Lee Yeon-Hee, Seo Solsol, Kim Tae-Seok, Lee Sang-Woo
Department of Orofacial Pain and Oral Medicine, Kyung Hee University, Kyung Hee University Dental Hospital, #613 Hoegi-dong, Dongdaemun-gu, Seoul 02447, Republic of Korea.
Center for Systems Biology, Massachusetts General Hospital, Harvard Medical School, 185 Cambridge Street, Boston, MA 02114, USA.
J Fungi (Basel). 2025 Aug 1;11(8):574. doi: 10.3390/jof11080574.
Stomatitis is a broad term for oral mucosal inflammation, and oral candidiasis represents one of its common subtypes caused by fungal infection. This study aimed to investigate the relationship between oral candidiasis and reduced salivary flow in patients diagnosed with stomatitis and to identify clinical predictors of oral candidiasis. A total of 259 patients (mean age 59.77 ± 15.93 years; range 10-87 years; 201 females) with stomatitis were evaluated for oral candidiasis through culture testing. Clinical characteristics were compared between -positive and -negative groups. Unstimulated salivary flow rate (UFR) and stimulated salivary flow rate (SFR) were measured to assess xerostomia. Among the 259 patients, 81 (31.3%) were diagnosed with oral candidiasis. Patients with candidiasis were significantly older (64.25 ± 14.66 years) than those without (57.73 ± 16.10 years; = 0.002). Both UFR (0.36 ± 0.32 vs. 0.47 ± 0.28 mL/min, = 0.006) and SFR (1.21 ± 0.68 vs. 1.41 ± 0.69 mL/min, = 0.032) were significantly lower in the candidiasis group. The prevalence of xerostomia was significantly higher among -positive patients, based on UFR ≤ 0.2 mL/min (49.4% vs. 18.5%, < 0.001) and SFR ≤ 0.7 mL/min (27.2% vs. 10.7%, < 0.001). The predictive accuracy for oral candidiasis was 62.2% based on age (AUC = 0.622; cutoff 64.50 years), 65.8% for UFR (AUC = 0.658; cutoff 0.335 mL/min), and 58.7% for SFR (AUC = 0.587; cutoff 1.150 mL/min). In the generalized linear model, xerostomia, as defined by UFR, was a significant predictor of oral candidiasis (B = 0.328, 95% CI: 0.177-0.480, < 0.001). Oral candidiasis in patients with stomatitis was more strongly associated with decreased UFR than with aging alone. Among the factors assessed, reduced unstimulated salivary flow may serve as a useful clinical indicator for predicting oral candidiasis, particularly in elderly individuals.
口腔炎是口腔黏膜炎症的统称，口腔念珠菌病是由真菌感染引起的常见亚型之一。本研究旨在调查诊断为口腔炎的患者中口腔念珠菌病与唾液分泌减少之间的关系，并确定口腔念珠菌病的临床预测指标。通过培养测试对259例口腔炎患者（平均年龄59.77±15.93岁；年龄范围10 - 87岁；女性201例）进行口腔念珠菌病评估。比较阳性和阴性组的临床特征。测量非刺激性唾液流速（UFR）和刺激性唾液流速（SFR）以评估口干症。在259例患者中，81例（31.3%）被诊断为口腔念珠菌病。患念珠菌病的患者（64.25±14.66岁）比未患念珠菌病的患者（57.73±16.10岁；P = 0.002）年龄显著更大。念珠菌病组的UFR（0.36±0.32 vs. 0.47±0.28 mL/分钟，P = 0.006）和SFR（1.21±0.68 vs. 1.41±0.69 mL/分钟，P = 0.032）均显著更低。根据UFR≤0.2 mL/分钟（49.4% vs. 18.5%，P<0.001）和SFR≤0.7 mL/分钟（27.2% vs. 10.7%，P<0.001），阳性患者中口干症的患病率显著更高。基于年龄，口腔念珠菌病的预测准确率为62.2%（AUC = 0.622；临界值64.50岁），UFR为65.8%（AUC = 0.658；临界值0.335 mL/分钟），SFR为58.7%（AUC = 0.587；临界值1.150 mL/分钟）。在广义线性模型中，由UFR定义的口干症是口腔念珠菌病的显著预测指标（B = 0.328，95%置信区间：0.177 - 0.480，P<0.001）。口腔炎患者的口腔念珠菌病与UFR降低的关联比仅与年龄增长的关联更强。在评估的因素中，非刺激性唾液分泌减少可能是预测口腔念珠菌病的有用临床指标，尤其是在老年个体中。
