General Dentistry, Department of Dentistry, Eastman Institute of Oral Health, University of Rochester, 625 Elmwood Avenue, Rochester, NY 14620, USA.
General Dentistry, Department of Dentistry, Eastman Institute of Oral Health, University of Rochester, 625 Elmwood Avenue, Rochester, NY 14620, USA; Specialty Care Clinic, Eastman Institute of Oral Health, University of Rochester, 625 Elmwood Avenue, Rochester, NY 14620, USA.
Arch Oral Biol. 2023 Dec;156:105824. doi: 10.1016/j.archoralbio.2023.105824. Epub 2023 Oct 13.
Medications with anticholinergic potential inhibit saliva secretion. Polypharmacy potentiates anticholinergic burden, causing dry mouth symptoms and chronic deterioration of oral health. Patients of any age can be affected by anticholinergic medication-triggered hyposalivation (the objective measure of dry mouth); therefore, seeking predictions of hyposalivation to screen dry mouth is needed.
In our prospective, cross-sectional clinical study, 55 middle-aged adult patients participated. We examined whether the anticholinergic burden calculated from anticholinergic medications (anticholinergic drug score; ADS) and blood serum anticholinergic activity (SAA; the gold standard measure of anticholinergic burden) is associated with hyposalivation. As no prior studies measured minor salivary glands regarding the quantifiable anticholinergic burden, we assessed hyposalivation by the minor saliva flow (MSF) and unstimulated whole saliva (UWS) secretion.
Our data showed a negative linear relationship between SAA and UWS (p < 0.05); when SAA increases by one pmol/ml unit, the saliva flow decreases by 0.058 ml/min. MSF showed a linear correlation (p < 0.005) with UWS. In a multivariate logistic regression model (including age, gender, race, smoking status, xerostomia severity, ADS, and BMI), we identified SAA and age as predictors of hyposalivation (p < 0.05).
We provide evidence for the significant relationship between measurable anticholinergic burden and saliva flow. The correlation between UWS and MSF suggests that both saliva flow rate measurement methods could reflect anticholinergics-induced changes in salivary health.
具有抗胆碱能潜力的药物会抑制唾液分泌。药物的多种联合应用会增加抗胆碱能负担，导致口干症状和口腔健康的慢性恶化。任何年龄的患者都可能受到抗胆碱能药物引发的唾液分泌减少（口干的客观测量）的影响；因此，需要寻找预测唾液分泌减少的方法来筛查口干。
在我们的前瞻性、横断面临床研究中，55 名中年成年患者参与了研究。我们研究了抗胆碱能药物计算出的抗胆碱能负担（抗胆碱能药物评分；ADS）和血清抗胆碱能活性（SAA；抗胆碱能负担的金标准测量）是否与唾液分泌减少有关。由于之前没有研究测量过唾液腺的微量抗胆碱能负担，我们通过小唾液流量（MSF）和非刺激性全唾液（UWS）分泌来评估唾液分泌减少。
我们的数据显示 SAA 与 UWS 呈负线性关系（p<0.05）；当 SAA 增加 1 pmol/ml 单位时，唾液流量减少 0.058 ml/min。MSF 与 UWS 呈线性相关（p<0.005）。在包括年龄、性别、种族、吸烟状况、口干严重程度、ADS 和 BMI 的多变量逻辑回归模型中，我们确定 SAA 和年龄是唾液分泌减少的预测因素（p<0.05）。
我们提供了可衡量的抗胆碱能负担与唾液流量之间存在显著关系的证据。UWS 与 MSF 之间的相关性表明，两种唾液流量测量方法都可以反映抗胆碱能药物引起的唾液健康变化。
