TY - JOUR
T1 - Contribution of systemic inflammation and nutritional status to the relationship between tooth loss and mortality in a community-dwelling older Japanese population
T2 - a mediation analysis of data from the Tsurugaya project
AU - Hiratsuka, Takako
AU - Komiyama, Takamasa
AU - Ohi, Takashi
AU - Tanji, Fumiya
AU - Tomata, Yasutake
AU - Tsuji, Ichiro
AU - Watanabe, Makoto
AU - Hattori, Yoshinori
N1 - Funding Information:
This research was partly supported by a Health Labour Sciences Research Grant (H21-Choju-Ippan-001, H22-Junkankitou-Ippan-001) and JSPS KAKENHI Grant Numbers 17H06533. The sponsors were the only source of funding and played no role in study design and methodology, subject recruitment, data collection and analysis, and manuscript preparation.
Publisher Copyright:
© 2019, Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2020/6/1
Y1 - 2020/6/1
N2 - 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. Clinical relevance: The data from this prospective cohort study help in elucidating parts of the biological mechanism underlying tooth loss and all-cause mortality in older individuals.
AB - 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. Clinical relevance: The data from this prospective cohort study help in elucidating parts of the biological mechanism underlying tooth loss and all-cause mortality in older individuals.
KW - Mediation analysis
KW - Mortality
KW - Nutritional status
KW - Prospective cohort study
KW - Systemic inflammation
KW - Tooth loss
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U2 - 10.1007/s00784-019-03072-y
DO - 10.1007/s00784-019-03072-y
M3 - Article
C2 - 31485781
AN - SCOPUS:85072187003
VL - 24
SP - 2071
EP - 2077
JO - Clinical Oral Investigations
JF - Clinical Oral Investigations
SN - 1432-6981
IS - 6
ER -