Alteración del metabolismo de catecolaminas en el dolor facial atípico: aportes cuantitativos y predictivos a partir de la expresión salival de COMT
DOI:
https://doi.org/10.15517/w2q1r170Palabras clave:
Dolor; Biomarcador; Salud mental; COMT; Saliva.Resumen
El dolor facial atípico (DFA) es un trastorno de dolor orofacial crónico caracterizado por dolor facial persistente e idiopático que afecta significativamente la salud mental y la calidad de vida. La identificación de biomarcadores continúa siendo un desafío. Este estudio evaluó los niveles salivales de COMT en pacientes con DFA y exploró su utilidad diagnóstica mediante enfoques estadísticos y de aprendizaje automático. Se realizó un estudio comparativo transversal con 20 pacientes con DFA y 20 controles sanos emparejados por edad y sexo. Las muestras de saliva no estimulada (8:00-10:00 a.m.) fueron analizadas utilizando un kit ELISA para COMT humano (KRISHGEN Biosystems). Las diferencias entre grupos se evaluaron mediante la prueba t para muestras independientes, y se calcularon el tamaño del efecto, los intervalos de confianza y la potencia estadística. Los pacientes con DFA presentaron niveles salivales de COMT significativamente más bajos (14,20±3,15 ng/mL) en comparación con los controles (20,08±2,39 ng/mL; t(18)=3,03; p=0,0073). El análisis ROC produjo un área bajo la curva (AUC) de 0,86, con una sensibilidad y especificidad del 90 % en un punto de corte de 17,7 ng/mL. La regresión logística confirmó que COMT es un predictor significativo de DFA (β=–1,19; p<0,05). Los niveles salivales de COMT se encuentran marcadamente reducidos en el DFA, lo que refleja alteraciones en el metabolismo de catecolaminas y en la modulación del dolor. Tanto los análisis estadísticos como los de aprendizaje automático confirmaron una excelente capacidad discriminativa, lo que respalda a COMT como un biomarcador prometedor, no invasivo y accesible para el tamizaje y diagnóstico del dolor facial atípico.
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