.37
2

.25
5
.36
8
.26
0

.17
0
.34
0
.09
7

.44
9
.30
7
.77
6

.10
7
.26
9
.26
4

.63
7
.42
4
.43
3

.49
1
.28
3
.96
2

T .09
M 5
F .16
4
.06
8

.67
5
.63
0
.84
1

-.290
-.509
-.061

.19
1
.11
0
.85
9

-.070
.043
-.146

.75
8
.90
0
.66
9

.29
1
.52
7
.02
1

.18
8
.09
6
.95
0

.16
5
.41
1
.27
2

.46
2
.20
9
.41
9

.53
8
.71
5
.47
3

.13
7
.05
9
.35
9

.54
4
.86
4
.27
8

T .15
M 3
F .07
2
.27
3

.49
6
.83
3
.41
7

-.341
-.231
-.397

.12
1
.49
5
.22
7

.072
-.231
.200

.75
0
.49
4
.55
6

.07
5
.23
9
.10
7

.74
1
.48
0
.75
4

.38
0
.11
0
.50
8

.08
1
.74
7
.11
0

.13
9
.12
5
.24
2
.06
7
.30
9
.18
5

.15
5
.35
6
.01
6
.27
7
.71
*
.28
6

.76
5
.35
5
.58
6

.11
2
.52
3
.16
7

.61
8
.09
8
.62
3

Parameters

HDL-

LDL-

C
(mmo

-C
(mmol

l/L

/L)
p
-

VLDL

/L)
r
.

079

HD

L-C

557

72
8

.172
-

59
3

.045

07
5
-

ol/L)

Mag
nesium
(mm
ol/L)

Calc
ium
(mm
ol/L)

Copper
(mm
ol/L)

44
4

05
7

80
0

.09
5

67
3

37
4

08
6

.11
1

62
4

.03
1

89
1

40
3

25
0

45
9

.10
4

76
2

53
2

09
2

06
6

84
8

.13
8

68
7

89
6

.08
3

80
8

.12
6

71
2

06
9

84
1

.24
6

46
5

18
5

58
7

31
9

.35
8

10
2

.30
4

16
9

06
7

76
8

07
0

75
6

.09
1

68
6

.281
.

Iron
(mm

.64
1
.41
4
.31
3

r
-

.182

(m
mol/L

(mmol

Inor
ganic
Phosphor
ous
(mm
ol/L)

.10
5
.27
4
.33
6

.21
2
.01
3
.39
4

.
161
-

.
47
4

223
.

92

Abdulkadir Mohammed Noori Jassim et al, 2016

Advances in Environmental Biology, 10(10) October 2016, Pages: 79-96
.036

196
.

474

91
6

.
291

14
0
LD

56
5

.53
2

09
2

.14
4

67
3

.04
3

90
0

23
2

49
3

.04
6

89
3

38
6

47
3

14
2

.51
0

10
9

20
9

53
7

.03
2

92
5

.14
6

66
7

65
0

22
6

31
1

16
7

45
7

10
0

65
9

13
9

53
8

.36
1

09
9

98
5

41
8

20
1

24
6

46
6

06
0

86
1

09
7

77
6

.66
6

02
5

51
3

12
6

71
2

02
8

93
4

14
0

68
2

17
3

61
1

09
4

78
2

81
4

09
9

66
2

13
2

55
7

03
3

88
5

.16
6

46
1

.01
2

95
8

81
4

10
2

76
6

06
3

85
5

02
3

94
6

.32
9

32
3

.43
5

18
1

99
0

13
0

70
4

20
1

55
4

06
6

84
6

.09
0

79
2

38
6

24
2

.27
1

22
2

04
4

84
6

.06
4

77
7

22
8

30
9

13
6

54
6

.40
6

21
5

.25
4

45
2

13
1

70
1

.28
8

39
1

.05
9

86
4

.24
8

46
3

25
6

44
7

.30
4

36
4

36
1

27
6

35
8

28
0

04
6

84
0

.08
1

72
1

12
2

58
9

05
2

82
0

15
7

48
6

08
7

79
9

.07
3

83
2

07
9

81
7

.23
6

48
5

18
5

58
6

.06
5

85
0

.12
3

71
9

16
4

63
0

28
2

40
1

17
5

60
6

21
9

32
8

32
5

14
1

17
5

43
6

19
7

37
9

35
9

27
9

.04
6

89
3

.03
1

92
9

01
0

97
6

10
4

76
0

59
9

05
1

18
2

59
3

34
5

29
9

.00
2

99
4

.25
4

25
3

.16
9

45
3

03
1

89
1

03
2

92
6

.28
0

40
4

.12
3

71
9

.00
4

99
0

.01
2

97
1

.07
0

83
7

.31
1

35
1

.03
3

92
4

03
8

86
7

17
2

44
3

39
3

07
0

.23
4

48
8

09
9

77
1

28
4

39
7

30
7

35
8

14
8

66
4

54
9

08
0

.16
5

46
3

08
2

71
6

.01
7

93
9

.50
3

11
4

12
1

72
2

.20
8

53
9

.103

L-C

(m
mol/L)

.007
.221

.053
.080
.
004

VL
DL-C
(m
mol/L)

Inor
ganic
Phosphor
ous
(m
mol/L)

Iron
(m
mol/L

93

Abdulkadir Mohammed Noori Jassim et al, 2016

Advances in Environmental Biology, 10(10) October 2016, Pages: 79-96

Ma
gnesium
(m
mol/L)

03
4

92
2

04
8

88
8

12
6

71
3

.10
4

64
5

.00
8

72

30
0

37
1

.39
6

.30
0

37
0

62
*

25
4

25
4

.21
6

33
5

03
1

92
8

.27
7

40
9

29
8

37
4

.10
5

75
9

.01
6

94
3

.18
0

59
6

00
7

98
3

.25
0

26
3

.01
7

96
0

.31
9

33
9

Cal

cium
(m
mol/L)

Copper
(m
mol/L)

22
8
04
1

Non- significant p 0.05,* Significant p 0.05, ** Highly Significant p 0.001, S= Serum, V= Saliva, T: Total, M: Male, F: Female

There are a few researches in the literature investigating the correlation of different parameters in serum and
saliva together of obese individuals. However,our results indicated that the levels of SFR werenegatively
correlated with pH of total, female groups in serum (r=-0.600, p=0.003; r=-0.820, p=0.002), respectively and in
saliva (r=-0.600, p=0.003, r=-0.825, p=0.002), respectively. Also, there was a negatively correlated between
serum albumin and BMI in total group with (r=-0.43, p= 0.04).The serum globulin was positively correlated
with total protein of groups, total and male (r=0.640, p=0.001, r=0.650, p=0.030), respectively, while in saliva a
highly positive correlation were shown in each groups (r=0.980, p=0.000, r=0.980, p=0.000, r=0.980, p=0.000 ),
respectively.On the other hand, the level of globulin was negatively correlated with albumin in total group (r=0.480, p=0.020). In addition, serum triglyceride was positively correlated with pH in total group (r=0.430,
p=0.040), while in saliva a negatively correlated was shown in female group(r=-0.734, p=0.010). Our results
indicated a positive correlation betweenserum cholesterol and total protein in total group(r=0.490, p=0.010),
while in saliva a negatively correlated was seen in male group (r=-0.610, p=0.043). Also, the serum cholesterol
was positively correlated with albumin of total and male groups (r=0.440, p=0.030, r=0.710, p=0.013),
respectively. The serum HDL-C level was positively correlated withtotal protein in total and male groups
(r=0.490, p=0.020, r=0.620, p=0.039). Furthermore, serum HDL-C level was highly positive correlated with
globulin in total and male groups (r=0.650, p=0.001, r=0.790, p=0.003). The serum HDL-C was positively
correlated with cholesterol in female group (r=0.690, p=0.019), while in saliva a positively correlated were
shown in total and female groups (r=0.440, p=0.039, r=0.760, p=0.023).
Our results indicated a positive correlation between serum LDL-C and total protein in total group(r=0.460,
p=0.020) while in saliva a positively correlated was shown in female group (r=0.610, p=0.045). Also, the serum
LDL-C level was positively correlated with albumin in total and male groups (r=0.470, p=0.020, r=0.670,
p=0.023) while in saliva a positively correlated was shown in female group (r=0. 670, p=0.023). The table 3

94

Abdulkadir Mohammed Noori Jassim et al, 2016

Advances in Environmental Biology, 10(10) October 2016, Pages: 79-96

showed that there was a highly positive correlation betweenLDL-C and cholesterol of each groups in serum
(r=0.880, p=0.000, r=0.890, p=0.000, r=0.870, p=0.000), respectively,and in saliva (r=0.790, p=0.000, r= 0.670,
p=0.023, r=0.940, p=0.000). Furthermore, the serum VLDL-C was positively correlated with pH in total group
(r=0.430, p=0.040). Also a highly positive correlation between VLDL-C and triglyceride of each groups in
serum (r=1.000, p=0.000, r=1.000, p=0.000, r=1.000, p=0.000), respectively while in saliva a highly positive
correlated was shown in female group (r=0.870, p=0.000).
The correlation study between serum inorganic phosphorous and BMI indicated that there were a significant
positive correlation in male (r=0.630, p=0.036) and negative correlation in female (r=0.600, p=0.047) of obese
(Table 3).Also, a study indicated the positively correlated between salivary inorganic phosphorous and pH
infemale group (r=0.644, p=0.032). The data show a negative correlation between salivary inorganic
phosphorous and SFRin total (r=-0.460, p=0.028) and highly correlation in male (r=-0.820, p=0.002) groups. On
the other hand, the level of salivary inorganic phosphorous was positively correlated with total protein in total
group (r=0.450, p=0.033). In addition, salivary inorganic phosphorous was positively correlated with globulin in
total group (r=0.440, p=0.039). The serum Mg level was highly positive correlated withtotal protein in total and
male groups (r=0.620,p=0.0002, r = 0.740, p=0.009), respectively. Our data also show apositive correlation
between serum Mg and albuminin total (r=0.480, p=0.028) and highly correlation in female (r=-0.750, p=0.008)
groups. The result indicated anegativecorrelation between serum Ca and SFRin total (r=-0.460, p=0.028) and
female (r=-0.630, p=0.038) groups. Also, serum Cu was negatively correlated with cholesterol in male group (r
=-0.710, p= 0.013). Finally, apositive correlation between serum Mg and Cuin female group(r=0.620, p=0.041)
as shown in Table 3.
There are a few researches in the literature investigating the correlation of serum and saliva parameter in
obese at the same time [6, 46-48]. In addition, there are some conflicting findings.Previous study indicated the
correlation and statistical significance between salivary phosphate and BMI [6]. Other study indicated a nonsignificant correlation (p>0.05) was found between serum Fe, Cu levels andlipid profile (TG,TC, HDL-C, LDLC) in the obese children[35].Sunet al. [49] presented no relationship between Mg concentration and lipid
parameters in a study conducted with both men and women. Some authors reported a negative correlation
between serumCu and HDL-C[50].
Concolusion:
Obesity is one of the major health problems, associated with increased mortality. Thus it is important to
understand its pathogenesis. There are a limited number of reports on the relation between serum and saliva of
obese persons, our study one of this approach.Values regarding blood and salivary biochemical parameters were
distinctly different between obese and healthy control groups, suggesting salivary parameters can be used as a
diagnostic alternative to blood parameters for obese persons.
From this study we can conclude that thepH, SFR, total protein, albumin, globulin, lipid profile (TC, TG,
HDL-C, LDL-C, VLDL-C)and bioavailability of trace elements ( inorganic P, Fe, Mg, Ca, Cu)will be disturbed
in serum and saliva of obese patients, and the exact prevalence of this alteration is still unknown.Our study
suggests that the TC, LDL-C, Fe, Ca levels in serum may be an early biomarker root of the obesity.
Furthermore, the results revealed that the human salivary TG, VLDL,inorganic P, Ca, Cu levels may be an early
biomarker of the obesity. The diagnostic importance lies in fact that the salivary level of these parameters could
provide a noninvasive predictive marker in the development of obesity. Also, further studies involving larger
number of subjects with parallel measurement of different parameters both in serum and saliva may provide
additional information about these parameters in obese subjects.
ACKNOWLEDGEMENTS
The authors would like to thank the staff of Al-Kindy Obesity Research and Therapy Center, Al-Kindy
College of Medicinefor his assistance in collecting the blood and saliva samples. We would also like to
acknowledge the staff of Department of Chemistry, College of Science, Al-Mustansiriyah University, specially
Ms. Halah, Ms.Teba, Ms.Hawraa and Mr.Hadifor their helpful in measurements.
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