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Heydari MH, Sharifi F, Sobhaninejad S, Sharifi A, Alizadeh L, Darmiani S, Bijari S, Parvaie P, Bakhshandeh S, Shoaee S, Khoshnevisan MH. The association between dental caries, periodontal diseases, and tooth loss with diabetes mellitus among the elderly population. J Diabetes Metab Disord 2024; 23:1371-1380. [PMID: 38932804 PMCID: PMC11196431 DOI: 10.1007/s40200-024-01434-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 04/10/2024] [Indexed: 06/28/2024]
Abstract
Purpose Our study investigated the association between dental caries, periodontal diseases, and tooth loss with diabetes mellitus (DM) among the elderly population, representing the first study of its kind in Iran. Methods This was a cross-sectional community-based study as a part of the second wave of the Birjand longitudinal aging study (BLAS, 2021-2022) for people older than 60. We used the Comprehensive Geriatric Oral Health Assessment Tool (CGOHAT) for the oral health evaluation. Participants were initially categorized into diabetic and non-diabetic groups. Those patients with DM were further categorised into uncontrolled and controlled diabetes based on their HbA1c level. The association between periodontitis, gingivitis, and edentulism with type II diabetes mellitus and uncontrolled diabetes was assessed using logistic regression. Results Among the 1,011 participants, 324 (32.04%) had DM. The mean ± SD DMFT was 27.06 ± 7.71 and 27.07 ± 7.72 among those with and without DM, respectively (p = 0.976). The M index comprised 85.46% of the total DMFT among those without DM and 84.51% among those with DM. The prevalence of periodontitis was higher among those without DM (110, 32.84%, p = 0.390). The prevalence of gingivitis was higher among those with DM (73, 45.06%, p = 0.617). Among the diabetic group, 137 (42.28%) had controlled DM. Based on the adjusted matched multivariate logistic model, decayed teeth (1.24, 95%CI: 1.06 - 1.46, p-value = 0.006), periodontitis (2.78, 95%CI: 1.02 - 7.56, p-value = 0.044), and moderate tooth loss (5.73, 95%CI: 1.13 - 28.88, p-value = 0.034) were significantly associated with increased odds of uncontrolled DM. Conclusions Based on the findings of this study, tooth loss was highly prevalent among the elderly Iranians regardless of their diabetes status. Also, periodontitis, tooth loss, and decayed teeth were significantly associated with increased odds of poor glycemic control among those with DM. Thus, it can be concluded that improving the oral health of the geriatric population may be a crucial part of improving the glycemic control among those with diabetes which has been frequently neglected. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-024-01434-2.
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Affiliation(s)
- Mohammad-Hossein Heydari
- Community Oral Health Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Evin City, Student Blvd. School of Dentistry, Tehran, Iran
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shayan Sobhaninejad
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Leili Alizadeh
- Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Birjand University of Medical Sciences, Birjand, Iran
| | - Soheila Darmiani
- Department of Endodontics, Faculty of Dentistry, Birjand University of Medical Sciences, Birjand, Iran
| | - Shima Bijari
- Department of Endodontics, Faculty of Dentistry, Birjand University of Medical Sciences, Birjand, Iran
| | - Parvin Parvaie
- Department of Oral and Maxillofacial Disease, School of Dentistry, Birjand University of Medical Sciences, Birjand, Iran
| | - Soheila Bakhshandeh
- Community Oral Health Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shervan Shoaee
- Research Centre for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, No. 10, Al-E-Ahmad and Chamran Highway Intersection, Tehran, 1411713136 Iran
| | - Mohammad-Hossein Khoshnevisan
- Community Oral Health Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Evin City, Student Blvd. School of Dentistry, Tehran, Iran
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Janović A, Miličić B, Antić S, Bracanović Đ, Marković-Vasiljković B. Feasibility of using cross-sectional area of masticatory muscles to predict sarcopenia in healthy aging subjects. Sci Rep 2024; 14:2079. [PMID: 38267441 PMCID: PMC10808244 DOI: 10.1038/s41598-024-51589-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/07/2024] [Indexed: 01/26/2024] Open
Abstract
Determination of sarcopenia is crucial in identifying patients at high risk of adverse health outcomes. Recent studies reported a significant decline in masticatory muscle (MM) function in patients with sarcopenia. This study aimed to analyze the cross-sectional area (CSA) of MMs on computed tomography (CT) images and to explore their potential to predict sarcopenia. The study included 149 adult subjects retrospectively (59 males, 90 females, mean age 57.4 ± 14.8 years) who underwent head and neck CT examination for diagnostic purposes. Sarcopenia was diagnosed on CT by measuring CSA of neck muscles at the C3 vertebral level and estimating skeletal muscle index. CSA of MMs (temporal, masseter, medial pterygoid, and lateral pterygoid) were measured bilaterally on reference CT slices. Sarcopenia was diagnosed in 67 (45%) patients. Univariate logistic regression analysis demonstrated a significant association between CSA of all MMs and sarcopenia. In the multivariate logistic regression model, only masseter CSA, lateral pterygoid CSA, age, and gender were marked as predictors of sarcopenia. These parameters were combined in a regression equation, which showed excellent sensitivity and specificity in predicting sarcopenia. The masseter and lateral pterygoid CSA can be used to predict sarcopenia in healthy aging subjects with a high accuracy.
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Affiliation(s)
- Aleksa Janović
- School of Dental Medicine, Center for Diagnostic Imaging, University of Belgrade, 6 Rankeova, 11000, Belgrade, Republic of Serbia.
| | - Biljana Miličić
- School of Dental Medicine, Department of Statistics, University of Belgrade, 2 dr Subotića, 11000, Belgrade, Republic of Serbia
| | - Svetlana Antić
- School of Dental Medicine, Center for Diagnostic Imaging, University of Belgrade, 6 Rankeova, 11000, Belgrade, Republic of Serbia
| | - Đurđa Bracanović
- School of Dental Medicine, Center for Diagnostic Imaging, University of Belgrade, 6 Rankeova, 11000, Belgrade, Republic of Serbia
| | - Biljana Marković-Vasiljković
- School of Dental Medicine, Center for Diagnostic Imaging, University of Belgrade, 6 Rankeova, 11000, Belgrade, Republic of Serbia
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Borgnakke WS. Current scientific evidence for why periodontitis should be included in diabetes management. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2024; 4:1257087. [PMID: 38274772 PMCID: PMC10809181 DOI: 10.3389/fcdhc.2023.1257087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 11/13/2023] [Indexed: 01/27/2024]
Abstract
This Perspective provides a brief summary of the scientific evidence for the two-way links between periodontal diseases and hyperglycemia (diabetes mellitus [DM] and pre-DM). It delivers in a nutshell current scientific evidence for manifestations of hyperglycemia on periodontal health status and effects of periodontal diseases on blood glucose levels and in turn incidence, progression, and complications of diabetes. Of outmost importance is presentation of scientific evidence for the potential of routine periodontal treatment to lower blood glucose levels, providing a novel, economical tool in DM management. Non-surgical periodontal treatment ("deep cleaning") can be provided by dental hygienists or dentists in general dental offices, although severe cases should be referred to specialists. Such therapy can decrease the costs of DM care and other health care costs for people with DM. The great importance of a healthy oral cavity free of infection and subsequent inflammation - especially periodontitis that if untreated will cause loosening and eventually loss of affected teeth - has largely gone unnoticed by the medical community as the health care curricula are largely void of content regarding the bi-directional links between oral health and systemic health, despite elevation of blood glucose levels being an integral part of the general systemic inflammation response. The importance of keeping disease-free, natural teeth for proper biting and chewing, smiling, self-esteem, and pain avoidance cannot be overestimated. Medical and dental professionals are strongly encouraged to collaborate in patient-centered care for their mutual patients with - or at risk for - hyperglycemia.
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Affiliation(s)
- Wenche Sylling Borgnakke
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, United States
- Department of Periodontics and Preventive Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, United States
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Moynihan P, Teo JL. Exploring Oral Function, Protein Intake, and Risk of Sarcopenia: A Scoping Review. JDR Clin Trans Res 2024; 9:4-20. [PMID: 36883673 PMCID: PMC10725128 DOI: 10.1177/23800844231157259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
INTRODUCTION Sarcopenia is loss of both muscle mass and function with age and is associated with inadequate protein intake. However, evidence to suggest an association with oral health is less clear. OBJECTIVE To scope peer-reviewed published evidence (2000-2022) pertaining to oral function in relation to sarcopenia and/or protein intake in older people. METHODS CINAHL, Embase, PubMed, and Scopus were searched. Included were peer-reviewed studies measuring oral function (e.g., tooth loss, salivary flow masticatory function, strength of muscles of mastication, and tongue pressure) and a measure of protein intake and/or a measure of sarcopenia (appendicular muscle mass and function). Full article screening was conducted by 1 reviewer with a random 10% screened in duplicate by a second reviewer. Relevant content pertaining to study type, country of origin, measures of exposure, and outcomes and key findings was mapped and the balance of data showing a positive versus null association of oral health with outcomes charted. RESULTS Of 376 studies identified, 126 were screened in full, yielding 32 included texts, of which 29 were original articles. Seven reported intake of protein and 22 reported measures of sarcopenia. Nine distinct oral health exposures were identified, with ≤4 studies relating to any one of these measures. Most data were cross-sectional in nature (27 studies) and from Japan (20 studies). The balance of data showed associations between tooth loss and measures of sarcopenia and protein intake. However, the balance of data pertaining to any association between chewing function, tongue pressure, or indices of oral hypofunction and sarcopenia was mixed. CONCLUSION A broad range of oral health measures have been studied in relation to sarcopenia. The balance of data suggests that tooth loss is associated with risk, but data pertaining to the oral musculature and indices of oral hypofunction are mixed. KNOWLEDGE TRANSFER STATEMENT The findings of this research will increase awareness among clinicians of the amount and nature of evidence pertaining to the relationship between oral health and risk of compromised muscle mass and function, including data showing that loss of teeth is associated with increased risk of sarcopenia in older people. The findings highlight to researchers the gaps in the evidence and where further research and clarification of the relationship between oral health and risk of sarcopenia is warranted.
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Affiliation(s)
- P.J. Moynihan
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - J-L. Teo
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
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Bukhary DM. Teeth Rehabilitation and Nutritional Influence on Diabetic Patients: A Review. Cureus 2023; 15:e46182. [PMID: 37790059 PMCID: PMC10544288 DOI: 10.7759/cureus.46182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2023] [Indexed: 10/05/2023] Open
Abstract
Diabetes mellitus (DM) is a globally prevalent endocrine and metabolic disorder characterized by hyperglycemia. Its complications significantly impact both the quality and longevity of the patient's life with a substantial burden on the healthcare system. Missing teeth make individuals more susceptible to malnutrition compared to those with functional teeth. This is especially true for people with diabetes, as the condition is closely linked to both oral health and food intake. Natural teeth loss can significantly reduce an individual's ability to chew food, leading to a decrease in the quality and quantity of their nutrition. Prosthodontics is a dental specialty that replaces missing teeth with artificial ones. Replacing missing teeth may prevent the risk of malnutrition due to decreased ability to chew. Good oral health is important for overall health, especially for those with conditions such as diabetes. Artificial teeth replacement may improve nutrition intake by improving chewing ability. Therefore, the ultimate objective of rehabilitating a patient's oral cavity is to replace the shape and function in terms of chewing performance to a degree that is as close to normal as feasible. The purpose of this review is to explore the literature showing the link between natural teeth loss and nutrition in individuals with DM, with a special focus on prosthodontic management. Several oral complications occur in diabetic patients specifically teeth loss, which in turn affects mastication function. This in turn cause malnutrition and affect glucose level. It is imperative for healthcare providers to take an interdisciplinary approach in order to improve the dental and nutritional status and overall well-being of DM patients.
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Affiliation(s)
- Dalea M Bukhary
- Department of Oral and Maxillofacial Prosthodontics, King Abdulaziz University, Jeddah, SAU
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Bunte K, Wiessner C, Bahat G, Erdogan T, Cruz-Jentoft AJ, Zapf A. Association of periodontitis with handgrip strength and skeletal muscle mass in middle-aged US adults from NHANES 2013-2014. Aging Clin Exp Res 2023; 35:1909-1916. [PMID: 37386343 PMCID: PMC10460310 DOI: 10.1007/s40520-023-02471-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 06/05/2023] [Indexed: 07/01/2023]
Abstract
OBJECTIVES The relationship between periodontitis and sarcopenia parameters in middle-aged adults is largely unexplored. This study investigated the association between periodontitis and combined handgrip strength and skeletal muscle mass in middle-aged adults. MATERIALS AND METHODS A sub-cohort of 1912 individuals with complete periodontal and whole-body dual X-ray absorptiometry examinations from the 2013-2014 wave of the National Health and Nutrition Examination Survey (n = 10,175) were analyzed using fully adjusted multiple linear regression models for associations between periodontitis and skeletal muscle mass index (kg/m2) and combined handgrip strength (kg). RESULTS The mean age of the study cohort was 43 (± 8.4) years and 49.4% of the participants were male. In total, 612 participants (32%) were determined to have periodontitis, of which 513 (26.8%) had non-severe (mild or moderate) periodontitis, and 99 (5.2%) had severe periodontitis. In unadjusted regression models, both non-severe and severe periodontitis were associated with SMMI (βnon-severe = 1.01, 95% CI 0.50; 1.52 and βsevere = 1.42, 95% CI 0.59; 2.25) but not with cHGS. After adjusting for age, sex, education, body mass index, bone mineral density, diabetic status, education, total energy intake, total protein intake, and serum vitamin D2 + D3, periodontitis was associated with cHGS (βnon-severe = -2.81, 95% CI - 4.7; - 1.15 and βsevere = - 2.73, 95% CI - 6.31; 0.83). The association between periodontitis and SMMI remained for non-severe periodontitis (βnon-severe = 0.07, 95% CI - 0.26; 0.40 and βsevere = 0.22, 95% CI - 0.34; 0.78). CONCLUSION The present study highlights the need of further prospective research to investigate the nature and direction of the relationship between periodontitis and sarcopenia indicators. Future studies can support the screening, prevention and clinical management of sarcopenia and periodontitis, and emphasize the interdisciplinary and complementary approach between the disciplines of geriatric medicine and periodontology.
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Affiliation(s)
- Kübra Bunte
- The Center for Experimental Medicine, Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Christoph-Probst-Weg 1, 4th Floor, 20246, Hamburg, Germany.
| | - Christian Wiessner
- The Center for Experimental Medicine, Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Christoph-Probst-Weg 1, 4th Floor, 20246, Hamburg, Germany
| | - Gülistan Bahat
- Department of Internal Medicine, Istanbul Medical Faculty, Division of Geriatrics, Istanbul University, Istanbul, Turkey
| | - Tugba Erdogan
- Department of Internal Medicine, Istanbul Medical Faculty, Division of Geriatrics, Istanbul University, Istanbul, Turkey
| | | | - Antonia Zapf
- The Center for Experimental Medicine, Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Christoph-Probst-Weg 1, 4th Floor, 20246, Hamburg, Germany
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Rengo C, Valletta A, Liccardo D, Spagnuolo G, Corbi G, De Luca F, Lauria MR, Perrotta A, Rengo G, Ferrara N, Rengo S, Valletta R, Cannavo A. Healthy aging: when periodontal health matters. JOURNAL OF GERONTOLOGY AND GERIATRICS 2023. [DOI: 10.36150/2499-6564-n580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
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Tominaga K, Abe T, Ando Y, Hamano T, Isomura M, Nabika T, Yano S. Changes in masticatory performance and the new onset of diabetes mellitus in older adults: a 5-year longitudinal study. Diabetol Int 2023; 14:165-171. [PMID: 37090125 PMCID: PMC10113411 DOI: 10.1007/s13340-022-00613-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022]
Abstract
Objective Although masticatory performance is affected by age-related reduction in number of teeth (or treatment), the relationship between longitudinal changes in masticatory performance and diabetes mellitus is unknown. This longitudinal study investigated the association between changes in masticatory performance and new-onset diabetes mellitus among community-dwelling Japanese older adults. Methods The data of 214 older adults living in Ohnan Town, Shimane, Japan, who participated in two surveys conducted between 2012 and 2017 were analyzed. Diabetes mellitus was defined as a hemoglobin A1c level ≥ 6.5% or self-reported diabetes mellitus. The masticatory performance (measured by number of gummy jelly pieces collected after chewing) was evaluated by dental hygienists. Masticatory performance was categorized into two groups (high or low) based on the median in each survey; further, four groups (Group A: remained consistently high, Group B: changed from low to high, Group C: remained consistently low, Group D: changed from high to low) were used to determine longitudinal changes in masticatory performance. Logistic regression was used to analyze the association between changes in masticatory performance and new-onset diabetes mellitus. Results Overall, 10.3% of participants had diabetes mellitus at the follow-up survey. Multivariate analysis showed that Group D (odds ratio 8.69, 95% confidence interval 1.98-38.22) was positively associated with the development of diabetes mellitus compared with Group A after adjusting for sex, age, body mass index, alcohol consumption, physical activity, and eating speed. Conclusions Deteriorating masticatory performance for 5 years may cause diabetes mellitus among older adults.
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Affiliation(s)
- Kazumichi Tominaga
- Tominaga Dental Office, Ochi District, Shimane Japan
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, 225-8 Enya-Cho, Izumo, Shimane 693-8501 Japan
| | - Takafumi Abe
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, 225-8 Enya-Cho, Izumo, Shimane 693-8501 Japan
| | - Yuichi Ando
- Department of Health Promotion, National Institute of Public Health, Wako, Saitama Japan
| | - Tsuyoshi Hamano
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, 225-8 Enya-Cho, Izumo, Shimane 693-8501 Japan
- Department of Sports Sociology and Health Sciences, Faculty of Sociology, Kyoto Sangyo University, Kyoto, Kyoto Japan
| | - Minoru Isomura
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, 225-8 Enya-Cho, Izumo, Shimane 693-8501 Japan
- Faculty of Human Sciences, Shimane University, Matsue, Shimane Japan
| | - Toru Nabika
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, 225-8 Enya-Cho, Izumo, Shimane 693-8501 Japan
- Department of Functional Pathology, Faculty of Medicine, Shimane University, Izumo, Shimane Japan
| | - Shozo Yano
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, 225-8 Enya-Cho, Izumo, Shimane 693-8501 Japan
- Department of Laboratory Medicine, Faculty of Medicine, Shimane University, Izumo, Shimane Japan
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Kurinami N, Ashida K, Sugiyama S, Morito Y, Hasuzawa N, Yoshida A, Morita A, Hieshima K, Miyamoto F, Kajiwara K, Jinnouchi K, Jinnouchi T, Jinnouchi H, Nomura M. Reduced Number of Remaining or Healthy Teeth in Patients with Type 2 Diabetes Mellitus: A Cross-sectional Study Assessed by Dentists or Dental Hygienists in Japan. Intern Med 2023; 62:987-993. [PMID: 37005297 PMCID: PMC10125810 DOI: 10.2169/internalmedicine.9773-22] [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: 04/03/2023] Open
Abstract
Objective This study assessed the relationships between oral health (number of remaining and healthy teeth and periodontal disease) and type 2 diabetes mellitus (T2DM) to contribute to improved patient care. Patients We conducted a cross-sectional cohort study of consecutive patients being regularly treated for chronic diseases (T2DM, hypertension, and dyslipidemia). A dentist or dental hygienist accurately evaluated the oral environment. Patients with fewer than 20 teeth were classified as having reduced remaining teeth (RRT). Results A total of 267 patients were enrolled, including 153 patients (57%) with T2DM and 114 without (43%). Patients with T2DM had 3 fewer remaining teeth on average than those without DM [median: 22 (interquartile range (IQR): 11-27) vs. median: 25 (IQR: 17.3-28), p=0.02]. In addition, patients with T2DM had 4 fewer healthy teeth on average than those without DM [median: 8 (IQR: 2.8-15) vs. median: 12 (IQR: 6-16), p=0.02]. The frequency of RRT was higher in the T2DM group (n=63; 41%) than in the non-DM group (n=31; 27%, p=0.02). Multivariable logistic regression for the presence of RRT in the T2DM group found that age [odds ratio (OR), 1.08; 95% confidence interval (CI), 1.03-1.13; p<0.01] and regular dental consultations (OR, 0.28; 95% CI, 0.10-0.76; p=0.01) were independently and significantly associated. Conclusion The number of remaining or healthy teeth was significantly lower in patients with T2DM than in those without T2DM in current Japanese clinical practice. Regular dental consultation is recommended to preserve remaining teeth in patients with T2DM.
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Affiliation(s)
- Noboru Kurinami
- Kurinami Clinic, Japan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Japan
- Diabetes Care Center, Jinnouchi Hospital, Japan
| | - Kenji Ashida
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Seigo Sugiyama
- Diabetes Care Center, Jinnouchi Hospital, Japan
- Division of Cardiovascular Medicine, Diabetes Care Center, Jinnouchi Hospital, Japan
| | | | - Nao Hasuzawa
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | | | | | | | | | | | | | | | - Hideaki Jinnouchi
- Diabetes Care Center, Jinnouchi Hospital, Japan
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Kumamoto University Hospital, Japan
| | - Masatoshi Nomura
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Japan
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Fujishiro M, Tanaka S, Watanabe K, Imatake K, Suzuki Y, Ishihara H, Tani S. Association of Glycated Hemoglobin Level with Self-Reported Chewing Problems in Elderly Community-Dwelling Individuals in Japan. J Multidiscip Healthc 2023; 16:1231-1238. [PMID: 37159603 PMCID: PMC10163885 DOI: 10.2147/jmdh.s404028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 04/18/2023] [Indexed: 05/11/2023] Open
Abstract
Purpose Chewing problems are associated with increased mortality, geriatric syndromes and poor activities of daily living. Starting in 2018, in Japan, a self-reported questionnaire investigating chewing status was implemented in the annual health checkup program. Considering the bidirectional association between hyperglycemia and poor oral health, it is hypothesized that people with self-reported chewing problems will have relatively poor glycemic profiles. We investigated the metabolic characteristics of elderly community dwellers with self-reported chewing problems, as well as the association between the problems and HbA1c levels. Patients and Methods This was a retrospective, cross-sectional study. We reviewed the data of 1018 adults ≥ 65 years of age who had undergone an annual health checkup at Nihon University Hospital during the period from January 2019 through December 2019. The presence of chewing problems was investigated using a self-reported questionnaire constructed based on guidance provided by the Japanese government. Results In the 1018 participants, the overall prevalence of chewing problems was 10.4%. Participants with chewing problems showed significantly higher levels and worse categories of HbA1c than those without such problems (HbA1c < 6.0%, 42.5% vs 54.8%; HbA1c 6.0-6.9%, 41.5% vs 37.0%; HbA1c ≥ 7.0%, 16.0% vs 8.2%, p = 0.008). Participants with HbA1c ≥ 7.0% have a significantly increased risk of chewing problems as compared to those with HbA1c < 6.0% (odds ratio 2.76, p = 0.002), even after adjusting for the effects of age, sex, body mass index, eating behaviors, and history of diabetes mellitus. Conclusion HbA1c ≥ 7.0% is associated with self-reported chewing problems in elderly Japanese community-dwellers. We thus recommend a proactive assessment of oral conditions for this population.
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Affiliation(s)
- Midori Fujishiro
- Division of Diabetes and Metabolic Diseases, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
- Department of Internal Medicine, Nihon University Hospital, Tokyo, Japan
| | - Sho Tanaka
- Division of Diabetes and Metabolic Diseases, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
- Amemiya Internal Medicine Clinic, Kanagawa, Japan
- Correspondence: Sho Tanaka, Division of Diabetes and Metabolic Diseases, Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-cho, Itabashi-ku, Tokyo, 173-8610, Japan, Tel +81-3-3972-8111, Fax +81-3-3959-9775, Email
| | - Kentaro Watanabe
- Division of Diabetes and Metabolic Diseases, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Kazuhiro Imatake
- Department of Health Planning Center, Nihon University Hospital, Tokyo, Japan
| | - Yasuyuki Suzuki
- Department of Health Planning Center, Nihon University Hospital, Tokyo, Japan
- Department of Cardiology, Nihon University Hospital, Tokyo, Japan
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Hisamitsu Ishihara
- Division of Diabetes and Metabolic Diseases, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Shigemasa Tani
- Department of Health Planning Center, Nihon University Hospital, Tokyo, Japan
- Department of Cardiology, Nihon University Hospital, Tokyo, Japan
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
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Xia X, Xu Z, Hu F, Hou L, Zhang G, Liu X. Nutrition mediates the relationship between number of teeth and sarcopenia: a pathway analysis. BMC Geriatr 2022; 22:649. [PMID: 35941556 PMCID: PMC9360705 DOI: 10.1186/s12877-022-03350-7] [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: 05/03/2022] [Accepted: 07/30/2022] [Indexed: 11/24/2022] Open
Abstract
Objectives The relationship between the number of teeth and sarcopenia remains poorly investigated. Although nutrition plays an important role in maintaining bone and muscle health, the complex relationship between number of teeth and nutrition in the pathogenesis of sarcopenia remains to be elucidated. Methods A large multi-ethnic sample of 4149 participants aged over 50 years old from West China Health and Aging Trend (WCHAT) study was analyzed. We examined the associations between number of teeth with nutritional status and sarcopenia, and the mediating role of nutrition in the association between number of teeth and sarcopenia. Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019. We assessed nutrition using Mini Nutrition Assessment-Short Form (MNA-SF) scale. Direct relationships between number of teeth, nutrition and sarcopenia were assessed using multiple linear regression. Mediation models and structural equation model (SEM) pathway analysis were used to test the mediating role of nutrition in the relationship between number of teeth and sarcopenia. Results Of 4149 participants aged 50 years old or older, the prevalence of sarcopenia was 22.5, 9.0% for moderate sarcopenia, and 13.5% for severe sarcopenia, respectively. Regression analysis indicated a total association between number of teeth (β = − 0.327, 95% CI − 0.471 to − 0.237, p < 0.001) and sarcopenia. After adjusted MNA-SF scores, the association between number of teeth and sarcopenia was still significant (β = − 0.269, 95% CI − 0.364 to − 0.175, p < 0.001), indicating a partial mediation effect of nutrition. Mediation analysis verified nutrition partially mediate the associations between number of teeth and sarcopenia (indirect effect estimate = − 0.0272, bootstrap 95% CI − 0.0324 to − 0.0222; direct effect estimate = − 0.0899, bootstrap 95% CI − 0.1049 to − 0.0738). And this mediation effect was through impacting SMI (indirect effect estimate = − 0.0283, bootstrap 95% CI − 0.0336 to − 0.0232) and grip strength (indirect effect estimate = − 0.0067, bootstrap 95% CI − 0.0094 to − 0.0043). Structural equation model (SEM) framework pathway analysis confirmed the association between number of teeth, nutrition, and sarcopenia. Conclusions Our findings indicated that sarcopenia was associated with number of teeth and poorer nutritional status, with nutrition partially mediating the association between number of teeth and sarcopenia. Our findings supported early nutritional assessment and intervention in oral health to mitigate the risk of sarcopenia.
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Affiliation(s)
- Xin Xia
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, Sichuan, China.,Geriatric Health Care and Medical Research Center, Sichuan University, Sichuan Province, Chengdu, China
| | - Zhigang Xu
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, Sichuan, China.,Geriatric Health Care and Medical Research Center, Sichuan University, Sichuan Province, Chengdu, China
| | - Fengjuan Hu
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, Sichuan, China.,Geriatric Health Care and Medical Research Center, Sichuan University, Sichuan Province, Chengdu, China
| | - Lisha Hou
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, Sichuan, China.,Geriatric Health Care and Medical Research Center, Sichuan University, Sichuan Province, Chengdu, China
| | - Gongchang Zhang
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, Sichuan, China.,Geriatric Health Care and Medical Research Center, Sichuan University, Sichuan Province, Chengdu, China
| | - Xiaolei Liu
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, Sichuan, China. .,Geriatric Health Care and Medical Research Center, Sichuan University, Sichuan Province, Chengdu, China.
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12
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Kim JE, Kim NY, Choi CH, Chung KH. Association between Present Teeth and Muscle Strength in Older People in Korea. J Pers Med 2022; 12:jpm12071163. [PMID: 35887660 PMCID: PMC9324741 DOI: 10.3390/jpm12071163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/13/2022] [Accepted: 07/15/2022] [Indexed: 11/16/2022] Open
Abstract
Background: As the world population continues to age, interest in muscle strength loss in older people is increasing. This study aimed to confirm the association between present teeth and muscle strength in older people in Korea. Methods: Using data extracted from the 2014–2019 Korea National Health and Nutrition Examination Survey, we analyzed 5136 older people aged 65–79 years. The present teeth were based on 20 teeth, which is the criteria for comfortable mastication. The association of the risk of low muscle strength according to the present teeth was assessed using multiple logistic regression analysis, and the association was confirmed by dividing into subgroups according to sex. Results: The prevalence of low muscle strength was 17.87% among all participants. Multiple logistic regression analysis confirmed the association between low muscle strength and present teeth; a significant association was found even in the model in which all covariates were adjusted (odds ratios (OR) = 1.35; 95% confidence interval (CI): 1.13–1.61). Subgroup analysis revealed a significant association between present teeth and low muscle strength even in the model in which both covariates were adjusted for sex (Men, OR = 1.41; 95% CI: 1.02–1.95; Women, OR = 1.31; 95% CI: 1.06–1.6). Conclusion: An association between present teeth and low muscle strength was confirmed in older people in Korea. These results indicate that the importance of oral hygiene management should be emphasized to prevent muscle strength loss in older people.
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Affiliation(s)
- Ji-Eun Kim
- Department of Preventive and Public Health Dentistry, Chonnam National University School of Dentistry, Gwangju 61186, Korea; (J.-E.K.); (N.-Y.K.); (C.-H.C.)
| | - Na-Yeong Kim
- Department of Preventive and Public Health Dentistry, Chonnam National University School of Dentistry, Gwangju 61186, Korea; (J.-E.K.); (N.-Y.K.); (C.-H.C.)
| | - Choong-Ho Choi
- Department of Preventive and Public Health Dentistry, Chonnam National University School of Dentistry, Gwangju 61186, Korea; (J.-E.K.); (N.-Y.K.); (C.-H.C.)
- Dental Science Research Institute, Chonnam National University, Gwangju 61186, Korea
| | - Ki-Ho Chung
- Department of Preventive and Public Health Dentistry, Chonnam National University School of Dentistry, Gwangju 61186, Korea; (J.-E.K.); (N.-Y.K.); (C.-H.C.)
- Dental Science Research Institute, Chonnam National University, Gwangju 61186, Korea
- Correspondence: ; Tel.: +82-62-530-5858
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13
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Ono T, Kato S, Kokubo Y, Hasegawa Y, Kosaka T, Maeda Y, Okamura T, Miyamoto Y, Ikebe K. Tooth Loss Related with Prevalence of Metabolic Syndrome in a General Urban Japanese Population: The Suita Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116441. [PMID: 35682027 PMCID: PMC9180197 DOI: 10.3390/ijerph19116441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/19/2022] [Accepted: 05/20/2022] [Indexed: 12/04/2022]
Abstract
We examined whether the number of teeth could be a surrogate marker for metabolic syndrome (MetS) risk in cross-section. A total of 3771 individuals from the general urban Japanese population (1690 men, 2081 women; mean age 67.1 ± 11.0 years) participated in this study. Participants were diagnosed with MetS with three or more components hypertension, hyperglycemia, lipid metabolism abnormality, and abnormal abdominal girth. Questionnaires were administered to determine the number of teeth, smoking status, drinking status, and past illnesses. To clarify the relationships between the number of teeth and the presence of MetS components, we divided subjects into two groups: those with less than 20 residual teeth and those with 20 or more, then statistical analyses (Mantel-Haenszel tests and logistic regression analysis) were performed. MetS were higher for those with ≤19 teeth than those with ≥20 teeth when examining all participants and women-only groups. Hyperglycemia, low HDL cholesterol, high triglycerides, and diagnosis with MetS were all significantly higher in the ≤19 teeth group for both sexes combined and for women. These results suggest that less than 20 teeth may be a surrogate marker for MetS risk, but further studies on gender differences and pathological background are needed.
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Affiliation(s)
- Takahiro Ono
- Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8514, Japan;
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita 565-0871, Japan; (S.K.); (T.K.); (Y.M.); (K.I.)
- Correspondence: ; Tel.: +81-25-227-2891; Fax: +81-25-229-3454
| | - Satoshi Kato
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita 565-0871, Japan; (S.K.); (T.K.); (Y.M.); (K.I.)
| | - Yoshihiro Kokubo
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan;
| | - Yoko Hasegawa
- Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8514, Japan;
| | - Takayuki Kosaka
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita 565-0871, Japan; (S.K.); (T.K.); (Y.M.); (K.I.)
| | - Yoshinobu Maeda
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita 565-0871, Japan; (S.K.); (T.K.); (Y.M.); (K.I.)
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Tokyo 160-8582, Japan;
| | - Yoshihiro Miyamoto
- Open Innovation Center, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan;
| | - Kazunori Ikebe
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita 565-0871, Japan; (S.K.); (T.K.); (Y.M.); (K.I.)
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14
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Shirahase R, Watanabe Y, Saito T, Sunakawa Y, Matsushita Y, Tsugayasu H, Yamazaki Y. A Cross-Sectional Study on the Relationship between Oral Function and Sarcopenia in Japanese Patients with Regular Dental Maintenance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095178. [PMID: 35564572 PMCID: PMC9099729 DOI: 10.3390/ijerph19095178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/12/2022] [Accepted: 04/22/2022] [Indexed: 11/30/2022]
Abstract
We aimed to clarify the relationship between oral function assessments regarding oral hypofunction and sarcopenia in patients who had completed treatment for organic dental problems, including oral pain, removable denture fit, and tooth loss. This cross-sectional study included 269 patients aged ≥65 years (mean age 74.9 ± 6.50 years, 133 men, 136 women) who visited a dental clinic between June 2019 and March 2021. We evaluated oral function and sarcopenia and analyzed their relationship using the Jonckheere–Terpstra test, Mantel–Haenszel trend test, and Poisson regression analysis. We diagnosed 132 (49.07%) patients with oral hypofunction, 30 (11.2%) with sarcopenia, and 24 (8.9%) with severe sarcopenia. The number of oral hypofunction items (prevalence rate ratio [PRR] = 1.39, 95%Wald = 0.11 to 0.56) was significantly associated with sarcopenia. For each of the items, tongue-lip motor function [ta] (PRR = 0.80, 95%Wald = −0.44 to −0.02)] [ka] (PRR = 0.76, 95%Wald = −0.53 to −0.03) and tongue pressure (PRR = 0.95, 95%Wald = −0.09 to −0.02) showed a significant association with sarcopenia. However, no significant association was found for other variables. Dentists should not only treat organic dental problems but also consider the relationship between oral function and sarcopenia.
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Affiliation(s)
- Ryuichi Shirahase
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo 060-8586, Japan; (R.S.); (Y.S.); (Y.M.); (Y.Y.)
- Medical Corporation Shuwa-Kai Tsugayasu Dental Clinic, Obihiro 080-0020, Japan; (T.S.); (H.T.)
| | - Yutaka Watanabe
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo 060-8586, Japan; (R.S.); (Y.S.); (Y.M.); (Y.Y.)
- Correspondence: ; Tel.: +81-01-1706-4582
| | - Tohru Saito
- Medical Corporation Shuwa-Kai Tsugayasu Dental Clinic, Obihiro 080-0020, Japan; (T.S.); (H.T.)
| | - Yusuke Sunakawa
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo 060-8586, Japan; (R.S.); (Y.S.); (Y.M.); (Y.Y.)
- Medical Corporation Shuwa-Kai Tsugayasu Dental Clinic, Obihiro 080-0020, Japan; (T.S.); (H.T.)
| | - Yuya Matsushita
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo 060-8586, Japan; (R.S.); (Y.S.); (Y.M.); (Y.Y.)
- Medical Corporation Shuwa-Kai Tsugayasu Dental Clinic, Obihiro 080-0020, Japan; (T.S.); (H.T.)
| | - Hideki Tsugayasu
- Medical Corporation Shuwa-Kai Tsugayasu Dental Clinic, Obihiro 080-0020, Japan; (T.S.); (H.T.)
| | - Yutaka Yamazaki
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo 060-8586, Japan; (R.S.); (Y.S.); (Y.M.); (Y.Y.)
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15
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Takahara M, Shiraiwa T, Maeno Y, Yamamoto K, Shiraiwa Y, Yoshida Y, Nishioka N, Katakami N, Shimomura I. Screening for a Decreased Masticatory Function by a Color-changeable Chewing Gum Test in Patients with Metabolic Disease. Intern Med 2022; 61:781-787. [PMID: 35296621 PMCID: PMC8987249 DOI: 10.2169/internalmedicine.8082-21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Objective This study aimed to reveal the screening performance of a color-changeable chewing gum test for a decreased masticatory function in the assessment of oral hypofunction in patients with metabolic diseases. Methods We analyzed 1,000 patients with metabolic diseases, including diabetes, dyslipidemia, hypertension, and hyperuricemia. A decreased masticatory function was diagnosed by a gummy jelly test. Patients were asked to chew a test gum, which changed from green to red by thorough mastication, 60 times for 1 minute. The color change was visually evaluated using the color scale, from 1 (green-dominant) to 10 points (red-dominant), and was colorimetrically quantified as delta E in the L*a*b* color space. The screening performance for a decreased masticatory function was evaluated with the receiver operating characteristic (ROC) curve. Results Seventy-seven patients (7.7%) were diagnosed with a decreased masticatory function. The mean color scale and delta E of the gum test were 6.7±1.8 points and 42.9±6.7 units, respectively. The area under the ROC curve was 0.822 (95% confidence interval, 0.768-0.872) for the color scale and 0.838 (0.781-0.890) for delta E (p=0.41). The optimal cut-off point of the color scale was 5.5 (5.0-6.5) points, whereas that of delta E was 37.7 (35.5-38.8) units. The optimal cut-off points were not significantly different between the subgroups divided by clinical characteristics. Conclusions A color-changeable chewing gum test using the color scale as well as delta E would be a useful tool for screening patients with metabolic diseases for a decreased masticatory function in the assessment of oral hypofunction.
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Affiliation(s)
- Mitsuyoshi Takahara
- Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine, Japan
| | | | | | | | | | | | | | - Naoto Katakami
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Japan
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Japan
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16
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Effect of Multimorbidity on Fragility Fractures in Community-Dwelling Older Adults: Shimane CoHRE Study. J Clin Med 2021; 10:jcm10153225. [PMID: 34362008 PMCID: PMC8348412 DOI: 10.3390/jcm10153225] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 07/15/2021] [Accepted: 07/20/2021] [Indexed: 12/14/2022] Open
Abstract
Fragility fractures (FFxs), which are a common musculoskeletal injury in older adults, is associated with an increased frequency of falls. Both FFxs and falls may result from drugs, habits, and co-occurring diseases. We aimed to evaluate the effects of various diseases on the risk of FFx. This retrospective study included 1420 individuals aged ≥60 years. We evaluated the history of clinical FFx and diseases using a detailed questionnaire and a health examination. The risk of comorbidities was assessed using the Age-Adjusted Charlson Comorbidity (AAC) Index. We performed binary logistic regression analysis to determine the risk of FFx and falls after adjusting for covariates. In elderly men, the incidence of FFx positively correlated with rheumatoid arthritis and parent's hip fracture. For elderly women, the incidence of FFx positively correlated with rheumatoid arthritis and antihypertensive drugs but was inversely associated with dyslipidemia and antilipidemic drugs. The FFX risk of older adults with an AAC Index ≥6 was higher than those with an AAC Index of 1-3. In addition, the AAC Index and falls were independently and strongly associated with a higher risk of FFx. Taken together, multimorbidity increases the risk of clinical FFx independent of falls in the community-dwelling elderly population.
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