Abstract
BACKGROUNDS: Psychological stress plays a role in the development of periodontal disease by influencing immune function and behavioral responses. Chromogranin A (CgA), a glycoprotein released due to activation of the sympathetic-adrenomedullary system, shows potential as a salivary biomarker for stress-related immune changes. This study aimed to assess salivary CgA levels in individuals with healthy and diseased periodontal conditions while investigating its correlation with clinical periodontal parameters and psychological stress. METHODS: This cross-sectional study involved 56 systemically healthy participants classified into groups based on their periodontal condition: periodontal health, gingivitis, Stage II, and Stage III periodontitis. Clinical periodontal parameters were assessed. Psychological stress levels were measured using the Beck Depression Inventory (BDI). Unstimulated saliva samples were collected and analyzed for CgA mRNA expression. Statistical analyses comprised ANOVA, Spearman's correlation, and chi-square tests. RESULTS: Salivary CgA levels were significantly higher in individuals with Stage III periodontitis compared to those with periodontal health, gingivitis, or Stage II periodontitis (p < 0.01). No significant correlation was observed between salivary CgA levels and BDI scores. DISCUSSION: Although salivary CgA levels were significantly elevated in patients with advanced periodontal disease, no direct associations were observed between CgA levels and individual clinical or psychological stress measures. These findings suggest that CgA may reflect systemic stress-related changes associated with disease severity rather than individual psychological status.