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Liu Y, Wang C, Zhang P, Fu W, Zhang J, Zhang Z, Mao J, Yang Y, Zou L. Association Between the Frequency of Tooth Brushing and the Risk of Cardiovascular Disease: A Systematic Review and Meta-analysis. Angiology 2024:33197231219836. [PMID: 38179951 DOI: 10.1177/00033197231219836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
Several epidemiological studies suggested that frequency of tooth brushing may be associated with cardiovascular disease (CVD) risk, but the results remain inconclusive. Therefore, the aim of this study was to synthesize frequency of tooth brushing and CVD risk using meta-analysis. Science Direct, PubMed, CINAHL, and OVID were searched through October 15, 2022. The random-effects model was used to quantitatively assess the combined risk estimation. In addition, we performed the sensitivity analysis to evaluate the robustness of the study results by excluding the included studies one by one. A total of 9 cohort studies containing 10 reports with 803,019 individuals were included in the meta-analysis. Pooled results showed that compared with the lowest brushing frequency, the highest brushing frequency (relative risk = 0.85, 95% confidence interval: 0.80-0.90) significantly reduced the risk of cardiovascular disease. There was moderate heterogeneity among included studies (P = .002, I2 = 65.4%). The exclusion of any one study did not materially change the combined risk estimates. Our meta-analysis supported the hypothesis that higher frequency of tooth brushing can reduce the risk of CVD, which may have important implications for conducting research on the prevention strategies of CVD.
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Affiliation(s)
- Yifang Liu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chao Wang
- School of Public Health, Wuhan University, Wuhan, China
| | - Pu Zhang
- Department of Cardiology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Wenning Fu
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jun Zhang
- Department of Endocrinology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Zeyu Zhang
- Institute for Hospital Management of Tsinghua University, Beijing, China
| | - Jing Mao
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yang Yang
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li Zou
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China
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2
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Imamura S, Miyata M, Ogawa M, Oketani N, Hamasaki S, Hirahara N, Ninomiya Y, Ohishi M. Effect of Oral Care on Endothelial Dysfunction in Patients with Acute Coronary Syndrome. Int Heart J 2024; 65:386-394. [PMID: 38825489 DOI: 10.1536/ihj.23-553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/04/2024]
Abstract
Periodontitis is a common chronic infection and is associated with cardiovascular disease. This study evaluated whether basic oral care for periodontal disease could improve endothelial function in patients with acute coronary syndrome (ACS).This study enrolled 54 patients with acute coronary syndrome admitted to Kagoshima City Hospital and who had undergone percutaneous coronary intervention. Flow-mediated endothelium-dependent dilatation (FMD) was measured before discharge (initial FMD) and at 8 months after percutaneous coronary intervention (follow-up FMD). The following periodontal characteristics were measured: periodontal pocket depth (PPD, mm), plaque control record (%), and bleeding on probing (%). All patients received basic oral care instructions from dentists. The oral health condition was generally poor in the participants and there were 24 patients (44.4%) who had severe PPD. Despite the intervention of basic oral care, the periodontal characteristics did not improve during the study period; initial FMD and follow-up FMD did not significantly differ (4.38 ± 2.74% versus 4.56 ± 2.51%, P = 0.562). However, the follow-up FMD was significantly lower in patients with severe PPD (≥ 6.0 mm, n = 24) than in patients without severe PPD (≤ 5.0 mm, n = 30) (FMD: 3.58 ± 1.91% versus 5.37 ± 2.67%, P = 0.007). FMD tended to be worse in patients with severe PPD than in patients without severe PPD (ΔFMD: -0.55 ± 2.12 versus 0.81 ± 2.77 %, P = 0.055). In conclusion, during the use of basic oral care, endothelial function improved in patients without severe PPD, while it worsened in patients with severe PPD.
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Affiliation(s)
| | - Masaaki Miyata
- School of Health Sciences, Faculty of Medicine, Kagoshima University
| | | | | | | | | | - Yuichi Ninomiya
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Mitsuru Ohishi
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
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3
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Kato-Kogoe N, Kamiya K, Sakaguchi S, Omori M, Komori E, Kudo A, Nakamura S, Nakano T, Ueno T, Tamaki J, Hoshiga M. Salivary Microbiota Associated with Peripheral Microvascular Endothelial Dysfunction. J Atheroscler Thromb 2022. [PMID: 36130883 DOI: 10.5551/jat.63681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIMS Oral health is associated with atherosclerotic cardiovascular disease (ACVD). We previously identified the salivary microbiota characteristics of patients with ACVD. However, whether salivary microbiota is characteristic under impaired vascular endothelial function before ACVD onset remains unclear. Therefore, we aimed to evaluate the characteristics of salivary microbiota associated with peripheral microvascular endothelial dysfunction. METHODS We collected saliva samples from 172 community-dwelling elderly individuals without a history of ACVD and performed 16S rRNA metagenomic analysis. We assessed the peripheral microvascular endothelial function using reactive hyperemia index (RHI) and compared the salivary microbiota in the groups with normal (RHI ≥ 2.10), borderline, and abnormal (RHI <1.67) peripheral endothelial function. Furthermore, we applied machine learning techniques to evaluate whether salivary microbiota could discriminate between individuals with normal and abnormal endothelial function. RESULTS The number of operational taxonomic units (OTUs) was higher in the abnormal group than in the normal group (p=0.037), and differences were found in the overall salivary microbiota structure (unweighted UniFrac distances, p=0.038). The linear discriminant analysis (LDA) effect size (LEfSe) algorithm revealed several significantly differentially abundant bacterial genera between the two groups. An Extra Trees classifier model was built to discriminate between groups with normal and abnormal vascular endothelial function based on the microbial composition at the genus level (AUC=0.810). CONCLUSIONS The salivary microbiota in individuals with endothelial dysfunction was distinct from that in individuals with normal endothelial function, indicating that the salivary microbiota may be related to endothelial function.
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Affiliation(s)
- Nahoko Kato-Kogoe
- Department of Dentistry and Oral Surgery, Faculty of Medicine, Osaka Medical and Pharmaceutical University
| | - Kuniyasu Kamiya
- Department of Hygiene and Public Health, Faculty of Medicine, Osaka Medical and Pharmaceutical University
| | - Shoichi Sakaguchi
- Department of Microbiology and Infection Control, Faculty of Medicine, Osaka Medical and Pharmaceutical University
| | - Michi Omori
- Department of Dentistry and Oral Surgery, Faculty of Medicine, Osaka Medical and Pharmaceutical University
| | - Eri Komori
- Department of Dentistry and Oral Surgery, Faculty of Medicine, Osaka Medical and Pharmaceutical University
| | - Asako Kudo
- Department of Hygiene and Public Health, Faculty of Medicine, Osaka Medical and Pharmaceutical University
| | - Shota Nakamura
- Department of Infection Metagenomics, Genome Information Research Center, Research Institute for Microbial Diseases, Osaka University
| | - Takashi Nakano
- Department of Microbiology and Infection Control, Faculty of Medicine, Osaka Medical and Pharmaceutical University
| | - Takaaki Ueno
- Department of Dentistry and Oral Surgery, Faculty of Medicine, Osaka Medical and Pharmaceutical University
| | - Junko Tamaki
- Department of Hygiene and Public Health, Faculty of Medicine, Osaka Medical and Pharmaceutical University
| | - Masaoki Hoshiga
- Department of Cardiology, Faculty of Medicine, Osaka Medical and Pharmaceutical University
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4
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Li Q, Ouyang X, Lin J. The impact of periodontitis on vascular endothelial dysfunction. Front Cell Infect Microbiol 2022; 12:998313. [PMID: 36118034 PMCID: PMC9480849 DOI: 10.3389/fcimb.2022.998313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 08/15/2022] [Indexed: 11/26/2022] Open
Abstract
Periodontitis, an oral inflammatory disease, originates from periodontal microbiota dysbiosis which is associated with the dysregulation of host immunoinflammatory response. This chronic infection is not only harmful to oral health but is also a risk factor for the onset and progress of various vascular diseases, such as hypertension, atherosclerosis, and coronary arterial disease. Vascular endothelial dysfunction is the initial key pathological feature of vascular diseases. Clarifying the association between periodontitis and vascular endothelial dysfunction is undoubtedly a key breakthrough for understanding the potential relationship between periodontitis and vascular diseases. However, there is currently a lack of an updated review of their relationship. Therefore, we aim to focus on the implications of periodontitis in vascular endothelial dysfunction in this review.
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Affiliation(s)
- Qian Li
- Department of Stomatology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xiangying Ouyang
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China
- *Correspondence: Xiangying Ouyang, ; Jiang Lin,
| | - Jiang Lin
- Department of Stomatology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- *Correspondence: Xiangying Ouyang, ; Jiang Lin,
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5
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Zou L, Zhang M, Fu W, Liu Y, Wen J, Lu Z. Meta-analysis on the association between the frequency of tooth brushing and hypertension risk. J Clin Hypertens (Greenwich) 2022; 24:689-697. [PMID: 35641122 PMCID: PMC9180317 DOI: 10.1111/jch.14498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/15/2022] [Accepted: 04/18/2022] [Indexed: 11/29/2022]
Abstract
It is unclear whether the frequency of tooth brushing affects the risk of hypertension; thus, we conducted the first meta-analysis to focus on this topic. In this meta-analysis, we systematically searched the PubMed, Scopus, and Web of Science databases from their inception to October 2021 to identify eligible studies, while reference lists from retrieved review paper were also reviewed. We then conducted a meta-analysis of the highest compared with the lowest tooth brushing frequency, along with a dose-response meta-analysis, to explore this association. Subgroup and sensitivity analyses were conducted to identify the sources of heterogeneity. Publication bias was evaluated using Begg's and Egger's tests. We found eight relevant studies, three cohort and five cross-sectional, involving a total of 274 124 patients. Compared to the highest tooth brushing frequency, the lowest increased the risk of hypertension by 84.0% (OR 1.84; 95% CI, 1.44-2.35). Furthermore, a nonlinear dose-response relationship was observed (P < .05). The exclusion of any studies did not significantly alter the combined risk estimate, and no publication bias was detected. In conclusions, we report that epidemiological evidence supports the hypothesis that a lower frequency of tooth brushing is significantly associated with a higher risk of hypertension. Preventive interventions, such as adopting a good oral health routine, should be encouraged to maintain good general health.
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Affiliation(s)
- Li Zou
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Mingye Zhang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wenning Fu
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Emergency and Trauma, Ministry of Education, College of Emergency and Trauma, Hainan Medical University, Haikou, China
| | - Yifang Liu
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Wen
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zuxun Lu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Yamada S, Komiyama T, Ohi T, Murakami T, Miyoshi Y, Endo K, Hiratsuka T, Hara A, Satoh M, Tatsumi Y, Inoue R, Asayama K, Kikuya M, Hozawa A, Metoki H, Imai Y, Ohkubo T, Hattori Y. Regular dental visits, periodontitis, tooth loss, and atherosclerosis: The Ohasama study. J Periodontal Res 2022; 57:615-622. [PMID: 35388479 PMCID: PMC9321748 DOI: 10.1111/jre.12990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 03/07/2022] [Accepted: 03/23/2022] [Indexed: 11/30/2022]
Abstract
Objective We aimed to explore the association between regular dental visits and atherosclerosis and between periodontitis, number of remaining teeth, and atherosclerosis among community dwellers in Japan. Background Few studies have examined the association between regular dental visits, periodontitis, tooth loss, and atherosclerosis in community dwellers in Japan. Methods The participants of this cross‐sectional study included community dwellers aged ≥55 years and residing in Ohasama. Exposure variables were regular dental visits; periodontitis, defined as radiographic alveolar bone loss (BL); the Centers for Disease Control/American Academy of Periodontology (CDC/AAP) classification; and number of remaining teeth. The primary outcome was atherosclerosis, defined as maximum carotid intima‐media thickness ≥1.1 mm or confirmation of atheromatous plaque. Results Of 602 participants, 117 had atherosclerosis. In the multivariate model, compared to those with regular dental visits, the odds ratio (OR) (95% confidence intervals [CIs]) of atherosclerosis among those with the absence of regular dental visits was 2.16 (1.03–4.49). Regarding BL‐max, compared with those in the first quartile, ORs (95% CIs) of those in the second, third, and fourth quartiles were 1.15 (0.65–2.30), 0.65 (0.32–1.35), and 1.57 (0.81–3.01), respectively. Regarding CDC/AAP classification, compared to those with no or mild periodontitis, ORs (95% CIs) for those with moderate and severe periodontitis were 2.48 (0.61–10.1) and 4.26 (1.01–17.5), respectively. Regarding the number of remaining teeth, compared to those with ≥20 teeth, ORs (95%CIs) for those with 10–19 and 1–9 teeth were 1.77 (1.004–3.12) and 0.96 (0.52–1.80), respectively. Conclusion The absence of regular dental visits and presence of periodontitis are associated with atherosclerosis among community dwellers in Japan.
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Affiliation(s)
- Sho Yamada
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Takamasa Komiyama
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Takashi Ohi
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan.,Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Japan
| | - Takahisa Murakami
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan.,Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Yoshitada Miyoshi
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Kosei Endo
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Takako Hiratsuka
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Azusa Hara
- Division of Drug Development and Regulatory Science, Faculty of Pharmacy, Keio University, Tokyo, Japan
| | - Michihiro Satoh
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Yukako Tatsumi
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Ryusuke Inoue
- Department of Medical Information Technology Center, Tohoku University Hospital, Sendai, Japan
| | - Kei Asayama
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.,Tohoku Institute for Management of Blood Pressure, Sendai, Japan
| | - Masahiro Kikuya
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Atsushi Hozawa
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Hirohito Metoki
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan.,Tohoku Institute for Management of Blood Pressure, Sendai, Japan
| | - Yutaka Imai
- Tohoku Institute for Management of Blood Pressure, Sendai, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.,Tohoku Institute for Management of Blood Pressure, Sendai, Japan
| | - Yoshinori Hattori
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
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7
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Wang Y, Jiang Y, Chen Y, Yu L, Zhou J, Wang N, Liu T, Fu C. Associations of oral hygiene with incident hypertension and type 2 diabetes mellitus: A population based cohort study in Southwest China. J Clin Hypertens (Greenwich) 2022; 24:483-492. [PMID: 35255181 PMCID: PMC8989750 DOI: 10.1111/jch.14451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 11/01/2022]
Abstract
Oral health has been previously reported to be related with cardiovascular diseases (CVD). This study aimed to evaluate whether oral hygiene could reduce the risk of incident hypertension and type 2 diabetes mellitus (T2DM) in a population-based cohort. A total of 9280 people aged 18 years or above in Guizhou province were recruited from November 20th, 2010 to December 19th, 2012. Sociodemographic characteristics, lifestyles, anthropometric measurements, oral health status and care were collected by trained interviewers. The occurrences of hypertension and T2DM were ascertained until 2020. Cox proportional hazard models were used to evaluate the associations between oral hygiene and the occurrence of hypertension and T2DM, respectively. Compared with almost no tooth brushing, tooth brushing at least twice a day was associated with a 45% reduction (HR: .55; 95% CI: .42-.73) in hypertension events and reduced diabetes risk by 35% (HR: .65; 95% CI: .45-.94). For hypertension, those associations tended to be more pronounced in participants with Han ethic, or living in urban area, while those aged less than 60 or without baseline hypertension were more likely to have T2DM when they brush teeth less than twice a day. Frequent tooth brushing was associated with reduced risks of incident hypertension and T2DM. Tooth brushing at least twice a day may prevent future hypertension and T2DM events.
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Affiliation(s)
- Yiying Wang
- Guizhou Province Centre for Disease Control and Prevention, Guizhou Province, Guiyang, China
| | - Yizhou Jiang
- School of Public Health, Key Laboratory of Public Health Safety, Fudan University, Shanghai, China.,NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Yun Chen
- School of Public Health, Key Laboratory of Public Health Safety, Fudan University, Shanghai, China.,NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Lisha Yu
- Guizhou Province Centre for Disease Control and Prevention, Guizhou Province, Guiyang, China
| | - Jie Zhou
- Guizhou Province Centre for Disease Control and Prevention, Guizhou Province, Guiyang, China
| | - Na Wang
- School of Public Health, Key Laboratory of Public Health Safety, Fudan University, Shanghai, China.,NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Tao Liu
- Guizhou Province Centre for Disease Control and Prevention, Guizhou Province, Guiyang, China
| | - Chaowei Fu
- School of Public Health, Key Laboratory of Public Health Safety, Fudan University, Shanghai, China.,NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
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8
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Matsui S, Maruhashi T, Kishimoto S, Kajikawa M, Yusoff FM, Nakashima A, Taguchi A, Higashi Y. Poor tooth brushing behavior is associated with high risk of cardiovascular events: A prospective observational study. Int J Cardiol 2021; 350:111-117. [PMID: 34979151 DOI: 10.1016/j.ijcard.2021.12.056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 12/06/2021] [Accepted: 12/29/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUNDS Poor oral care is associated with cardiovascular disease. The aim of this study was to determine the impact of tooth brushing behavior on the incidences of future cardiovascular events in a general population including patients with cardiovascular disease. METHODS This was a prospective observational study which included 692 participants (437 men and 255 women, mean age, 63 ± 16 years). The participants were divided into three groups according to the frequency and duration of tooth brushing: low frequency and short duration group (<twice/day and <2 min/procedure), low frequency or short duration group (<twice/day or <2 min/procedure), and non-low frequency and non-short duration group (≥twice/day and ≥2 min/procedure). We assessed the associations of tooth brushing behavior with major adverse cardiovascular events (MACEs) including death from cardiovascular causes, acute myocardial infarction, hospitalization for heart failure, and stroke. RESULTS During a median follow-up period of 28.5 (15.4-35.1) months, 32 events occurred (10 deaths from cardiovascular causes, one acute myocardial infarction, 13 hospitalizations for heart failure, and eight strokes). Kaplan-Meier curves for MACEs among the groups were significantly different (P = 0.001). After adjustment for cardiovascular risk factors, the combination of low frequency and short duration of tooth brushing was significantly associated with high incidences of MACEs compared with the incidences of MACEs for the combination of non-low frequency and non-short duration of tooth brushing (hazard ratio, 3.06; 95% confidence interval, 1.24-7.63; P = 0.02). CONCLUSIONS The combination of decreased frequency and duration of tooth brushing is associated with a higher risk of cardiovascular events. CLINICAL TRIAL REGISTRATION INFORMATION URL for Clinical Trial: http://UMIN; Registration Number for Clinical Trial: UMIN000003409.
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Affiliation(s)
- Shogo Matsui
- Department of Cardiovascular Medicine, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tatsuya Maruhashi
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Shinji Kishimoto
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Masato Kajikawa
- Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
| | - Farina Mohamad Yusoff
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Ayumu Nakashima
- Department of Stem Cell Biology and Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Akira Taguchi
- Department of Oral and Maxillofacial Radiology, Matsumoto Dental University, Shiojiri, Japan
| | - Yukihito Higashi
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan; Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan.
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9
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Poor oral hygiene and dental caries predict high mortality rate in hemodialysis: a 3-year cohort study. Sci Rep 2020; 10:21872. [PMID: 33318507 PMCID: PMC7736314 DOI: 10.1038/s41598-020-78724-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 11/30/2020] [Indexed: 12/20/2022] Open
Abstract
The aim of this study was to investigate the impact of oral hygiene, periodontal diseases, and dental caries on all-cause mortality in hemodialysis. This prospective cohort study included 266 patients with end-stage renal disease who were undergoing hemodialysis. Medical interviews, blood biochemical tests, and comprehensive dental examinations including periodontal pocket examination on all teeth and dental plaque accumulation by debris index-simplified (DI-S), were performed. Survival rates were assessed at a 3-year follow-up. Overall, 207 patients were included in the longitudinal analysis, and 38 subjects died during the follow-up period. Cox proportional hazards analysis of the multivariate model demonstrated that the highest tertile of DI-S had a significantly higher risk of all-cause mortality than the lowest two tertiles after adjustment for age, sex, smoking habit, body mass index, diabetes, prior cardiovascular disease, hemodialysis vintage, high sensitivity C-reactive protein, albumin, and number of remaining teeth (hazard ratio, 3.04; 95% confidence interval, 1.50–6.17; p = 0.002). Moreover, the number of decayed teeth significantly increased the hazard ratio to 1.21 (95% confidence interval, 1.06.1.37; p = 0.003). This study suggests that accumulated dental plaque and untreated decay, but not periodontal disease, may be independently associated with all-cause mortality in patients undergoing hemodialysis.
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10
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Fujitani T, Aoyama N, Hirata F, Minabe M. Association between periodontitis and vascular endothelial function using noninvasive medical device-A pilot study. Clin Exp Dent Res 2020; 6:576-582. [PMID: 32737946 PMCID: PMC7545230 DOI: 10.1002/cre2.312] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/07/2020] [Accepted: 07/10/2020] [Indexed: 12/15/2022] Open
Abstract
The present study aimed to assess the relationship between periodontal condition and endothelial function using a noninvasive device. Many recent studies have reported associations between periodontitis and cardiovascular diseases. Endothelial dysfunction is the first step of atherosclerosis, but information on the association between periodontal disease and endothelial dysfunction remains limited. Thirty‐three subjects were recruited from among patients at a private medical clinic. We examined vascular endothelial function using a noninvasive medical device and periodontal measurements including probing pocket depth, attachment level, tooth mobility, and oral cleaning condition. Subjects were divided into two groups according to endothelial function score. Tooth mobility and number of lost teeth were increased in the group with endothelial dysfunction. A greater frequency of elderly subjects and altered hemoglobin A1c levels were seen in the endothelial dysfunction group. On multiple logistic regression analysis, increased tooth mobility was independently associated with endothelial dysfunction. Increased tooth mobility, a major periodontal parameter, appears related to endothelial dysfunction.
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Affiliation(s)
- Takahito Fujitani
- Division of Periodontology, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan
| | - Norio Aoyama
- Division of Periodontology, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan
| | | | - Masato Minabe
- Division of Periodontology, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan
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11
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Yokoyama H, Yamamoto T, Tanaka M, Kudo C, Hidaka K, Kuribayashi N, Minabe M. Albuminuria, C-reactive protein, and socioeconomic factors are associated with periodontal status in subjects with type 2 diabetes. Diabetol Int 2019; 10:250-259. [PMID: 31592401 DOI: 10.1007/s13340-018-0388-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 12/02/2018] [Indexed: 01/14/2023]
Abstract
Diabetes and periodontitis may increase risk of cardiovascular disease. Whether albuminuria, C-reactive protein (CRP), and socioeconomic factors, known as cardiovascular risks in subjects with poorly controlled diabetes, are independently associated with periodontal status in well-controlled diabetes remains to be elucidated. In 503 subjects with type 2 diabetes, the cross-sectional associations of clinical and socioeconomic factors with periodontal parameters were investigated. Periodontal parameters on all teeth included the probing pocket depth at 6 sites per tooth, bleeding on probing, the plaque score, tooth mobility, and the number of teeth. The subjects had a mean HbA1c value of 6.85% and a median CRP value of 0.06 mg/dL, and 27.9% of the subjects had albuminuria. Albuminuria and CRP values had significant associations with several periodontal parameters, whereas other variables including HbA1c did not. Subjects with albuminuria had significantly higher HbA1c, CRP, and % sites of pocket depth ≥ 4 mm than subjects with normoalbuminuria; additionally, those with high CRP (≥ median) had significantly higher body mass index, HbA1c, % sites of pocket depth ≥ 4 mm, and plaque score than those with low CRP. In multiple linear regression analysis, albuminuria, CRP, education, smoking, and dental attendance exhibited significant associations with periodontal parameters, independent of the effect of age, sex, body mass index, and diabetes therapy. Albuminuria, CRP, education, smoking, and dental attendance were independently associated with periodontal parameters even in subjects with a mean of HbA1c of 6.85%, implying the importance of these factors for the prevention of cardiovascular disease.
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Affiliation(s)
- Hiroki Yokoyama
- Jiyugaoka Medical Clinic, Internal Medicine, West 6, South 6-4-3, Obihiro, 080-0016 Japan
| | - Tatsuo Yamamoto
- 2Division of Dental Sociology, Department of Oral Science, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, 238-8580 Japan
| | - Michio Tanaka
- 2Division of Dental Sociology, Department of Oral Science, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, 238-8580 Japan
| | - Chieko Kudo
- 3Division of Periodontology, Department of Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, 238-8580 Japan
| | - Koichi Hidaka
- 3Division of Periodontology, Department of Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, 238-8580 Japan
| | | | - Masato Minabe
- 3Division of Periodontology, Department of Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, 238-8580 Japan
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12
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Matsui S, Kajikawa M, Maruhashi T, Iwamoto Y, Iwamoto A, Oda N, Kishimoto S, Hidaka T, Kihara Y, Chayama K, Goto C, Aibara Y, Nakashima A, Noma K, Taguchi A, Higashi Y. Decreased frequency and duration of tooth brushing is a risk factor for endothelial dysfunction. Int J Cardiol 2017; 241:30-34. [PMID: 28341376 DOI: 10.1016/j.ijcard.2017.03.049] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 03/01/2017] [Accepted: 03/09/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Periodontal disease is associated with endothelial dysfunction, leading to cardiovascular disease. The effect of detailed tooth brushing behavior, not only frequency but also duration of tooth brushing, on endothelial function is unclear. The purpose of this study was to evaluate the relationships of detailed methods of tooth brushing with vascular function. METHODS We evaluated flow-mediated vasodilation (FMD), nitroglycerine-induced vasodilation, and frequency and duration of tooth brushing in 896 subjects. We divided the subjects into three groups according to the frequency and duration of tooth brushing: low frequency and short duration group (<twice/day and <2min/procedure), low frequency or short duration group (<twice/day or <2min/procedure), non-low frequency and non-short duration group (≥twice/day and ≥2min/procedure). RESULTS FMD in the low frequency and short duration group was significantly lower than FMD in the low frequency or short duration group and FMD in the non-low frequency and non-short duration group [3.1 (2.7)% vs. 4.2 (3.1)% and 4.7 (3.1)%, P=0.001 and <0.001, respectively]. Nitroglycerine-induced vasodilation was similar in the three groups. Using the non-low frequency and non-short duration group as the reference, the low frequency and short duration of tooth brushing group was significantly associated with an increased odds ratio of a low FMD tertile after adjustment for conventional risk factors (OR: 2.25, 95% CI: 1.39-3.59; P<0.001). CONCLUSIONS These findings suggest that low frequency and short duration of tooth brushing are associated with endothelial dysfunction. CLINICAL TRIAL REGISTRATION INFORMATION URL for clinical trial: http://UMIN; registration number for clinical trial: UMIN000003409.
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Affiliation(s)
- Shogo Matsui
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
| | - Masato Kajikawa
- Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
| | - Tatsuya Maruhashi
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
| | - Yumiko Iwamoto
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
| | - Akimichi Iwamoto
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
| | - Nozomu Oda
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
| | - Shinji Kishimoto
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
| | - Takayuki Hidaka
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
| | - Yasuki Kihara
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
| | - Kazuaki Chayama
- Department of Gastroenterology and Metabolism, Institute of Biomedical and Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University Hiroshima, Japan
| | - Chikara Goto
- Hiroshima International University, Hiroshima, Japan
| | - Yoshiki Aibara
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Ayumu Nakashima
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Kensuke Noma
- Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan; Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Akira Taguchi
- Department of Oral and Maxillofacial Radiology, Matsumoto Dental University, Shiojiri, Japan
| | - Yukihito Higashi
- Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan; Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.
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13
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Kuwabara M, Motoki Y, Sato H, Fujii M, Ichiura K, Kuwabara K, Nakamura Y. Low frequency of toothbrushing practices is an independent risk factor for diabetes mellitus in male and dyslipidemia in female: A large-scale, 5-year cohort study in Japan. J Cardiol 2016; 70:107-112. [PMID: 27863909 DOI: 10.1016/j.jjcc.2016.10.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 09/23/2016] [Accepted: 10/11/2016] [Indexed: 12/29/2022]
Abstract
BACKGROUND We previously reported the association between toothbrushing practices and diabetes mellitus (DM) and dyslipidemia (DL) in a cross-sectional study. This study was conducted to clarify whether low frequency of toothbrushing practices is an independent risk factor for DM and DL using a follow-up design. METHODS This study was a 5-year retrospective cohort study at St. Luke's International Hospital, Tokyo, Japan. We analyzed study subjects between 30 and 85 years old in 2004, who underwent annual medical examination both in 2004 and 2009. We compared the cumulative incidences of developing DM, DL, hypertension (HT), and hyperuricemia (HUA) between 2004 and 2009 among 3 groups: toothbrushing practices 'after every meal,' 'at least once a day,' and 'less than once a day'. Furthermore, we analyzed odds ratios (ORs) of risk for developing DM and DL by sex after making adjustments for age, obesity, DM, DL, HT, and HUA between two groups: 'after every meal' and 'not after every meal.' RESULTS The number of study subjects was 13,070. Of 13,070 study subjects, 575 had DM, 5118 had DL, 2599 had HT, and 1908 had HUA in 2004. We excluded the subjects with each disease in 2004. The cumulative incidences (rates) of DM, DL, HT, and HUA between 2004 and 2009 were 318 (2.5%), 1454 (18.3%), 1108 (10.6%), and 489 (4.4%), respectively. Toothbrushing practices 'not after every meal' was a significant risk factor for developing DM in male [OR: 1.43; 95% confidence interval (CI), 1.040-1.970] and developing DL in female (OR: 1.18; 95% CI, 1.004-1.383) compared with toothbrushing practices 'after every meal.' CONCLUSION Toothbrushing practices 'after every meal' prevented developing DM in males and DL in females significantly. Toothbrushing practices may be beneficial to reduce developing risk factors for cardiovascular disease.
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Affiliation(s)
- Masanari Kuwabara
- Department of Cardiology, Toranomon Hospital, Tokyo, Japan; Department of Cardiology, St. Luke's International Hospital, Tokyo, Japan; Department of Public Health, Jichi Medical University, Shimotsuke, Japan; School of Medicine, University of Colorado Denver, Aurora, United States.
| | - Yoko Motoki
- Department of Obstetrics, Gynecology and Molecular Reproductive Science, Yokohama City University, Yokohama, Japan
| | - Hiroki Sato
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan
| | - Mizue Fujii
- School of Nursing, Sapporo City University, Sapporo, Japan
| | - Kayoko Ichiura
- Department of Clinical Nursing, Shiga University of Medical Science, Shiga, Japan
| | | | - Yosikazu Nakamura
- Department of Public Health, Jichi Medical University, Shimotsuke, Japan
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14
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Kajikawa M, Maruhashi T, Matsumoto T, Iwamoto Y, Iwamoto A, Oda N, Kishimoto S, Matsui S, Aibara Y, Hidaka T, Kihara Y, Chayama K, Goto C, Noma K, Nakashima A, Tomiyama H, Takase B, Yamashina A, Higashi Y. Relationship between serum triglyceride levels and endothelial function in a large community-based study. Atherosclerosis 2016; 249:70-5. [DOI: 10.1016/j.atherosclerosis.2016.03.035] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 03/08/2016] [Accepted: 03/30/2016] [Indexed: 12/31/2022]
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15
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Oyama JI, Nagatomo D, Yoshioka G, Yamasaki A, Kodama K, Sato M, Komoda H, Nishikido T, Shiraki A, Node K. The relationship between neutrophil to lymphocyte ratio, endothelial function, and severity in patients with obstructive sleep apnea. J Cardiol 2016; 67:295-302. [DOI: 10.1016/j.jjcc.2015.06.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 05/28/2015] [Accepted: 06/17/2015] [Indexed: 01/04/2023]
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16
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Porto AN, Cortelli SC, Borges AH, Matos FZ, Aquino DR, Miranda TB, Oliveira Costa F, Aranha AF, Cortelli JR. Oral and endotracheal tubes colonization by periodontal bacteria: a case-control ICU study. Eur J Clin Microbiol Infect Dis 2016; 35:343-51. [PMID: 26810057 DOI: 10.1007/s10096-015-2518-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 10/30/2015] [Indexed: 10/22/2022]
Abstract
Periodontal infection is a possible risk factor for respiratory disorders; however, no studies have assessed the colonization of periodontal pathogens in endotracheal tubes (ET). This case-control study analyzed whether periodontal pathogens are able to colonize ET of dentate and edentulous patients in intensive care units (ICU) and whether oral and ET periodontal pathogen profiles have any correlation between these patients. We selected 18 dentate and 18 edentulous patients from 78 eligible ICU patients. Oral clinical examination including probing depth, clinical attachment level, gingival index , and plaque index was performed by a single examiner, followed by oral and ET sampling and processing by quantitative polymerase chain reaction (total bacterial load, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Tannerella forsythia). Data were statistically analyzed by Mann-Whitney U, two-way analysis of variance (p < 0.05). Among dentate, there was no correlation between clinical parameters and ET bacterial levels. Both dentate and edentulous patients showed similar ET bacterial levels. Dentate patients showed no correlation between oral and ET bacterial levels, while edentulous patients showed positive correlations between oral and ET levels of A. actinomycetemcomitans, P. gingivalis, and T. forsythia. Periodontal pathogens can colonize ET and the oral cavity of ICU patients. Periodontal pathogen profiles tend to be similar between dentate and edentulous ICU patients. In ICU patients, oral cavity represents a source of ET contamination. Although accompanied by higher oral bacterial levels, teeth do not seem to influence ET bacterial profiles.
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Affiliation(s)
- A N Porto
- Dental School, University of Cuiaba, Avenida Beira Rio, Cuiabá, Mato Grosso, 78000, Brazil.
| | - S C Cortelli
- Nucleus of Periodontal Research, Dental School, University of Taubate, São Paulo, Brazil
| | - A H Borges
- Dental School, University of Cuiaba, Avenida Beira Rio, Cuiabá, Mato Grosso, 78000, Brazil
| | - F Z Matos
- Dental School, University of Cuiaba, Avenida Beira Rio, Cuiabá, Mato Grosso, 78000, Brazil
| | - D R Aquino
- Nucleus of Periodontal Research, Dental School, University of Taubate, São Paulo, Brazil
| | - T B Miranda
- Nucleus of Periodontal Research, Dental School, University of Taubate, São Paulo, Brazil
| | - F Oliveira Costa
- Periodontal Department, Dental School, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - A F Aranha
- Dental School, University of Cuiaba, Avenida Beira Rio, Cuiabá, Mato Grosso, 78000, Brazil
| | - J R Cortelli
- Nucleus of Periodontal Research, Dental School, University of Taubate, São Paulo, Brazil
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17
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Kuwabara M, Motoki Y, Ichiura K, Fujii M, Inomata C, Sato H, Morisawa T, Morita Y, Kuwabara K, Nakamura Y. Association between toothbrushing and risk factors for cardiovascular disease: a large-scale, cross-sectional Japanese study. BMJ Open 2016; 6:e009870. [PMID: 26769787 PMCID: PMC4735199 DOI: 10.1136/bmjopen-2015-009870] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVES To clarify the association between toothbrushing and risk factors for cardiovascular disease--namely, hypertension (HT), diabetes mellitus (DM), dyslipidaemia (DL), hyperuricaemia (HUA) and chronic kidney disease (CKD). DESIGN A large-scale, single-centre, cross-sectional study. SETTING St Luke's International Hospital, Center for Preventive Medicine, Tokyo, Japan, between January 2004 and June 2010. PARTICIPANTS This study examined the toothbrushing practices of 85,866 individuals according to the 3-category frequency criterion: 'after every meal', 'at least once a day' and 'less than once a day'. The ORs by frequency were calculated for the prevalences of HT, DM, DL, HUA and CKD according to binominal logistic regression analyses adjusted for age, gender, body mass index and lifestyle habits--smoking, drinking, walk time and sleep time. RESULTS The prevalences of the risk factors were as follows: HT ('after every meal': 13.3%, 'at least once a day': 17.9% and 'less than once a day': 31.0%), DM (3.1%, 5.3% and 17.4%, respectively), DL (29.0%, 42.1% and 60.3%, respectively), HUA (8.6%, 17.5% and 27.2%, respectively) and CKD (3.8%, 3.1% and 8.3%, respectively). The prevalences were significantly higher in the 'less than once a day' group than in the 'after every meal' group for DM (OR=2.03; 95% CI 1.29 to 3.21) and DL (OR=1.50; 95% CI 1.06 to 2.14), but not for HT, HUA and CKD. CONCLUSIONS Even taking into account lifestyle habits, a lower frequency of toothbrushing was associated with high prevalences of DM and DL. Toothbrushing practices may be beneficial for oral health improvement and also for prevention of certain systemic diseases.
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Affiliation(s)
- Masanari Kuwabara
- Department of Cardiology, Toranomon Hospital, Tokyo, Japan
- Department of Cardiology, St Luke's International Hospital, Tokyo, Japan
- Department of Public Health, Jichi Medical University, Shimotsuke, Japan
| | - Yoko Motoki
- Department of Obstetrics, Gynecology and Molecular Reproductive Science, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kayoko Ichiura
- Department of Clinical Nursing, Shiga University of Medical Science, Otsu, Japan
| | - Mizue Fujii
- School of Nursing, Sapporo City University, Sapporo, Japan
| | - Chisato Inomata
- Graduate School of Dentistry, Osaka University, Osaka, Japan
| | - Hiroki Sato
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan
| | - Taichiro Morisawa
- Department of Internal Medicine and Cardiology, Tama-Nagayama Hospital, Nippon Medical School, Tokyo, Japan
| | - Yoshinori Morita
- Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Shimotsuke, Japan
| | | | - Yosikazu Nakamura
- Department of Public Health, Jichi Medical University, Shimotsuke, Japan
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18
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Tomioka K, Okamoto N, Kurumatani N, Hosoi H. Association of Psychosocial Conditions, Oral Health, and Dietary Variety with Intellectual Activity in Older Community-Dwelling Japanese Adults. PLoS One 2015; 10:e0137656. [PMID: 26360380 PMCID: PMC4567331 DOI: 10.1371/journal.pone.0137656] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 08/19/2015] [Indexed: 11/18/2022] Open
Abstract
Background This study examined the factors related to intellectual activity in community-dwelling elderly persons. Methods Self-administered questionnaires mailed to all people aged ≥65 years in a dormitory suburb in Japan (n = 15,210). The response rate was 72.2%. Analytical subjects (n = 8,910) were those who lived independently and completely answered questions about independent and dependent variables and covariates. Independent variables included psychosocial conditions (i.e., social activities, hobbies, and a sense that life is worth living (ikigai)), oral health (i.e., dental health behaviors and oral function evaluated by chewing difficulties, swallowing difficulties, and oral dryness), and dietary variety measured using the dietary variety score (DVS). A dependent variable was intellectual activity measured using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Covariates included age, gender, family structure, pensions, body mass index, alcohol, smoking, medical history, self-rated health, medications, cognitive function, depression, and falling. Logistic regression was used to estimate the odds ratio (OR) for poor intellectual activity. Results Poor intellectual activity was reported by 28.9% of the study population. After adjustment for covariates and independent variables, poor intellectual activity was significantly associated with nonparticipation in social activities (OR = 1.90, 95%CI = 1.61–2.24), having neither hobbies nor ikigai (3.13, 2.55–3.84), having neither regular dental visits nor daily brushing (1.70, 1.35–2.14), the poorest oral function (1.61, 1.31–1.98), and the lowest DVS quartile (1.96, 1.70–2.26). Conclusion These results indicate that psychosocial conditions, oral health, and dietary variety are independently associated with intellectual activity in elderly persons. The factors identified in this study may be used in community health programs for maintaining the intellectual activity ability of the elderly.
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Affiliation(s)
- Kimiko Tomioka
- Nara Prefectural Health Research Center, Nara Medical University, Kashihara, Nara, Japan
- * E-mail:
| | - Nozomi Okamoto
- Department of Community Health and Epidemiology, Nara Medical University, Kashihara, Nara, Japan
| | - Norio Kurumatani
- Nara Prefectural Health Research Center, Nara Medical University, Kashihara, Nara, Japan
- Department of Community Health and Epidemiology, Nara Medical University, Kashihara, Nara, Japan
| | - Hiroshi Hosoi
- Nara Prefectural Health Research Center, Nara Medical University, Kashihara, Nara, Japan
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19
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Dietary Research to Reduce Children's Oral Health Disparities: An Exploratory Cross-Sectional Analysis of Socioeconomic Status, Food Insecurity, and Fast-Food Consumption. J Acad Nutr Diet 2015; 115:1599-604. [PMID: 25840937 DOI: 10.1016/j.jand.2015.02.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 02/04/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Tooth decay is the most common childhood disease and it disproportionately affects low-income children. The dietary risk factors associated with socioeconomic status (SES), such as food insecurity and fast-food consumption, are poorly understood. OBJECTIVE To better understand how upstream social factors are related to dietary behaviors by testing the hypothesis that food insecurity mediates the SES-fast-food consumption relationship. DESIGN A 36-item survey was administered to caregivers of children younger than age 18 years (n=212). The predictor variable was SES, measured by whether the child was insured by Medicaid (no/yes). Food insecurity, the potential dietary mediator, was measured using the six-item US Department of Agriculture Household Food Security Survey (food secure/food insecure without hunger/food insecure with hunger). The outcome variable was whether the household reported eating at a fast-food restaurant ≥2 times a week (no/yes). We used logistic structural equation and mediation models to test our hypothesis. RESULTS About 63% of children were classified as low SES. Thirty percent of caregivers reported food insecurity (with or without hunger) and 18.6% of households consumed fast food ≥2 times per week. Lower SES was significantly associated with food insecurity (odds ratio [OR] 3.03, 95% CI 1.51 to 6.04; P=0.002), but SES was not related to fast-food consumption (OR 1.94, 95% CI 0.86 to 4.36; P=0.11). Food insecurity was not associated with fast-food consumption (OR 1.76, 95% CI 0.86 to 3.62; P=0.12). The mediation analyses suggest food insecurity does not mediate the relationship between SES and fast-food consumption. However, there are important potential differences in fast-food consumption by SES and food insecurity status. CONCLUSIONS Future dietary research focusing on tooth decay prevention in vulnerable children may need to account for the differential effects of SES on food insecurity and dietary behaviors like fast-food consumption. Studies are needed to further elucidate the mechanisms linking SES, dietary behaviors, and tooth decay in children.
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20
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Higashi Y. Assessment of endothelial function. History, methodological aspects, and clinical perspectives. Int Heart J 2015; 56:125-34. [PMID: 25740586 DOI: 10.1536/ihj.14-385] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In 1986, endothelial function was measured for the first time in patients with atherosclerotic coronary arteries. Since then, several methods for assessment of endothelial function, such as endothelium-dependent vasodilation induced by intra-arterial infusion of vasoactive agents using coronary angiography, Doppler flow guide wire, mercury-filled Silastic strain-gauge plethysmography, flow-mediated vasodilation, reactive hyperemia-peripheral arterial tonometry, and vascular response using an oscillometric method have been performed in humans. This review focuses on the assessment of endothelial function, including measurement history, methodological issues, and clinical perspectives.
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Affiliation(s)
- Yukihito Higashi
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University; Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
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21
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Kajikawa M, Nakashima A, Fujimura N, Maruhashi T, Iwamoto Y, Iwamoto A, Matsumoto T, Oda N, Hidaka T, Kihara Y, Chayama K, Goto C, Aibara Y, Noma K, Takeuchi M, Matsui T, Yamagishi SI, Higashi Y. Ratio of serum levels of AGEs to soluble form of RAGE is a predictor of endothelial function. Diabetes Care 2015; 38:119-25. [PMID: 25336748 DOI: 10.2337/dc14-1435] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Advanced glycation end products (AGEs) and their specific receptor, the receptor for AGEs (RAGE), play an important role in atherosclerosis. Recently, a soluble form of RAGE (sRAGE) has been identified in human serum. However, the role of sRAGE in cardiovascular disease is still controversial. There is no information on the association between simultaneous measurements of AGEs and sRAGE and vascular function. In this study, we evaluated the associations between serum levels of AGEs and sRAGE, ratio of AGEs to sRAGE, and vascular function. RESEARCH DESIGN AND METHODS We measured serum levels of AGEs and sRAGE and assessed vascular function by measurement of flow-mediated vasodilation (FMD) and nitroglycerine-induced vasodilation in 110 subjects who underwent health examinations. Multivariate regression analyses were performed to identify factors associated with vascular function. RESULTS Univariate regression analysis revealed that FMD correlated with age, BMI, systolic blood pressure, diastolic blood pressure, heart rate, triglycerides, HDL cholesterol, glucose, smoking pack-years, nitroglycerine-induced vasodilation, serum levels of AGEs and sRAGE, and ratio of AGEs to sRAGE. Multivariate analysis revealed that the ratio of AGEs to sRAGE remained an independent predictor of FMD, while serum level of AGEs alone or sRAGE alone was not associated with FMD. CONCLUSIONS These findings suggest that sRAGE may have a counterregulatory mechanism that is activated to counteract the vasotoxic effect of the AGE-RAGE axis. The ratio of AGEs to sRAGE may be a new chemical biomarker of endothelial function.
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Affiliation(s)
- Masato Kajikawa
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Ayumu Nakashima
- Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
| | | | - Tatsuya Maruhashi
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yumiko Iwamoto
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Akimichi Iwamoto
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takeshi Matsumoto
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Nozomu Oda
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takayuki Hidaka
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yasuki Kihara
- Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kazuaki Chayama
- Department of Gastroenterology and Metabolism, Institute of Biomedical and Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Chikara Goto
- Hiroshima International University, Hiroshima, Japan
| | - Yoshiki Aibara
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Kensuke Noma
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Masayoshi Takeuchi
- Department of Advanced Medicine, Medical Research Institute, Kanazawa Medical University, Ishikawa, Japan
| | - Takanori Matsui
- Department of Pathophysiology and Therapeutics of Diabetic Vascular Complications, Kurume University School of Medicine, Kurume, Japan
| | - Sho-Ichi Yamagishi
- Department of Pathophysiology and Therapeutics of Diabetic Vascular Complications, Kurume University School of Medicine, Kurume, Japan
| | - Yukihito Higashi
- Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
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Kajikawa M, Maruhashi T, Iwamoto Y, Iwamoto A, Matsumoto T, Hidaka T, Kihara Y, Chayama K, Nakashima A, Goto C, Noma K, Higashi Y. Borderline ankle-brachial index value of 0.91-0.99 is associated with endothelial dysfunction. Circ J 2014; 78:1740-5. [PMID: 24813179 DOI: 10.1253/circj.cj-14-0165] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND An ankle-brachial index (ABI) value of 0.91-0.99 is considered borderline and associated with an increased risk of cardiovascular events. However, there is no information on the relationship between borderline ABI and endothelial function. METHODS AND RESULTS We measured ABI and assessed vascular function by flow-mediated vasodilation (FMD) and nitroglycerin-induced vasodilation in 389 subjects who underwent health examinations. Subjects were divided into 3 groups according to ABI (normal group: 1.00-1.40, borderline group: 0.91-0.99, abnormal group: ≤0.90 or >1.40). FMD was significantly smaller in both the borderline and the abnormal group than in the normal group. There was no significant difference in the vascular responses to nitroglycerin between the normal and borderline groups. Vascular response to nitroglycerin was significantly higher in the normal group than in the abnormal group. Borderline and abnormal ABI values were significantly associated with an increased odds ratio of low tertile of FMD levels, using the normal ABI group as the reference. Multiple logistic regression analysis for FMD revealed that age, sex, hypertension, diabetes mellitus, and borderline ABI independently remained associated with FMD. CONCLUSIONS ABI of 0.91-0.99 is associated with endothelial dysfunction. ABI examination is a simple and cost-effective method for obtaining the additional information on the initial step of atherosclerosis beyond the assessment of peripheral artery disease.
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Affiliation(s)
- Masato Kajikawa
- Department of Cardiovascular Medicine, Institute of Biomedical & Health Sciences
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23
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Affiliation(s)
- Kazuo Kimura
- Department of Intensive Care Medicine, National Defense Medical College
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