Journal of Research in Dental
and Maxillofacial Sciences
Volume 11, Issue 2 (6-2026)
J Res Dent Maxillofac Sci 2026, 11(2): 126-135 |
Back to browse issues page
Ethics code: CDCRI/DEAN/ETHICSCOMMITTEE/STAFF/OMRD-01/2024
Clinical trials code: NA
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
R Patil S, Daniel S, Veeraraghavan V P, Padmashali Jayappa N, Manyam R, A Rao K. Exploring Lactate Dehydrogenase as a Biomarker for Early Detection and Monitoring of Oral Submucous Fibrosis: A Preliminary Study. J Res Dent Maxillofac Sci 2026; 11 (2) :126-135
URL: http://jrdms.dentaliau.ac.ir/article-1-969-en.html
URL: http://jrdms.dentaliau.ac.ir/article-1-969-en.html
Santosh R Patil1 
, Shikhar Daniel *2 , Vishnu Priya Veeraraghavan3 , Nagarathna Padmashali Jayappa4 , Ravikanth Manyam5 , Krishna A Rao6
, Shikhar Daniel *2 , Vishnu Priya Veeraraghavan3 , Nagarathna Padmashali Jayappa4 , Ravikanth Manyam5 , Krishna A Rao6
1- Department of Oral Medicine and Radiology, Chhattisgarh Dental College and Research Institute, Chhattisgarh, India
2- Department of Oral Medicine and Radiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India ,shikhardaniel555@gmail.com
3- Centre of Molecular Medicine and Diagnostics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
4- Department of Pediatric Dentistry, Chhattisgarh Dental College and Research Institute, Chhattisgarh
5- Department of Oral Pathology, Vishnu Dental College, Bhimavaram
6- Department of Oral Pathology JSS Dental College & Hospital, Mysuru
2- Department of Oral Medicine and Radiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India ,
3- Centre of Molecular Medicine and Diagnostics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
4- Department of Pediatric Dentistry, Chhattisgarh Dental College and Research Institute, Chhattisgarh
5- Department of Oral Pathology, Vishnu Dental College, Bhimavaram
6- Department of Oral Pathology JSS Dental College & Hospital, Mysuru
Abstract: (2 Views)
Background and Aim: This study compared the serum and salivary lactate dehydrogenase (LDH) levels in patients with oral submucous fibrosis (OSMF) and healthy controls, and assessed their potential as biomarkers for OSMF diagnosis, and monitoring its progression.
Materials and Methods: This case-control study involved 50 OSMF patients and 50 age- and sex-matched healthy controls. Serum and salivary LDH levels were measured using standard laboratory techniques. Clinical staging of OSMF was performed based on the severity of symptoms, and the relationship between LDH levels and disease stage was analyzed using statistical methods. Descriptive and inferential statistics including t-test, ANOVA, and correlation coefficients based on data distribution were used to assess the association between LDH levels and OSMF clinical features (alpha=0.05).
Results: OSMF patients showed significantly higher serum LDH levels (225.4±58.2 U/L) than healthy controls (187.6±42.4 U/L; P=0.0004). They also showed significantly higher salivary LDH levels (180.3±53.1 U/L) compared to controls (148.2±37.9 U/L; P=0.0006). A strong positive correlation was found between serum LDH levels and clinical stage of OSMF (r=0.65, P<0.001), while a moderate inverse correlation was observed between salivary LDH levels and mouth opening (r=-0.48, P<0.001).
Conclusion: Both serum and salivary LDH levels were significantly elevated in patients with OSMF compared to healthy controls. Salivary LDH, in particular, demonstrated a strong association with clinical severity and disease stage, supporting its potential as an effective, non-invasive biomarker for OSMF diagnosis, and monitoring its progression.
Materials and Methods: This case-control study involved 50 OSMF patients and 50 age- and sex-matched healthy controls. Serum and salivary LDH levels were measured using standard laboratory techniques. Clinical staging of OSMF was performed based on the severity of symptoms, and the relationship between LDH levels and disease stage was analyzed using statistical methods. Descriptive and inferential statistics including t-test, ANOVA, and correlation coefficients based on data distribution were used to assess the association between LDH levels and OSMF clinical features (alpha=0.05).
Results: OSMF patients showed significantly higher serum LDH levels (225.4±58.2 U/L) than healthy controls (187.6±42.4 U/L; P=0.0004). They also showed significantly higher salivary LDH levels (180.3±53.1 U/L) compared to controls (148.2±37.9 U/L; P=0.0006). A strong positive correlation was found between serum LDH levels and clinical stage of OSMF (r=0.65, P<0.001), while a moderate inverse correlation was observed between salivary LDH levels and mouth opening (r=-0.48, P<0.001).
Conclusion: Both serum and salivary LDH levels were significantly elevated in patients with OSMF compared to healthy controls. Salivary LDH, in particular, demonstrated a strong association with clinical severity and disease stage, supporting its potential as an effective, non-invasive biomarker for OSMF diagnosis, and monitoring its progression.
Type of Study: Original article |
Subject:
Oral medicine
References
1. Chhabra AK, Sune R, Reche A. Oral Submucous Fibrosis: A Review of the Current Concepts in Management. Cureus. 2023 Oct;15(10):e47259. [DOI:10.7759/cureus.47259]
2. Murthy V, Mylonas P, Carey B, Yogarajah S, Farnell D, Addison O, et al. Malignant Transformation Rate of Oral Submucous Fibrosis: A Systematic Review and Meta-Analysis. J Clin Med. 2022 Mar;11(7):1793. [DOI:10.3390/jcm11071793] [PMID] [PMCID]
3. Lorini L, Bescós Atín C, Thavaraj S, Müller-Richter U, Alberola Ferranti M, Pamias Romero J, et al. Overview of Oral Potentially Malignant Disorders: From Risk Factors to Specific Therapies. Cancers (Basel). 2021 Jul;13(15):3696. [DOI:10.3390/cancers13153696] [PMID] [PMCID]
4. Foy JP, Bertolus C, William WN Jr, Saintigny P. Oral premalignancy: the roles of early detection and chemoprevention. Otolaryngol Clin North Am. 2013 May;46(4):579-97. [DOI:10.1016/j.otc.2013.04.010] [PMID] [PMCID]
5. More CB, Jatti Patil D, Rao NR. Medicinal management of oral submucous fibrosis in the past decade- A systematic review. J Oral Biol Craniofac Res. 2020 Oct;10(4):552-68. [DOI:10.1016/j.jobcr.2020.08.004] [PMID] [PMCID]
6. Mahapatra M, Panda A, Kumar H, Barman D, Talukdar R, Dakshinakabat P. Lactate Dehydrogenase as a Biomarker in Oral Submucous Fibrosis: A Systematic Review and Meta-Analysis. Cureus. 2023 Dec;15(12):e51008. [DOI:10.7759/cureus.51008]
7. Farhana A, Lappin SL. Biochemistry, Lactate Dehydrogenase. [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557536
8. Shih YH, Wang TH, Shieh TM, Tseng YH. Oral submucous fibrosis: A review on etiopathogenesis, diagnosis, and therapy. Int J Mol Sci. 2019 Jun;20(12):2940. [DOI:10.3390/ijms20122940] [PMID] [PMCID]
9. Kim J, Kim YW, Kim TY. Diagnostic value of serum lactate dehydrogenase level measured in the emergency department in predicting clinical outcome in out-of-hospital cardiac arrest: A multicenter, observational study. J Clin Med. 2023 Apr;12(8):3006. [DOI:10.3390/jcm12083006] [PMID] [PMCID]
10. Kumar P, Gupta S, Das BC. Saliva as a potential non-invasive liquid biopsy for early and easy diagnosis/prognosis of head and neck cancer. Transl Oncol. 2024 Feb;40:101827. [DOI:10.1016/j.tranon.2023.101827] [PMID] [PMCID]
11. Wahi PN, Kapur VL, Luthra UK, Srivastava MC. Submucous fibrosis of the oral cavity. 1. Clinical features. Bull World Health Organ. 1966;35(5):789-92.
12. Wani RT. Socioeconomic status scales-modified Kuppuswamy and Udai Pareekh's scale updated for 2019. J Family Med Prim Care. 2019 Jun;8(6):1846-9. [DOI:10.4103/jfmpc.jfmpc_288_19] [PMID] [PMCID]
13. Navazesh M. Methods for collecting saliva. Ann N Y Acad Sci. 1993 Sep;694(1):72-7. [DOI:10.1111/j.1749-6632.1993.tb18343.x] [PMID]
14. More CB, Gupta S, Joshi J, Varma SN. Classification system for oral submucous fibrosis. J. Indian Acad. Oral Med. Radiol. 2012;24(1):24. [DOI:10.5005/jp-journals-10011-1254]
15. Mokwatsi GG, Schutte AE, Kruger R. A biomarker of tissue damage, lactate dehydrogenase, is associated with fibulin-1 and oxidative stress in blacks: the SAfrEIC study. Biomarkers. 2016 Jan;21(1):48-55. [DOI:10.3109/1354750X.2015.1118532] [PMID]
16. Yada M, Miyazaki M, Motomura K, Masumoto A, Nakamuta M, Kohjima M, et al. The prognostic role of lactate dehydrogenase serum levels in patients with hepatocellular carcinoma who are treated with sorafenib: the influence of liver fibrosis. J Gastrointest Oncol. 2016 Aug;7(4):615-23. [DOI:10.21037/jgo.2016.03.10] [PMID] [PMCID]
17. Chen X, Chen T, Xie H, Guo J. Salivary and serum levels of lactate dehydrogenase in oral submucous fibrosis: A meta-analysis. Medicine (Baltimore). 2024 Apr;103(15):e37788. [DOI:10.1097/MD.0000000000037788] [PMID] [PMCID]
18. Gupta GS. The Lactate and the Lactate Dehydrogenase in Inflammatory Diseases and Major Risk Factors in COVID-19 Patients. Inflammation. 2022 Dec;45(6):2091-123. [DOI:10.1007/s10753-022-01680-7] [PMID] [PMCID]
19. Alonso-Bernáldez M, Cuevas-Sierra A, Micó V, Higuera-Gómez A, Ramos-Lopez O, Daimiel L, et al. An interplay between oxidative stress (lactate dehydrogenase) and inflammation (anisocytosis) mediates COVID-19 severity defined by routine clinical markers. Antioxidants (Basel). 2023 Jan;12(2):234. [DOI:10.3390/antiox12020234] [PMID] [PMCID]
20. Xu H, Lyu FY, Song JY, Xu YM, Jiang EH, Shang ZJ, et al. Research Achievements of Oral Submucous Fibrosis: Progress and Prospect. Biomed Res Int. 2021 Mar;2021:6631856. [DOI:10.1155/2021/6631856] [PMID] [PMCID]
21. Ahmed J, Puri A, Nangia R, Bhat S, Pasbola A. Oral submucous fibrosis: Histopathogenesis. Arch Dent Res. 2023;13(2):64-8. [DOI:10.18231/j.adr.2023.014]
22. Seo YS, Park JM, Kim JH, Lee MY. Cigarette smoke-induced reactive oxygen species formation: a concise review. Antioxidants. 2023 Sep;12(9):1732. [DOI:10.3390/antiox12091732] [PMID] [PMCID]
23. Hashibe M, Sankaranarayanan R, Thomas G, Kuruvilla B, Mathew B, Somanathan T, et al. Body mass index, tobacco chewing, alcohol drinking and the risk of oral submucous fibrosis in Kerala, India. Cancer Causes Control. 2002 Feb;13(1):55-64. [DOI:10.1023/A:1013991025848] [PMID]
24. Ariyawardana A, Athukorala AD, Arulanandam A. Effect of betel chewing, tobacco smoking and alcohol consumption on oral submucous fibrosis: a case-control study in Sri Lanka. J Oral Pathol Med. 2006 Apr;35(4):197-201. [DOI:10.1111/j.1600-0714.2006.00400.x] [PMID]
25. Rao NR, Villa A, More CB, Jayasinghe RD, Kerr AR, Johnson NW. Oral submucous fibrosis: a contemporary narrative review with a proposed inter-professional approach for an early diagnosis and clinical management. J Otolaryngol Head Neck Surg. 2020 Jan;49(1):3. [DOI:10.1186/s40463-020-0399-7] [PMID] [PMCID]
26. Singh AG, Roy S, Oza S, Singhavi H, Chatterjee K, Chaturvedi P. A contemporary narrative review to guide molecular epidemiology of oral submucous fibrosis. Int J Mol Epidemiol Genet. 2021 Aug;12(4):61-70.
27. Avezov K, Reznick AZ, Aizenbud D. LDH enzyme activity in human saliva: the effect of exposure to cigarette smoke and its different components. Arch Oral Biol. 2014 Feb;59(2):142-8. [DOI:10.1016/j.archoralbio.2013.11.003] [PMID]
28. Żmudka K, Jaroszewicz J, Zarębska-Michaluk D, Rogalska M, Czupryna P, Rorat M, et al. Association between liver damage and disease progression markers with mortality risk and mechanical ventilation in hospitalized COVID-19 patients: A nationwide retrospective SARSTer study. Viruses. 2024 Sep;16(10):1530. [DOI:10.3390/v16101530] [PMID] [PMCID]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |