Center for Community-Based Healthcare Research and Education (CoHRE), Organization for Research and Academic Information, Shimane University, Izumo City, Shimane, Japan.
Tominaga Dental Office, Ochi-gun, Shimane, Japan.
PLoS One. 2021 Jun 2;16(6):e0252625. doi: 10.1371/journal.pone.0252625. eCollection 2021.
We aimed to examine the number of teeth and masticatory function as oral health indices and clarify their roles in the pathogenesis of sarcopenia and diabetes mellitus in community-dwelling older adults.
This cross-sectional study was conducted with 635 older adults in Ohnan, Shimane Prefecture, in rural Japan. The number of teeth and masticatory function (measured by the number of gummy jelly pieces collected after chewing) were evaluated by dental hygienists. Sarcopenia status was assessed using handgrip strength, skeletal muscle index, calf circumference, and a possible sarcopenia diagnosis based on the Asian Working Group for Sarcopenia 2019. Diabetes mellitus status was defined as a hemoglobin A1c level ≥6.5% or self-reported diabetes. A multivariable logistic regression model was used to analyze the association between oral health, sarcopenia, and diabetes mellitus after adjusting for confounders.
After adjusting for all confounders, logistic regression analysis showed that the number of remaining teeth was negatively associated with a low level of handgrip strength (odds ratio [OR], 0.961; 95% confidence interval [CI], 0.932-0.992) and possible sarcopenia (OR, 0.949; 95% CI, 0.907-0.992). Higher levels of masticatory function were also negatively associated with a low level of handgrip strength (OR, 0.965; 95% CI, 0.941-0.990) and possible sarcopenia (OR, 0.941; 95% CI, 0.904-0.979). Logistic regression analysis showed that the number of remaining teeth and a higher level of masticatory function were negatively associated with diabetes mellitus (OR, 0.978; 95% CI, 0.957-0.999; OR, 0.976; 95% CI, 0.960-0.992, respectively).
Our findings suggest that improvement in oral health, including the maintenance of masticatory function and remaining teeth, may contribute to the prevention of sarcopenia and diabetes mellitus in older adults.
我们旨在研究牙齿数量和咀嚼功能作为口腔健康指标，并阐明它们在社区居住的老年人中肌少症和糖尿病发病机制中的作用。
本横断面研究在日本农村岛根县大谷町的 635 名老年人中进行。牙齿数量和咀嚼功能（通过咀嚼后收集的 gummy 果冻片数量来衡量）由口腔卫生学家进行评估。肌少症状态通过握力、骨骼肌指数、小腿围和基于亚洲肌少症工作组 2019 年的可能肌少症诊断来评估。糖尿病状态定义为血红蛋白 A1c 水平≥6.5%或自我报告的糖尿病。使用多变量逻辑回归模型在调整混杂因素后分析口腔健康、肌少症和糖尿病之间的关联。
在调整所有混杂因素后，逻辑回归分析显示，剩余牙齿数量与握力水平较低（比值比 [OR]，0.961；95%置信区间 [CI]，0.932-0.992）和可能的肌少症（OR，0.949；95% CI，0.907-0.992）呈负相关。较高的咀嚼功能水平也与握力水平较低（OR，0.965；95% CI，0.941-0.990）和可能的肌少症（OR，0.941；95% CI，0.904-0.979）呈负相关。逻辑回归分析显示，剩余牙齿数量和较高的咀嚼功能水平与糖尿病呈负相关（OR，0.978；95% CI，0.957-0.999；OR，0.976；95% CI，0.960-0.992）。
我们的研究结果表明，改善口腔健康，包括维持咀嚼功能和保留牙齿，可能有助于预防老年人肌少症和糖尿病。
