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Salivary glutathione peroxidase-1 levels in periodontitis
Leonardo Lorente, Esther Hernández Marrero, Pedro Abreu-Gonzalez, Angel Daniel Lorente Martín, Marina Lorente Martín, María José Marrero González, Carmen Hernández Marrero, Olga Hernández Marrero, Alejandro Jiménez, Cándido Manuel Hernández Padilla
Leonardo Lorente, Intensive Care Unit, Hospital Universitario de Canarias, San Cristóbal de La Laguna 38320, Tenerife, Spain
Esther Hernández Marrero, María José Marrero González, Carmen Hernández Marrero, Olga Hernández Marrero, Cándido Manuel Hernández Padilla, Department of Periodontology, Clínica Dental Cándido, San Cristóbal de La Laguna 38204, Tenerife, Spain
Pedro Abreu-Gonzalez, Department of Basic Medical Sciences, University of La Laguna, La Laguna 38320, Tenerife, Spain
Angel Daniel Lorente Martín, Department of Odontology, CEU San Pablo University, Madrid 28660, Spain
Marina Lorente Martín, Department of Nursing, Salus Infirmorum-Universidad Pontificia de Salamanca, Madrid 28015, Spain
Alejandro Jiménez, Research Unit, Hospital Universitario de Canarias, San Cristóbal de La Laguna 38320, Tenerife, Spain
Author contributions: Lorente L conceived, designed and coordinated the study, participated in acquisition and interpretation of data, and drafted the manuscript. Hernández Marrero E, Lorente Martín AD, Lorente Martín M, Marrero González MJ, Hernández Marrero C, Hernández Marrero O, and Hernández Padilla CM participated in acquisition of data; Abreu-Gonzalez PA participated in salivary levels determinations; Jiménez A participated in the interpretation of data; and all authors revised the manuscript critically for important intellectual content and made the final approval of the version to be published.
Institutional review board statement: This study was initiated after obtaining approval from the Clinical Research Ethics Committee of the Hospital Universitario de Canarias (CHUC_2023_138; November 30, 2023).
Informed consent statement: Prior to inclusion, all participants provided written informed consent.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The datasets generated during the current study are available from the corresponding author on reasonable request.
Corresponding author: Leonardo Lorente, MD, PhD, Intensive Care Unit, Hospital Universitario de Canarias, Ofra s/n, San Cristóbal de La Laguna 38320, Tenerife, Spain.
lorentemartin@msn.com
Received: March 30, 2026
Revised: April 29, 2026
Accepted: May 18, 2026
Published online: September 20, 2026
Processing time: 104 Days and 22.4 Hours
BACKGROUND
Periodontitis consists of a chronic inflammatory disease of the periodontal tissue. In addition to inflammation, oxidation is also involved in periodontitis. Glutathione peroxidase (GPx) is an antioxidant enzyme. There are 8 forms of GPx (GPx 1-8) and GPx-1 is the most abundant. The comparison of salivary GPx-1 levels in patients with periodontitis and periodontally healthy subjects has been explored in small sample size studies (the largest including 101 subjects) and the results are contradictory.
AIM
To compare salivary GPx-1 concentrations in subjects with and without periodontitis in a study with a larger sample size. In addition, novel aims were exploring the possible association of salivary GPx-1 concentrations with periodontitis by a regression analysis and determining the capability of salivary GPx-1 concentrations to predict the diagnosis of periodontitis by a receiver operating characteristic (ROC) analysis.
METHODS
Observational and prospective study including subjects with and without periodontitis. Salivary samples were taken to determine GPx-1 concentrations. A multivariate logistic regression analysis was performed to determine whether salivary GPx-1 levels were independently associated with periodontitis. A ROC analysis was carried out to determine the capability for the diagnosis of periodontitis by salivary GPx-1 concentrations.
RESULTS
We found lower salivary GPx-1 concentrations in 57 subjects with periodontitis than in 86 without periodontitis. We found that salivary GPx-1 concentrations showed an area under the curve for periodontitis diagnosis of 76% (95%CI: 68%-83%; P < 0.001) in ROC analysis, and that salivary GPx-1 levels < 1214 pg/mL showed an independent association with periodontitis (odds ratio: 6.25; 95%CI: 2.844-13.717; P < 0.001) in regression analysis.
CONCLUSION
To our knowledge, our series has the largest sample size on salivary GPx-1 concentrations in periodontitis. Novel findings of our study were that salivary GPx-1 levels were able to diagnose periodontitis and were independently associated with periodontitis. However, our preliminary study has some limitations as there were significant differences in age between subjects with and without periodontitis, other antioxidant enzymes or total antioxidant capacity were not assessed, other biological samples were not analyzed, and GPx-1 genetic variations were not studied. Nevertheless, we think that the results of our study could encourage further research on the role of salivary biomarkers concentrations (as GPx-1) in the management of periodontitis.
Core Tip: Periodontitis consists of a chronic inflammatory disease of periodontal tissue. In addition to inflammation, oxidation is also involved in periodontitis. Glutathione peroxidase (GPx)-1 is an antioxidant enzyme. Novel findings of our study were that salivary GPx-1 levels were able to diagnose periodontitis and were independently associated with periodontitis.
