Halme A M, Salminen A, Suominen A L, Havulinna A, Mäntylä P, Buhlin K, Paju S, Männistö S, Salomaa V, Sattler W, Sinisalo J, Pussinen P J
Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.
J Dent Res. 2025 Apr;104(4):389-397. doi: 10.1177/00220345241298219. Epub 2025 Jan 3.
Missing teeth have been linked to incident cardiovascular disease, diabetes, and all-cause mortality. Our previous study revealed that signs of oral infections and inflammatory conditions (i.e., periodontal disease and dental caries) are associated with disadvantageous features of circulating metabolites. This study investigates whether missing teeth and tooth loss, the end points of these diseases, are associated with similar metabolic features. The 2 Finnish population-based studies Health-2000 ( = 6,197) and FINRISK-97 ( = 6,050) were included, as was Parogene ( = 465), a cohort of patients with an indication for coronary angiography. The number of teeth was recorded in clinical examinations. Serum concentrations of 157 metabolites were determined by a nuclear magnetic resonance spectroscopy-based method. Health-2000 participants ( = 3,371) provided follow-up serum samples, and 1,186 of them participated in a repeated oral examination 11 y after the baseline. Linear regression models adjusted for age, sex, smoking, body mass index, and diabetes were fitted to the number of teeth and metabolite measures. The results from the separate cohorts were combined in a fixed-effects meta-analysis. We also analyzed whether the number of teeth at baseline and tooth loss during follow-up were associated with changes in metabolite concentrations. Missing teeth were associated with increased very-low-density lipoprotein-related measures and triglyceride concentrations, as well as with decreased high-density lipoprotein parameters and small particle size. Missing teeth also had an association with low levels of unsaturated fatty acids (FAs), including omega-3 and omega-6 FAs, and elevated proportions of monounsaturated and saturated FAs. The number of teeth at baseline predicted changes in several concentrations, such as measures related to intermediate-density lipoprotein, low-density lipoprotein, and FAs, but no associations with tooth loss during the 11-y follow-up were observed. To conclude, missing teeth are associated with adverse metabolic features characterized by systemic inflammation and several risk factors for cardiometabolic diseases.
牙齿缺失与心血管疾病、糖尿病的发病以及全因死亡率相关。我们之前的研究表明，口腔感染和炎症状况（即牙周病和龋齿）的迹象与循环代谢物的不利特征有关。本研究调查这些疾病的终点——牙齿缺失和牙齿脱落是否与类似的代谢特征相关。纳入了两项基于芬兰人群的研究，即健康2000研究（n = 6197）和芬兰风险97研究（n = 6050），以及冠状动脉造影适应证患者队列Parogene研究（n = 465）。在临床检查中记录牙齿数量。采用基于核磁共振波谱法测定157种代谢物的血清浓度。健康2000研究的参与者（n = 3371）提供了随访血清样本，其中1186人在基线后11年参与了重复口腔检查。针对年龄、性别、吸烟、体重指数和糖尿病进行调整的线性回归模型用于牙齿数量和代谢物测量。各队列的结果在固定效应荟萃分析中进行合并。我们还分析了基线时的牙齿数量和随访期间的牙齿脱落是否与代谢物浓度变化相关。牙齿缺失与极低密度脂蛋白相关指标和甘油三酯浓度升高有关，同时与高密度脂蛋白参数降低和颗粒尺寸变小有关。牙齿缺失还与不饱和脂肪酸（FAs）水平低有关，包括ω-3和ω-6 FAs，以及单不饱和脂肪酸和饱和脂肪酸比例升高。基线时的牙齿数量预测了几种浓度的变化，如与中密度脂蛋白、低密度脂蛋白和FAs相关的指标，但在11年随访期间未观察到与牙齿脱落的关联。总之，牙齿缺失与以全身炎症和几种心血管代谢疾病危险因素为特征的不良代谢特征有关。
