Comparative Assessment of Salivary Neutrophil Gelatinase-Associated Lipocalin Levels (NGAL) Among Subjects With Periodontitis, Liver Cirrhosis, and Healthy Individuals: A Cross-Sectional Study.

Authors

Sayali S Dongare, Sameer A Zope, Girish Suragimath, Siddhartha Varma, Apurva V Kale

Published in

Cureus. Volume 18. Issue 6. Pages e110562. Epub Jun 09, 2026.

Abstract

Periodontitis and liver cirrhosis are chronic inflammatory disorders characterized by dysregulated immune responses and an increased systemic inflammatory load. Neutrophil gelatinase-associated lipocalin (NGAL) is a neutrophil-derived biomarker implicated in inflammation, tissue injury, and systemic disease. The relationship between salivary NGAL and periodontal health has not been previously studied in individuals with liver cirrhosis.
To evaluate and compare salivary NGAL levels among patients with liver cirrhosis with and without periodontitis, periodontitis alone, and healthy controls.
This cross-sectional study included 40 participants divided into four groups (n=10 each): liver cirrhosis with periodontitis, liver cirrhosis only, periodontitis only, and healthy controls. Periodontal status was evaluated using standardized clinical parameters in accordance with the 2017 American Academy of Periodontology (AAP) classification criteria. Unstimulated whole saliva samples were obtained, and salivary NGAL concentrations were quantified using enzyme-linked immunosorbent assay (ELISA). Intergroup comparisons were analyzed using one-way analysis of variance (ANOVA).
Salivary NGAL levels differed significantly among the study groups (p<0.001). The highest NGAL levels were observed in patients with liver cirrhosis and periodontitis, followed by liver cirrhosis alone, periodontitis alone, and healthy controls. These findings indicate an additive inflammatory effect when periodontal disease coexists with liver cirrhosis.
Salivary neutrophil gelatinase-associated lipocalin (NGAL) levels were significantly increased in patients presenting with both liver cirrhosis and periodontitis, indicating an enhanced cumulative systemic and periodontal inflammatory burden. Salivary NGAL may serve as a potential non-invasive biomarker linking periodontal inflammation and liver disease. Further longitudinal investigations involving larger sample populations are required to substantiate its clinical applicability and diagnostic utility.

PMID:
42434656
Bibliographic data and abstract were imported from PubMed on 11 Jul 2026.

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