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绝经后女性血浆骨钙素升高、口腔疾病与下颌骨密度改变

Increased Plasma Osteocalcin, Oral Disease, and Altered Mandibular Bone Density in Postmenopausal Women.

作者信息

Thanakun Supanee, Pornprasertsuk-Damrongsri Suchaya, Na Mahasarakham Chantida Pawaputanon, Techatanawat Suteera, Izumi Yuichi

机构信息

College of Dental Medicine, Rangsit University, Pathum Thani 12000, Thailand.

Oral Diagnosis and Oral Medicine Clinic, Dental Hospital, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand.

出版信息

Int J Dent. 2019 Oct 24;2019:3715127. doi: 10.1155/2019/3715127. eCollection 2019.

Abstract

An association between oral diseases and postmenopausal status has been recognized. However, the relationship between all oral disease, mandibular bone density, health status, and osteocalcin (OCN) bone markers in postmenopausal dental patients has not been reported. This study was therefore to verify the differences in plasma OCN levels, dental, periodontal, and oral mucosal disease, and mandibular bone density alterations from panoramic radiograph and systemic parameters in postmenopausal women, compared to premenopausal women. Oral, radiographic, and blood examination were performed in 92 females. Dental, periodontal, and oral mucosal statuses were recorded. Health profile parameters were collected from medical charts. Plasma OCN was evaluated by enzyme-linked immunosorbent assay. Forty-two (45.7%) participants were postmenopausal with a higher median age (55 (51, 62) years) than the premenopausal group (43 (38, 45) years). Overweight or obesity, hypercholesterolemia, and impaired fasting blood sugar were more prevalent in postmenopause. The average postmenopausal OCN level (425.62 ng/mL) was significantly higher than the premenopausal group (234.77 ng/mL, < 0.001). The average number of missing teeth, mean attachment loss, alveolar bone loss, periapical lesion count, and clinical oral dryness score were also significantly higher in postmenopause (=0.008,   < 0.001,  0.031,  0.006,  and 0.005, respectively). However, mandibular bone density determined by mandibular cortical index was lower in postmenopause ( < 0.001). The panoramic mandibular index, mandibular cortical width, fractal dimension, and other oral mucosal disease did not differ between the groups. Postmenopause was associated with elevated plasma OCN ( = 0.504, < 0.001) when related covariates were adjusted. Elevated plasma OCN, oral mucosal dryness, high number of periapical radiolucencies and missing teeth, and lower mandibular bone density from panoramic radiograph were prevalent in postmenopausal women. Dentists should suspect an increased risk of low bone mineral density in postmenopausal patients who display these clinical and radiographic findings, and they should be referred for further examination. Plasma OCN may interconnect a relationship between postmenopausal status and the low mandibular bone density.

摘要

口腔疾病与绝经后状态之间的关联已得到认可。然而,绝经后牙科患者中所有口腔疾病、下颌骨密度、健康状况和骨钙素(OCN)骨标志物之间的关系尚未见报道。因此,本研究旨在验证绝经后女性与绝经前女性相比,血浆OCN水平、牙齿、牙周和口腔黏膜疾病以及全景X线片显示的下颌骨密度改变和全身参数之间的差异。对92名女性进行了口腔、影像学和血液检查。记录牙齿、牙周和口腔黏膜状况。从病历中收集健康状况参数。采用酶联免疫吸附测定法评估血浆OCN。42名(45.7%)参与者为绝经后女性,其年龄中位数(55(51,62)岁)高于绝经前组(43(38,45)岁)。超重或肥胖、高胆固醇血症和空腹血糖受损在绝经后更为普遍。绝经后OCN平均水平(425.62 ng/mL)显著高于绝经前组(234.77 ng/mL,<0.001)。绝经后缺失牙平均数量、平均附着丧失、牙槽骨丧失、根尖周病变数量和临床口腔干燥评分也显著更高(分别为=0.008,<0.001,0.031,0.006和0.005)。然而,通过下颌骨皮质指数测定的绝经后下颌骨密度较低(<0.001)。两组之间全景下颌指数、下颌骨皮质宽度、分形维数和其他口腔黏膜疾病无差异。调整相关协变量后,绝经后与血浆OCN升高相关(=0.504,<0.001)。绝经后女性中血浆OCN升高、口腔黏膜干燥、根尖周透射区和缺失牙数量多以及全景X线片显示下颌骨密度较低的情况较为普遍。对于出现这些临床和影像学表现的绝经后患者,牙医应怀疑其低骨矿物质密度风险增加,并应建议其进一步检查。血浆OCN可能将绝经后状态与下颌骨密度降低联系起来。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/879b/6855022/fd8e169ea770/IJD2019-3715127.001.jpg

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