Serum sodium level within the normal range is associated with maximum voluntary tongue pressure against the palate among community-dwelling older Japanese men
Serum sodium level within the normal range is associated with maximum voluntary tongue pressure against the palate among community-dwelling older Japanese men
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在社区居住的日本老年男性中，正常范围内的血清钠水平与舌头对上颚的最大自愿压力有关
DOI：
10.1111/ggi.13152
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发表时间：
2017
影响因子：
3.3
通讯作者：
Maeda Takahiro
中科院分区：
文献类型：
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作者：
Shimizu Yuji;Sato Shimpei;Koyamatsu Jun;Yamanashi Hirotomo;Higashi Miho;Nagayoshi Mako;Kadota Koichiro;Kawashiri Shin-Ya;Takamura Noboru;Maeda Takahiro
目的最近的老年医学研究集中在最大自主舌压（MTP）作为吞咽困难的诊断价值，因为吞咽困难导致吸入性肺炎。吞咽困难也可引起饮水困难，通过指示高渗性脱水的存在而导致高钠血症。然而，没有研究报告降低MTP和血清钠水平之间可能存在关联。方法为了评估正常范围内的高渗性脱水作为降低MTP的指标，我们对655名日本老年社区居民男性（年龄≥60岁）进行了一项横断面研究，他们在2015年至2016年进行了一般健康检查。由于高浓度的葡萄糖影响血清渗透压，这可能是这种关联的一个强混杂因素，因此额外的分析仅限于无糖尿病的个体。MTP降低定义为舌压等于或低于研究人群的第20百分位数（≤24.0 kPa）。结果独立于经典的心血管危险因素，血清钠增加1标准差（2.21 mEq/L）时MTP降低的校正比值比为1.29（95%置信区间1.10-1.52）。当分析仅限于无糖尿病的个体时，这种关联变得稍微强一些，调整后的相应值为1.59（95%置信区间1.21-2.10）。结论正常范围内的血清钠水平与日本老年男性的MTP降低独立相关。这一发现表明，在日常临床实践中，测量MTP与估计病理生理学值（如吞咽困难风险和吸入性肺炎风险）具有临床相关性。Geriatr Gerontol Int 2018; 18：183-186。
AimRecent geriatric studies have focused on maximum voluntary tongue pressure against the palate (MTP) as a diagnostic value for dysphagia, as dysphagia causes aspiration pneumonia. Dysphagia can also cause water intake difficulties, resulting in hypernatremia by indicating the presence of hyperosmotic dehydration. However, no studies have reported on a possible association between reduced MTP and serum sodium levels.MethodsTo evaluate hyperosmotic dehydration within the normal range as an indicator of reduced MTP, we carried out a cross‐sectional study of 655 older Japanese community‐dwelling men (age ≥60 years) who undertook a general health check‐up from 2015 to 2016. As a high concentration of glucose influences serum osmolarity, which might act as a strong confounding factor on this association, the additional analysis was limited to individuals without diabetes. Reduced MTP is defined as a tongue pressure at or under the 20th percentile of the study population (≤24.0 kPa).ResultsIndependent of classical cardiovascular risk factors, the adjusted odds ratio of reduced MTP for a 1‐standard deviation increment of serum sodium (2.21 mEq/L) was 1.29 (95% confidence interval 1.10–1.52). When the analysis was limited to individuals without diabetes, the association became slightly stronger, with an adjusted corresponding value of 1.59 (95% confidence interval 1.21–2.10).ConclusionsSerum sodium level within the normal range is independently associated with reduced MTP in older Japanese men. This finding suggests that measuring the MTP is clinically relevant for estimating the pathophysiological values (such as dysphagia risks and aspiration pneumonia risks) in daily clinical practice.Geriatr Gerontol Int 2018; 18: 183–186.