Kim Sung Min, Kong Mi-Sun, Kim Yoon-Young, Chang Ji-Youn, Kim Moon-Jong, Kho Hong-Seop
Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Jongno-gu, Seoul, South Korea.
Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Jongno-gu, Seoul, South Korea; Department of Oral Medicine, Gwanak Seoul National University Dental Hospital, Gwanak-gu, Seoul, South Korea.
Int Dent J. 2025 Aug 23;75(5):103868. doi: 10.1016/j.identj.2025.103868.
Despite its relevance to physical frailty, the pathophysiological mechanisms underlying oral frailty remain poorly understood. This study aimed to investigate salivary biomarkers associated with oral frailty.
Ninety-eight postmenopausal women (mean age, 65.2 ± 7.2 years) with burning mouth symptoms were included in this study. This study was conducted as an ancillary analysis of our previous cohort. Oral frailty was assessed using a validated 4-point scale for difficulties in chewing, speaking, and swallowing. The levels of inflammatory and oxidative stress biomarkers, stress hormones, and female gonadal hormones were measured using unstimulated (UWS) and stimulated whole saliva (SWS) samples. Blood biomarkers were assessed using complete blood counts. Oral frailty indicator scores, salivary and blood biomarker levels were analysed based on the presence or absence of additional oral dysfunctions, including dry mouth and taste disturbances. Furthermore, correlations between oral frailty indicators and salivary or blood biomarkers were examined.
The oral frailty scores, as well as salivary and blood biomarker levels did not differ significantly among the patients based on the presence or absence of additional oral dysfunctions. In UWS, 'speaking difficulties' correlated significantly with C-reactive protein (CRP) levels (r = 0.360, P = .006), while 'swallowing difficulties' was correlated significantly with the cortisol/dehydroepiandrosterone ratio (r = 0.325, P = .016). In SWS, 'chewing difficulties' correlated significantly with interleukin-1β levels (r = 0.252, P = .017), whereas 'speaking difficulties' correlated significantly with CRP (r = 0.267, P = .010), 8-hydroxy-2'-deoxyguanosine (r = 0.220, P = .040), and 17β-estradiol levels (r = 0.265, P = .011). Regarding blood biomarkers, 'swallowing difficulties' was significantly negatively correlated with the total leukocyte (r = -0.269, P = .007) and lymphocyte counts (r = -0.249, P = .013).
Oral frailty was significantly associated with inflammatory, oxidative stress, and endocrine salivary biomarkers, suggesting multifactorial pathophysiological mechanisms.
尽管口腔衰弱与身体衰弱相关，但其潜在的病理生理机制仍知之甚少。本研究旨在调查与口腔衰弱相关的唾液生物标志物。
本研究纳入了98名有口腔烧灼感症状的绝经后女性（平均年龄65.2±7.2岁）。本研究作为我们之前队列研究的辅助分析进行。使用经过验证的4分制量表评估咀嚼、说话和吞咽困难情况，以此来评估口腔衰弱。使用未刺激全唾液（UWS）和刺激全唾液（SWS）样本测量炎症和氧化应激生物标志物、应激激素和女性性腺激素水平。通过全血细胞计数评估血液生物标志物。根据是否存在包括口干和味觉障碍在内的其他口腔功能障碍，分析口腔衰弱指标评分、唾液和血液生物标志物水平。此外，还研究了口腔衰弱指标与唾液或血液生物标志物之间的相关性。
根据是否存在其他口腔功能障碍，患者的口腔衰弱评分以及唾液和血液生物标志物水平无显著差异。在UWS中，“说话困难”与C反应蛋白（CRP）水平显著相关（r = 0.360，P = 0.006），而“吞咽困难”与皮质醇/脱氢表雄酮比值显著相关（r = 0.325，P = 0.016）。在SWS中，“咀嚼困难”与白细胞介素-1β水平显著相关（r = 0.252，P = 0.017），而“说话困难”与CRP（r = 0.267，P = 0.010）、8-羟基-2'-脱氧鸟苷（r = 0.220，P = 0.040）和17β-雌二醇水平（r = 0.265，P = 0.011）显著相关。关于血液生物标志物，“吞咽困难”与总白细胞计数（r = -0.269，P = 0.007）和淋巴细胞计数（r = -0.249，P = 0.013）显著负相关。
口腔衰弱与炎症、氧化应激和内分泌唾液生物标志物显著相关，提示其病理生理机制具有多因素性。
