Ferrillo Martina, Migliario Mario, Marotta Nicola, Lippi Lorenzo, Antonelli Alessandro, Calafiore Dario, Ammendolia Valerio, Fortunato Leonzio, Renò Filippo, Giudice Amerigo, Invernizzi Marco, de Sire Alessandro
Dentistry Unit, Department of Health Sciences, University of Catanzaro "Magna Graecia", 88100 Catanzaro, Italy.
Dentistry Unit, Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy.
J Clin Med. 2022 Aug 9;11(16):4662. doi: 10.3390/jcm11164662.
Breast cancer (BC) survivors treated with aromatase inhibitors (AIs) commonly show several pathological issues, including poor oral health, bone health impairment, and vitamin D deficiency. However, to date, oral health issues in BC survivors treated with AIs have been poorly investigated and their relationship with vitamin D deficiency are far from being understood. This study aimed to evaluate the correlation between oral health and vitamin D status in BC survivors undergoing treatment with AIs through a machine learning approach. In this cross-sectional study, we included post-menopausal BC women with vitamin D deficiency undergoing AIs therapy. The outcome measures were the following: oral health indexes as the Decayed, Missing, and Filled Permanent Teeth Index (DMFT); serum levels of 25(OH)D; Bone Mineral Density (BMD); and the diagnosis of osteoporosis. We included 41 post-menopausal BC women, mean aged 66.10 ± 8.47 years, with mean serum levels of vitamin D of 14.63 ± 6.62 ng/mL. Furthermore, 56.10% of patients had a diagnosis of osteoporosis and 36.59% were osteopenic. DMFT was significantly related to smoking (-value = 0.005) and dental floss use (-value = 0.001). There was a significant correlation between DMFT and vitamin D levels (Pearson's r: -0.73; -value = 0.001). The regression machine learning model showed that vitamin D status and the use of dental floss were the most relevant variables in terms of correlation with DMFT. In conclusion, vitamin D deficiency, inadequate use of dental floss, and smoking had a negative impact on oral health in BC women. Thus, vitamin D deficiency screening and supplementation and a prompt oral rehabilitation plan should be suggested and implemented in the complex treatment framework of BC survivors undergoing treatment with AIs.
接受芳香化酶抑制剂（AI）治疗的乳腺癌（BC）幸存者通常会出现一些病理问题，包括口腔健康不佳、骨骼健康受损和维生素D缺乏。然而，迄今为止，接受AI治疗的BC幸存者的口腔健康问题研究较少，其与维生素D缺乏的关系也远未明确。本研究旨在通过机器学习方法评估接受AI治疗的BC幸存者口腔健康与维生素D状态之间的相关性。在这项横断面研究中，我们纳入了接受AI治疗且维生素D缺乏的绝经后BC女性。观察指标如下：口腔健康指数，即恒牙龋失补指数（DMFT）；血清25（OH）D水平；骨矿物质密度（BMD）；以及骨质疏松症的诊断。我们纳入了41名绝经后BC女性，平均年龄66.10±8.47岁，平均血清维生素D水平为14.63±6.62 ng/mL。此外，56.10%的患者被诊断为骨质疏松症，36.59%为骨量减少。DMFT与吸烟（P值=0.005）和使用牙线（P值=0.001）显著相关。DMFT与维生素D水平之间存在显著相关性（Pearson相关系数r：-0.73；P值=0.001）。回归机器学习模型显示，就与DMFT的相关性而言，维生素D状态和牙线使用是最相关的变量。总之，维生素D缺乏、牙线使用不足和吸烟对BC女性的口腔健康有负面影响。因此，在接受AI治疗的BC幸存者的综合治疗框架中，应建议并实施维生素D缺乏筛查和补充以及及时的口腔康复计划。
