{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T13:30:14Z","timestamp":1783603814147,"version":"3.55.0"},"reference-count":78,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T00:00:00Z","timestamp":1748390400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Sialolithiasis is a common disorder of the major salivary glands characterized by the formation of salivary stones, known as sialoliths. It is predominantly observed in patients in their fourth to sixth decades of life. Several potential factors have been associated with the development of sialolithiasis, including obesity, smoking, medication use, and several systemic diseases such as dyslipidemia, hypertension, and diabetes mellitus. Despite extensive research into the pathogenesis of sialolithiasis, it remains elusive. Therefore, this study aims to explore the characteristics of sialolithiasis among patients residing in Saudi Arabia and to detect the possible role of systemic disorders in the development of sialolithiasis. Methods: This study included 375 patients with a confirmed diagnosis of sialolithiasis between 1 January 2016 and 31 December 2024, at the National Guard Health Affairs centers in Saudi Arabia. Demographic information, body mass index (BMI), presence of systemic disorders (hypertension, diabetes mellitus, dyslipidemia, asthma, cancer), and the age at diagnosis of each disease were collected for data analysis. Results: A total of 55.5% of the patients were male, with a mean age of 39.8 and a mean BMI of 28. Dyslipidemia represented the most prevalent systemic condition (32.9%), followed by diabetes mellitus (23.5%) and hypertension (20.3%). Moreover, 74.4% and 74.2% of the patients developed hypertension and diabetes mellitus before sialolithiasis, respectively. Furthermore, dyslipidemia was associated with a higher risk profile compared with diabetes mellitus and other systemic disorders. Conclusions: This exploratory study indicates that the incidence pattern of sialolithiasis among both genders likely depends on lifestyle factors and other underlying systemic conditions. Elevated BMI may be a contributing characteristic, and the development of systemic diseases such as diabetes mellitus could be linked to the formation of salivary stones. Furthermore, these findings support a multifactorial pathophysiology of sialolithiasis. The aforementioned factors may play a role in the formation of salivary stones through hyposalivation, whether disease-related or medication-induced hyposalivation, potentially serving as a common mechanism.<\/jats:p>","DOI":"10.3390\/jcm14113795","type":"journal-article","created":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T12:28:42Z","timestamp":1748435322000},"page":"3795","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Comorbidity Patterns Among Patients Diagnosed with Sialolithiasis: A Retrospective Analysis"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4654-245X","authenticated-orcid":false,"given":"Rimah Abdullah","family":"Saleem","sequence":"first","affiliation":[{"name":"Department of Biochemistry and Molecular Medicine, College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3736-5989","authenticated-orcid":false,"given":"Hatouf Husni","family":"Sukkarieh","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Molecular Medicine, College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4473-3594","authenticated-orcid":false,"given":"Rana K.","family":"Alkattan","sequence":"additional","affiliation":[{"name":"Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh 11426, Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh 11481, Saudi Arabia"},{"name":"Dental Services King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Riyadh 11426, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9974-2108","authenticated-orcid":false,"given":"Hana M. A.","family":"Fakhoury","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Molecular Medicine, College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8337-5454","authenticated-orcid":false,"given":"Ahmad","family":"Aljada","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Molecular Medicine, College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulrahman","family":"Theyab","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Molecular Medicine, College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia"},{"name":"Security Forces Hospital, Mecca 14799, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khansa Taha","family":"Ababneh","sequence":"additional","affiliation":[{"name":"King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Riyadh 11481, Saudi Arabia"},{"name":"Dental Services King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Riyadh 11426, Saudi Arabia"},{"name":"Preventive Dental Science Department, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1002\/lary.27860","article-title":"Evidence of a microbial etiology for sialoliths","volume":"130","author":"Kao","year":"2020","journal-title":"Laryngoscope"},{"key":"ref_2","first-page":"e540","article-title":"Biochemical composition of salivary stones in relation to stone- and patient-related factors","volume":"23","author":"Kraaij","year":"2018","journal-title":"Med. Oral Patol. Oral Cir. Bucal"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/j.tripleo.2004.12.023","article-title":"Lithiasis of minor salivary glands: Current data","volume":"100","author":"Lagha","year":"2005","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endodontology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1016\/j.jds.2021.12.019","article-title":"Minor salivary gland sialolithiasis of the upper lip","volume":"17","author":"Huang","year":"2022","journal-title":"J. Dent. Sci."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.4081\/cp.2019.1119","article-title":"Submandibular sialolithiasis: A series of three case reports with review of literature","volume":"9","author":"Pachisia","year":"2019","journal-title":"Clin. Pract."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"E23","DOI":"10.1038\/sj.bdj.2014.1054","article-title":"Salivary stones: Symptoms, aetiology, biochemical composition and treatment","volume":"217","author":"Kraaij","year":"2014","journal-title":"Br. Dent. J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1017\/S002221511600966X","article-title":"Does saliva composition affect the formation of sialolithiasis?","volume":"131","author":"Wagner","year":"2017","journal-title":"J. Laryngol. Otol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1007\/BF01606428","article-title":"Histochemical and biochemical determination of calcium in salivary glands with particular reference to chronic submandibular sialadenitis","volume":"423","author":"Harrison","year":"1993","journal-title":"Virchows Arch. A Pathol. Anat. Histopathol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2447","DOI":"10.1016\/j.joms.2016.05.011","article-title":"Possible Drug-Associated Sialolithiasis From the Bicarbonate Anhydrase Inhibitor Topiramate: A Case Report and Literature Review","volume":"74","author":"Buhler","year":"2016","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1288\/00005537-198001000-00016","article-title":"The fine surface structure and composition of salivary calculi","volume":"90","author":"Hiraide","year":"1980","journal-title":"Laryngoscope"},{"key":"ref_11","first-page":"33","article-title":"The incidence and composition of salivary stones (sialolithiasis) in Iran: Analysis of 95 cases\u2014A short report","volume":"14","author":"Taher","year":"1989","journal-title":"Singap. Dent. J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1879","DOI":"10.1002\/lary.25377","article-title":"Nearly 3,000 salivary stones: Some clinical and epidemiologic aspects","volume":"125","author":"Sigismund","year":"2015","journal-title":"Laryngoscope"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1975","DOI":"10.1007\/s00405-016-4437-z","article-title":"Incidence of sialolithiasis in Denmark: A nationwide population-based register study","volume":"274","author":"Andersson","year":"2017","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"44","DOI":"10.5125\/jkaoms.2012.38.1.44","article-title":"Clinical, statistical and chemical study of sialolithiasis","volume":"38","author":"Lim","year":"2012","journal-title":"J. Korean Assoc. Oral Maxillofac. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e16153","DOI":"10.1097\/MD.0000000000016153","article-title":"Association between cholelithiasis and sialolithiasis: Two longitudinal follow-up studies","volume":"98","author":"Kim","year":"2019","journal-title":"Medicine"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1007\/s00784-025-06179-7","article-title":"Systemic risk factors contributing to sialolithiasis: A big-data retrospective analysis","volume":"29","author":"Jonas","year":"2025","journal-title":"Clin. Oral Investig."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Schapher, M., Koch, M., Weidner, D., Scholz, M., Wirtz, S., Mahajan, A., Herrmann, I., Singh, J., Knopf, J., and Leppkes, M. (2020). Neutrophil extracellular traps promote the development and growth of human salivary stones. Cells, 9.","DOI":"10.3390\/cells9092139"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1001\/archotol.127.1.66","article-title":"Retrograde theory in sialolithiasis formation","volume":"127","author":"Marchal","year":"2001","journal-title":"Arch. Otolaryngol. Head Neck Surg."},{"key":"ref_19","first-page":"49","article-title":"A case of a salivary calculus containing a limb of a shrimp\u2014The structural analysis","volume":"3","author":"Takeshita","year":"1990","journal-title":"Aichi Gakuin Dent. Sci."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1016\/j.otc.2009.08.012","article-title":"Causes, natural history, and incidence of salivary stones and obstructions","volume":"42","author":"Harrison","year":"2009","journal-title":"Otolaryngol. Clin. N. Am."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1177\/0194599811415489","article-title":"Etiologic factors in sialolithiasis","volume":"145","author":"Huoh","year":"2011","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1016\/j.oooo.2015.01.010","article-title":"Systemic diseases and the risk of developing salivary stones: A case control study","volume":"119","author":"Kraaij","year":"2015","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1016\/j.ijom.2016.02.007","article-title":"Association of serum electrolytes and smoking with salivary gland stone formation","volume":"45","author":"Yiu","year":"2016","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1177\/0022034510382548","article-title":"Five-Year Incidence of Periodontal Disease Is Related to Body Mass Index","volume":"90","author":"Morita","year":"2011","journal-title":"J. Dent. Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1172\/JCI25102","article-title":"Inflammation, stress, and diabetes","volume":"115","author":"Wellen","year":"2005","journal-title":"J. Clin. Investig."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1111\/odi.15095","article-title":"Characteristics of sialolithiasis in Israel, a big-data retrospective study of 5100 cases","volume":"31","author":"Jonas","year":"2025","journal-title":"Oral Dis."},{"key":"ref_27","first-page":"1329","article-title":"Clinico-statistical, morphologic and microstructural analysis of 400 cases of sialolithiasis","volume":"38","author":"Laforgia","year":"1989","journal-title":"Minerva Stomatol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1007\/s001060050476","article-title":"Clinical and diagnostic findings of sialolithiasis","volume":"47","author":"Zenk","year":"1999","journal-title":"HNO"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Wahabi, H., Fayed, A.A., Shata, Z., Esmaeil, S., Alzeidan, R., Saeed, E., Amer, Y., Titi, M., Bahkali, K., and Hneiny, L. (2023). The Impact of Age, Gender, Temporality, and Geographical Region on the Prevalence of Obesity and Overweight in Saudi Arabia: Scope of Evidence. Healthcare, 11.","DOI":"10.3390\/healthcare11081143"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1092905","DOI":"10.3389\/fpubh.2023.1092905","article-title":"National and regional prevalence rates of hypertension in Saudi Arabia: A descriptive analysis using the national survey data","volume":"11","author":"Alenazi","year":"2023","journal-title":"Front. Public Health"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"19","DOI":"10.4103\/0256-4947.75773","article-title":"Prevalence of diabetes mellitus in a Saudi community","volume":"31","author":"Alqurashi","year":"2011","journal-title":"Ann. Saudi Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1186\/1741-7015-9-76","article-title":"Diabetes mellitus type 2 and other chronic non-communicable diseases in the central region, Saudi Arabia (Riyadh cohort 2): A decade of an epidemic","volume":"9","author":"Alokail","year":"2011","journal-title":"BMC Med."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Al Mansour, M.A. (2020). The Prevalence and Risk Factors of Type 2 Diabetes Mellitus (DMT2) in a Semi-Urban Saudi Population. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17010007"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"481","DOI":"10.15537\/smj.2021.42.5.20200676","article-title":"Prevalence and reasons of increased type 2 diabetes in Gulf Cooperation Council Countries","volume":"42","author":"Aljulifi","year":"2021","journal-title":"Saudi Med. J."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1186\/s13690-023-01121-3","article-title":"Patient journey for hypertension and dyslipidemia in Saudi Arabia: Highlighting the evidence gaps","volume":"81","author":"Amir","year":"2023","journal-title":"Arch. Public Health"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1016\/S0030-6665(05)70175-4","article-title":"Sialolithiasis","volume":"32","author":"Williams","year":"1999","journal-title":"Otolaryngol. Clin. N. Am."},{"key":"ref_37","first-page":"30","article-title":"Multiple imputation with multivariate imputation by chained equation (MICE) package","volume":"4","author":"Zhang","year":"2016","journal-title":"Ann. Transl. Med."},{"key":"ref_38","unstructured":"Hammett, J.T., and Walker, C. (2025). Sialolithiasis. StatPearls, StatPearls Publishing."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1","DOI":"10.32868\/rsj.v1i1.22","article-title":"The prevalence of cigarette smoking in Saudi Arabia in 2018","volume":"1","author":"Algabbani","year":"2018","journal-title":"Food Drug Regul. Sci. J."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Qattan, A.M.N., Boachie, M.K., Immurana, M., and Al-Hanawi, M.K. (2021). Socioeconomic Determinants of Smoking in the Kingdom of Saudi Arabia. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18115665"},{"key":"ref_41","unstructured":"Witt, R.L. (2019). Surgery of the Salivary Glands E-Book, Elsevier Health Sciences."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"186","DOI":"10.9734\/jpri\/2021\/v33i56B33944","article-title":"Prevalence of Xerostomia and Associated Systemic Risk Factors in Riyadh, Saudi Arabia: A Cross-sectional Study","volume":"33","author":"Mumtaz","year":"2021","journal-title":"J. Pharm. Res. Int."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"451","DOI":"10.2147\/CCIDE.S337581","article-title":"Xerostomia, Salivary Flow, and Oral Health Status Among Saudi Diabetic Patients: A Comparative Cross-Sectional Study","volume":"13","author":"Altayyar","year":"2021","journal-title":"Clin. Cosmet. Investig. Dent."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2839","DOI":"10.4103\/jfmpc.jfmpc_511_21","article-title":"Renal stone prevalence and risk factors in Jeddah and Riyadh","volume":"11","author":"Alblowi","year":"2022","journal-title":"J. Fam. Med. Prim. Care"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e84","DOI":"10.1017\/jns.2021.81","article-title":"Awareness of dehydration state and fluid intake practice among adults population in the Jazan Region of Saudi Arabia, 2019","volume":"10","author":"Albasheer","year":"2021","journal-title":"J. Nutr. Sci."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1002\/hed.23926","article-title":"Association of sialolithiasis with cholelithiasis: A population-based study","volume":"38","author":"Hung","year":"2016","journal-title":"Head Neck"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Jin, Y.J., Han, Y.E., and Choi, H.G. (2020). The association between sialolithiasis and smoking, alcohol drinking and obesity in Korea: A nested case-control study. BMC Public Health, 20.","DOI":"10.1186\/s12889-020-08674-w"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"bcr2012007480","DOI":"10.1136\/bcr-2012-007480","article-title":"Parotid sialolithiasis","volume":"2012","author":"Moghe","year":"2012","journal-title":"BMJ Case Rep."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/j.jds.2016.02.007","article-title":"Biochemical structure, symptoms, location and treatment of sialoliths","volume":"11","author":"Stelmach","year":"2016","journal-title":"J. Dent. Sci."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"e12757","DOI":"10.1111\/eos.12757","article-title":"Xerostomia and hyposalivation among a 65-yr-old population living in Oslo, Norway","volume":"129","author":"Diep","year":"2021","journal-title":"Eur. J. Oral Sci."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1111\/j.1365-2842.1984.tb00565.x","article-title":"Salivary flow, saliva, pH and buffering capacity in 70-year-old men and women: Correlation to dental health, dryness in the mouth, disease and drug treatment","volume":"11","author":"Landahl","year":"1984","journal-title":"J. Oral Rehabil."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1002\/lary.20008","article-title":"Outcome of minimally invasive management of salivary calculi in 4,691 patients","volume":"119","author":"Iro","year":"2009","journal-title":"Laryngoscope"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"4035","DOI":"10.1038\/s41598-022-25639-8","article-title":"Ageing in Saudi Arabia: New dimensions and intervention strategies","volume":"13","author":"Salam","year":"2023","journal-title":"Sci. Rep."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1093\/oxfordjournals.bmb.a011611","article-title":"Assessing obesity: Classification and epidemiology","volume":"53","author":"Seidell","year":"1997","journal-title":"Br. Med. Bull."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Issrani, R., Reddy, J., Bader, A.K., Albalawi, R.F.H., Alserhani, E.D.M., Alruwaili, D.S.R., Alanazi, G.R.A., Alruwaili, N.S.R., Sghaireen, M.G., and Rao, K. (2023). Exploring an Association between Body Mass Index and Oral Health-A Scoping Review. Diagnostics, 13.","DOI":"10.3390\/diagnostics13050902"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Tsetsos, N., Stavrakas, M., and Garefis, K. (2025). Sialolithiasis. Otolaryngology Study Guide: A Case-Based Approach, Springer Nature Switzerland.","DOI":"10.1007\/978-3-031-77374-7"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1007\/s11906-018-0812-z","article-title":"The Global Epidemic of the Metabolic Syndrome","volume":"20","author":"Saklayen","year":"2018","journal-title":"Curr. Hypertens. Rep."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Dybiec, J., Baran, W., D\u0105bek, B., Fularski, P., M\u0142ynarska, E., Radzioch, E., Rysz, J., and Franczyk, B. (2023). Advances in treatment of dyslipidemia. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms241713288"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.atherosclerosis.2016.07.925","article-title":"Dyslipidaemia in the Middle East: Current status and a call for action","volume":"252","author":"Almahmeed","year":"2016","journal-title":"Atherosclerosis"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1186\/s12902-018-0244-4","article-title":"Prevalence of metabolic syndrome in Saudi Arabia-a cross sectional study","volume":"18","author":"Bawazeer","year":"2018","journal-title":"BMC Endocr. Disord."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Ahmed, A.E., Alsamghan, A., Momenah, M.A., Alqhtani, H.A., Aldawood, N.A., Alshehri, M.A., Ali Alshehri, A.M., Alhag, S.K., Mosaad, Y.O., and Ahmed, H. (2022). Metabolic Syndrome and Cardiometabolic Risk Factors in the Mixed Hypercholesterolemic Populations with Respect to Gender, Age, and Obesity in Asir, Saudi Arabia. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph192214985"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"725","DOI":"10.15537\/smj.2023.44.8.20220724","article-title":"Obesity management in the Saudi population","volume":"44","author":"Aldubikhi","year":"2023","journal-title":"Saudi Med. J."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"e24","DOI":"10.1055\/s-0042-1744167","article-title":"Association of Hyper-Low-Density Lipoprotein and Hypo-High-Density Lipoprotein Cholesterolemia with Low Saliva Flow Rates in Japanese Community-Dwelling Elders","volume":"27","author":"Mizoguchi","year":"2023","journal-title":"Int. Arch. Otorhinolaryngol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"829","DOI":"10.2214\/ajr.175.3.1750829","article-title":"MR imaging of the salivary glands in sicca syndrome: Comparison of lipid profiles and imaging in patients with hyperlipidemia and patients with Sj\u00f6gren\u2019s syndrome","volume":"175","author":"Izumi","year":"2000","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.1016\/j.bjoms.2022.08.005","article-title":"Sialolithiasis: Mineralogical composition, crystalline structure, calculus site, and epidemiological features","volume":"60","year":"2022","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/S0003-9969(02)00211-X","article-title":"Sialolith crystals localized intraglandularly and in the Wharton\u2019s duct of the human submandibular gland: An X-ray diffraction analysis","volume":"48","author":"Teymoortash","year":"2003","journal-title":"Arch. Oral Biol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s12014-023-09402-3","article-title":"Proteomic analysis of sialoliths from calcified, lipid and mixed groups as a source of potential biomarkers of deposit formation in the salivary glands","volume":"20","author":"Bogucka","year":"2023","journal-title":"Clin. Proteom."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1016\/0003-9969(81)90173-4","article-title":"Lipids associated with mineralization of human submandibular gland sialoliths","volume":"26","author":"Boskey","year":"1981","journal-title":"Arch. Oral Biol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1556\/2060.2020.00019","article-title":"Salivary dysfunction caused by medication usage","volume":"107","author":"Einhorn","year":"2020","journal-title":"Physiol. Int."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"549","DOI":"10.4103\/2141-9248.139311","article-title":"Effect of Diuretics on Salivary Flow, Composition and Oral Health Status: A Clinico-biochemical Study","volume":"4","author":"Prasanthi","year":"2014","journal-title":"Ann. Med. Health Sci. Res."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1111\/j.1834-7819.2010.01226.x","article-title":"Asthma and oral health: A review","volume":"55","author":"Thomas","year":"2010","journal-title":"Aust. Dent. J."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1111\/pai.13494","article-title":"Genome-wide association studies of exacerbations in children using long-acting beta2-agonists","volume":"32","author":"Slob","year":"2021","journal-title":"Pediatr. Allergy Immunol."},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Pacheco-Quito, E.-M., Jaramillo, J., Sarmiento-Ordo\u00f1ez, J., and Cuenca-Le\u00f3n, K. (2023). Drugs Prescribed for Asthma and Their Adverse Effects on Dental Health. Dent. J., 11.","DOI":"10.3390\/dj11050113"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"e20200854","DOI":"10.1590\/1678-7757-2020-0854","article-title":"Prevalence of hyposalivation and associated factors in survivors of head and neck cancer treated with radiotherapy","volume":"29","author":"Schulz","year":"2021","journal-title":"J. Appl. Oral Sci."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1007\/s00520-010-0827-8","article-title":"A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: Prevalence, severity and impact on quality of life","volume":"18","author":"Jensen","year":"2010","journal-title":"Support. Care Cancer"},{"key":"ref_76","first-page":"1220","article-title":"Xerostomia, hyposalivation, and oral microbiota in type 2 diabetic patients: A preliminary study","volume":"92","author":"Khovidhunkit","year":"2009","journal-title":"J. Med. Assoc. Thai."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1007\/s00784-011-0543-x","article-title":"Clinical questionnaire study of oral health care and symptoms in diabetic vs. non-diabetic predialysis chronic kidney disease patients","volume":"16","author":"Vesterinen","year":"2012","journal-title":"Clin. Oral Investig."},{"key":"ref_78","first-page":"4372852","article-title":"Xerostomia, Hyposalivation, and Salivary Flow in Diabetes Patients","volume":"2016","author":"Serrano","year":"2016","journal-title":"J. Diabetes Res."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/11\/3795\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:42:33Z","timestamp":1760031753000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/11\/3795"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,28]]},"references-count":78,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["jcm14113795"],"URL":"https:\/\/doi.org\/10.3390\/jcm14113795","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,28]]}}}