Identificação de biomarcadores salivares e urinários para desenvolvimento de plataformas sustentáveis para diagnóstico e monitoramento do diabetes mellitus

Abstract

The diagnosis and monitoring of diabetes mellitus (DM) by blood is highly accurate, however it is an invasive procedure, it causes discomfort to patients and has a high cost for both the health system and patients. The development of alternatives non-invasive platforms with other biological samples, which are sustainable, with high sensitivity and reduced cost, can collaborate to diabetes surveillance. In this thesis, potential salivary and urinary biomarkers were investigated as alternatives for the diagnosis and monitoring of DM divided in 3 studies. Firstly, an analysis was performed with the Fourie transform infrared spectroscopy (FTIR) tool to evaluate the urinary components of non-diabetic, diabetic and diabetic rats treated with insulin. In another study, the FTIR platform was used in association with the classification of the support vector machine (SVM) for discriminate non-diabetic subjects and type 2 diabetic patients using saliva. Besides that, a systematic review and meta-analysis was carried out to assess the correlation between the salivary alpha-2-macroglobulin (A2MG) protein with glycemia and glycated hemoglobin (HbA1c) to systematically review the effectiveness of this protein to determine the levels of glycemia and HbA1c in type 2 diabetic patients. Briefly, Here we outline the potential of the FTIR platform as an alternative tool without reagent, non-invasive and highly sensitive for screening and monitoring diabetic patients using a reduced volume and minimal sample preparation (saliva or urine). Besides, the data show a strong correlation between HbA1C and salivary A2MG that should be proved in large cohort of patients to monitoring diabetes using saliva.