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口腔潜在恶性疾病亚型对男性全因和死因特异性死亡率的影响。

Impact of oral potentially malignant disorder subtypes on all-cause and cause-specific mortality in males.

机构信息

School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.

Oral Health Care Research Center, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.

出版信息

Oral Dis. 2019 Apr;25(3):750-757. doi: 10.1111/odi.13028. Epub 2019 Feb 14.

Abstract

OBJECTIVES

To quantify the effect of oral potentially malignant disorder (OPMD) subtypes on mortality from oral cancer and type 2 diabetes among areca nut chewers and/or cigarette smokers.

MATERIALS AND METHODS

A retrospective cohort design was devised to follow 14,749 men attending community-based screening program for oral cancer between 1998 and 2000 and followed until 2010. The Cox proportional hazards regression model was applied to assess the effect of OPMD on death.

RESULTS

A total of 1,291(8.75%) patients were detected as OPMD. Among those free of T2DM at baseline, the elevated risk for death from T2DM was noted for OSF (aHR = 3.62, 95% CI: 1.25-10.51) and erythroplakia (aHR = 5.01, 95% CI: 1.17-21.45). The elevated risk for all-cause death for OPMD was mainly explained by deaths from oral cancer and T2DM but not other causes of death.

CONCLUSIONS

Oral potentially malignant disorder, particularly OSF and erythroplakia, in male cigarette smokers and/or areca nut chewers led to an incremental elevated risk of T2DM mortality in the way of being distal to the occurrence of T2DM, implying that early detection and prevention of OPMD may not only reduce oral cancer mortality but also result in the reduction of T2DM mortality.

摘要

目的

定量评估口腔潜在恶性疾病(OPMD)亚型对咀嚼槟榔和/或吸烟人群口腔癌和 2 型糖尿病(T2DM)相关死亡率的影响。

材料与方法

采用回顾性队列设计,对 1998 年至 2000 年间参加社区口腔癌筛查项目的 14749 名男性进行随访,随访至 2010 年。采用 Cox 比例风险回归模型评估 OPMD 对死亡的影响。

结果

共发现 1291 例(8.75%)患者存在 OPMD。在基线时无 T2DM 的人群中,OSF(aHR=3.62,95%CI:1.25-10.51)和红斑(aHR=5.01,95%CI:1.17-21.45)与 T2DM 相关死亡风险增加。所有 OPMD 患者的全因死亡风险主要归因于口腔癌和 T2DM 导致的死亡,而不是其他原因导致的死亡。

结论

男性吸烟和/或咀嚼槟榔者的 OPMD,尤其是 OSF 和红斑,与 T2DM 死亡率的增加有关,其作用途径是在 T2DM 发生之前。这意味着早期发现和预防 OPMD 不仅可以降低口腔癌死亡率,还可能降低 T2DM 死亡率。

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