Contribution of systemic inflammation and nutritional status to the relationship between tooth loss and mortality in a community-dwelling older Japanese population: a mediation analysis of data from the Tsurugaya project
Contribution of systemic inflammation and nutritional status to the relationship between tooth loss and mortality in a community-dwelling older Japanese population: a mediation analysis of data from the Tsurugaya project
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DOI：
10.1007/s00784-019-03072-y
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发表时间：
2020-06-01
影响因子：
3.4
通讯作者：
Hattori, Yoshinori
中科院分区：
文献类型：
--
作者：
Hiratsuka, Takako;Komiyama, Takamasa;Hattori, Yoshinori
目的评估全身炎症和营养状况是否有助于牙齿脱落和死亡率之间的关系，在社区居住的日本老年人使用中介分析。材料和方法本纵向研究的目标是社区居住的老年日本人（N = 891）。暴露变量是牙齿数量（缺牙，1-9，10- 1 - 9，>= 20），而结果是2003年至2016年的全因死亡率。营养状况和全身炎症作为介质进行评估，并根据血清白蛋白和高敏C反应蛋白水平，分别。协变量包括年龄、性别、吸烟、饮酒、病史、教育水平、抑郁症状、认知障碍和身体功能。应用考克斯比例风险模型计算牙齿脱落与死亡率之间相关性的风险比（HR）以及全身炎症和营养状况对该相关性的贡献。结果无牙参与者（HR，1.84; 95%置信区间[CI]，1.30-2.59）和有1-9颗牙齿的参与者（HR，1.75; 95% CI，1.28-2.40）组的死亡风险显著高于有≥ 20颗牙齿的参与者。中介分析表明，营养状况有助于牙齿脱落与1-9颗牙齿的参与者死亡率之间的关联，而全身炎症在这种关联中没有作用。结论营养状况可能有助于牙齿脱落和死亡率之间的关联，在社区居住的老年人与剩余牙齿较少的日本人。
Objectives To assess whether systemic inflammation and nutritional status contribute to a relationship between tooth loss and mortality in community-dwelling older Japanese individuals using mediation analyses. Materials and methods This longitudinal study targeted community-dwelling older Japanese individuals (N = 891). The exposure variable was the number of teeth (edentulous, 1-9, 10-19, >= 20), while the outcome was all-cause mortality from 2003 to 2016. Nutritional status and systemic inflammation were evaluated as mediators and based on serum albumin and high-sensitivity C-reactive protein levels, respectively. Covariates included age, sex, smoking, alcohol consumption, medical history, educational level, depressive symptoms, cognitive impairment, and physical function. The Cox proportional hazards model was applied to calculate hazard ratios (HRs) for the association between tooth loss and mortality and the contributions of systemic inflammation and nutritional status to this association. Results Edentulous participants (HR, 1.84; 95 % confidence interval [CI], 1.30-2.59) and those with 1-9 teeth (HR, 1.75; 95% CI, 1.28-2.40) groups exhibited a significantly higher risk of mortality than did those with >= 20 teeth. Mediation analyses showed that nutritional status contributed to the association between tooth loss and mortality in participants with 1-9 teeth, whereas systemic inflammation played no role in this association. Conclusions Nutritional status may contribute to the association between tooth loss and mortality in community-dwelling older Japanese individuals with fewer remaining teeth.