老年人牙齿缺失、咀嚼能力低与营养指标的关系：一项横断面研究。
Relationship between tooth loss, low masticatory ability, and nutritional indices in the elderly: a cross-sectional study.
机构信息
Department of School Psychology, Developmental Science and Health Education, Hyogo University of Teacher Education, Simokume 942-1, Kato City, Hyogo, Japan.
Department of Clinical Nutrition and Dietetics, Konan Women's University, Morikita-cho 6-2-23, Higashinadaku, Kobe City, Hyogo, Japan.
出版信息
BMC Oral Health. 2019 Jun 13;19(1):110. doi: 10.1186/s12903-019-0778-5.
BACKGROUND
Low masticatory ability and the resulting decrease in intake of masticable foods can result in undernutrition. The present study investigated the relationship between tooth loss, low masticatory ability, and nutritional indices in the elderly.
METHODS
The data analyzed in this study were retrieved from the baseline data of the 2007 Fujiwara-kyo study, a prospective cohort study of community-dwelling elderly individuals. Subjects included 1591 men and 1543 women, both with a median age of 71 years. The maximum occlusal force was measured as an objective index of masticatory ability. Foods were divided into five groups based on hardness: Group 1 (bananas, etc.), 0.53 kg; Group 2 (boiled rice, etc.), 1.22 kg; Group 3 (raisins, etc.), 2.93 kg; Group 4 (raw carrots, etc.), 4.38 kg; and Group 5 (beef jerky), 6.56 kg. To obtain a subjective index of masticatory ability, a questionnaire-based survey was conducted to determine whether subjects could masticate foods within each group. As nutritional indices, serum albumin levels and body mass index (BMI) data were used.
RESULTS
The median number of teeth was 21. The proportion of subjects for whom all five food groups were masticable showed a significant decrease in the number of teeth in both males and females. Logistic regression analysis showed that, after adjustment for confounders, no significant relationships were observed between the number of teeth and the masticatory ability with nutritional indices in males. In females, a maximum occlusal force of 100 to 300 N (OR = 1.65; 95% CI = 1.06-2.55) or less than 100 N (OR = 1.95; 95% CI = 1.15-3.31) showed a significant correlation with serum albumin levels below 4.4 g/dL (reference: 500 N or more). In addition, the masticability of all five food groups showed a significant correlation with BMI < 21.0 kg/m (OR = 0.62; 95% CI = 0.46-0.85) in females.
CONCLUSIONS
A low number of teeth was associated with low masticatory ability in both males and females. Low masticatory ability was associated with low plasma albumin levels and low BMI in females. Not smoking, maintaining grip strength, preventing cancer, and masticatory ability are important for preventing undernutrition.
背景
咀嚼能力低下以及由此导致的可咀嚼食物摄入量减少可能导致营养不足。本研究调查了老年人牙齿缺失、咀嚼能力低下与营养指标之间的关系。
方法
本研究分析的数据来自于 2007 年富士见町研究的基线数据，这是一项针对社区居住老年人的前瞻性队列研究。受试者包括 1591 名男性和 1543 名女性，中位年龄均为 71 岁。最大咬合力作为咀嚼能力的客观指标进行测量。食物根据硬度分为五组：第 1 组（香蕉等），0.53kg；第 2 组（米饭等），1.22kg；第 3 组（葡萄干等），2.93kg；第 4 组（生胡萝卜等），4.38kg；第 5 组（牛肉干），6.56kg。为了获得咀嚼能力的主观指标，我们进行了一项基于问卷的调查，以确定受试者是否可以咀嚼每组食物。作为营养指标，使用血清白蛋白水平和体重指数（BMI）数据。
结果
中位牙齿数为 21 颗。在男性和女性中，所有五组食物均可咀嚼的受试者比例均随着牙齿数量的减少而显著下降。Logistic 回归分析显示，在调整混杂因素后，男性牙齿数量和咀嚼能力与营养指标之间没有显著关系。在女性中，100-300N（OR=1.65；95%CI=1.06-2.55）或低于 100N（OR=1.95；95%CI=1.15-3.31）的最大咬合力与血清白蛋白水平低于 4.4g/dL（参考值：500N 或更高）显著相关。此外，在女性中，所有五组食物的可咀嚼性与 BMI<21.0kg/m（OR=0.62；95%CI=0.46-0.85）显著相关。
结论
在男性和女性中，牙齿数量少与咀嚼能力低下有关。咀嚼能力低下与女性的低血浆白蛋白水平和低 BMI 有关。不吸烟、保持握力、预防癌症和咀嚼能力对于预防营养不足很重要。
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