Assessment of skeletal maturity using salivary dehydroepiandrosterone sulfate as a biomarker: A clinical study

Objectives: The aim of the study is to evaluate skeletal maturation using salivary dehydroepiandrosterone sulfate (DHEA-S) levels and their correlation with existing skeletal maturity indicators represented by 4 cervical vertebrae growth stages. Material and Methods: Based on cervical vertebral maturation index (CVMI) growth, 48 samples were split into four groups with ages ranging from 9 to 16 years. Using the passive drooling approach, saliva was collected at a consistent 10 am and placed in marked, sterile plastic centrifuging tubes. These tubes were then immediately frozen at −4°C in a home freezer. Before the DHEA level was determined, samples were centrifuged for 5 min at 5000 rpm. 3 mL of the centrifuged supernatant was then transferred to storage containers and kept at −80 C. Before the assessment, all samples were brought to room temperature. Results: Analysis of variance test was applied to compare the DHEA-S levels among the CVMI stages. DHEA-S levels in the group were found to be 12.03 ± 0.87 nmol/mL for CVMI 2, 15.12 ± 1.33 nmol/mL for CVMI 3, 18.9 ± 0.81 nmol/mL for CVMI 4, and CVMI5 to be 22.11 ± 3.17 nmol/mL. Mean DHEA-S levels were higher in CVMI stage 5, followed by stage 4, stage 3, and stage 2. Conclusion: In the present study, salivary DHEA-S levels and cervical maturational stages demonstrated the potential utility of salivary DHEA-S as a prospective marker of skeletal maturation to pinpoint the pubertal growth spurt.