Mikari Asakawa, Shinya Kageyama, Heba Shehta Said, Jiale Ma, Shino Suma, Michiko Furuta and Toru Takeshita : Association of oral fungal profiles with health status and bacterial composition in elderly adults receiving community support and home care service, Applied and Environmental Microbiology, 90, 8, e0085724, 2024.
(要約)
Fungi compose a minority but a common component of normal oral microbiota and contribute to oral and systemic health by interacting with bacterial inhabitants. This study investigated the relationship of oral fungal profiles to health status and bacterial profiles of 159 elderly adults receiving community support and home care services. Fungal and bacterial densities and compositions were determined based on the fungal ribosomal internal transcribed spacer region and bacterial 16S rRNA gene amplicon analyses, respectively. The total fungal density of 87 individuals exceeded 5,000 copies, and their microbiota was characterized by significantly less dense bacterial populations and lower relative abundances of oral health-associated taxa, such as Neisseria perflava and Porphyromonas pasteri, compared with those with less than 5,000 copies of fungi. These individuals were significantly older, had fewer teeth, had lower physical function, and comprised more denture users and individuals with cognitive decline. Fungal compositions were classified into three profiles (Candida albicans-dominant, non-albicans Candida-dominant, and non-Candida-dominant), and individuals with a non-albicans Candida-dominant profile exhibited significantly lower physical and cognitive function than those with the Candida albicans-dominant profile. These results demonstrate that a high-density fungal population co-occurs with poor oral and systemic health status of the host and dysbiosis of the bacterial community, and particularly, the overgrowth of non-albicans Candida species may be implicated in worsening systemic conditions. The interaction between fungal and bacterial components involved in the virulence of oral microbiota has received attention. This study demonstrates that an increase in fungal components is associated with a dysbiotic bacterial community and poor health status in elderly adults. Among individuals with a high-density fungal population, particularly, those with a non-albicans Candida-dominant profile had lower physical and cognitive functions than those with a C. albicans-dominant profile. These findings indicate that the evaluation of fungal components, in addition to the bacterial components, is important to understand the involvement of oral microbiota in oral and systemic diseases in elderly adults.
(キーワード)
Humans / Aged / Female / Male / Aged, 80 and over / Bacteria / Microbiota / Fungi / Mouth / Health Status / Home Care Services / RNA, Ribosomal, 16S / Oral Health
Subaru Inoue, Shino Suma, Michiko Furuta, Naohisa Wada and Yoshihisa Yamashita : Possible association between oral health status and appetite loss in community-dwelling older adults, Nursing & Health Sciences, 26, 1, e13111, 2024.
(要約)
This study aimed to evaluate the association between the oral health status and appetite in community-dwelling older adults. We enrolled 100 people aged ≥65 years who had participated in long-term care prevention projects between December 2018 and January 2019. Appetite was assessed using the Council on Nutrition Appetite Questionnaire score. The oral health status was assessed based on the number of teeth, occlusal condition, swallowing function, tongue coating, and the Oral Health Assessment Tool. A multiple linear regression analysis was performed with appetite as the dependent variable and each variable related to oral health status as an independent variable. The analysis was adjusted for sex, age, activities of daily living, cognitive function, smoking habit, and alcohol consumption. Dental pain was associated with poor appetite in community-dwelling older adults. No other oral health status parameter was associated with appetite. Thus, controlling dental pain is critical to prevent appetite loss while considering other factors.
(キーワード)
Humans / Aged / Independent Living / Oral Health / Appetite / Activities of Daily Living / Pain
Michiko Furuta, Kenji Takeuchi, Toru Takeshita, Yukie Shibata, Shino Suma, Shinya Kageyama, Mikari Asakawa, Yoshihiro Shimazaki, Jun Hata, Toshiharu Ninomiya and Yoshihisa Yamashita : Baseline periodontal status and modifiable risk factors are associated with tooth loss over a 10-year period: Estimates of population attributable risk in a Japanese community, Journal of Periodontology, 93, 4, 526-536, 2022.
(要約)
This study aimed to examine whether modifiable risk factors can predict tooth loss over 10 years and estimate population attributable risk (PAR) for a combination of modifiable factors. This longitudinal study included 1466 participants who underwent dental examinations in 2007 and 2017 and were aged 40 to 79 years at baseline. Periodontal conditions were assessed using the 2018 periodontal classification. Incident tooth loss was defined as ≥4 teeth lost over a 10-year period. We calculated the partial PAR (pPAR%) for tooth loss to estimate the combined effect of modifiable risk factors. Incidence of tooth loss was 17.5%. Directed acyclic graphs were used to identify risk factors for tooth loss. A logistic regression model showed that baseline periodontitis, dental caries experience, no regular dental visit, periodontal treatment, smoking, and obesity were associated with tooth loss after adjusting for covariates; pPAR% was 55.5% (95% confidence interval: 31.1% to 73.0%) in periodontitis Stage III to IV and 87.6% (50.4% to 97.4%) in the combination of all factors, respectively. The sex-stratified analysis showed that smoking and no regular dental visit in men and obesity in women were identified as potential risk factors for tooth loss. Modifiable factors accounted for most cases of incident tooth loss. Risk factors for tooth loss might differ by sex, suggesting that the appropriate approach for preventing tooth loss base on sex.
(キーワード)
health behavior / obesity / periodontitis / risk factors / tooth loss
Jiale Ma, Michiko Furuta, Kazuhiro Uchida, Toru Takeshita, Shinya Kageyama, Mikari Asakawa, Kenji Takeuchi, Shino Suma, Satoko Sakata, Jun Hata, Woosung Sohn, Toshiharu Ninomiya and Yoshihisa Yamashita : Yogurt product intake and reduction of tooth loss risk in a Japanese community, Journal of Clinical Periodontology, 49, 4, 345-352, 2022.
(要約)
To evaluate the longitudinal association between yogurt product intake and oral health in a population-based study. This study included 1967 Japanese residents aged 40-79 years who underwent dental examinations in 2012. Among them, 1469 participants were followed up in 2017 for the incidence of tooth loss, which was defined as two or more teeth lost over 5 years. The intake of yogurt products, defined as yogurt and lactic acid beverages, was estimated using a semi-quantitative food frequency questionnaire. The composition of the salivary microbiota was evaluated. The Poisson regression model showed that a higher intake of yogurt products was negatively associated with the incidence of tooth loss (p for trend = .020), adjusted for potential confounding factors. Mediation analysis confirmed that periodontal condition partly mediated the effect of yogurt product intake on tooth loss, while dental caries experience did not. Additionally, we confirmed the association of a high intake of yogurt products with a low percentage of the salivary microbiota pattern, which was associated with poor oral health. These findings suggest that the intake of yogurt products is associated with a lower risk of tooth loss resulting from periodontal disease, probably via modulation of the oral microbiome composition.
Michiko Furuta, Kenji Takeuchi, Toru Takeshita, Yukie Shibata, Shino Suma, Shinya Kageyama, Mikari Asakawa, Jun Hata, Daigo Yoshida, Yoshihiro Shimazaki, Toshiharu Ninomiya and Yoshihisa Yamashita : 10-year trend of tooth loss and associated factors in a Japanese population-based longitudinal study, BMJ Open, 11, 8, e048114, 2021.
(要約)
We examined the trend in the number of missing teeth in a Japanese community over a 10-year period and the potential associated explanatory factors. Prospective cohort study. A population-based study conducted in 2007, 2012 and 2017 in Japan (Hisayama Study). Residents of a Japanese community aged 40-79 years undergoing dental examination in 2007 (n=2665), 2012 (n=2325) and 2017 (n=2285). The number of missing teeth, periodontal condition, dental caries experience, dental plaque index and oral health behaviours were evaluated each year. The longitudinal analysis of variation in these factors were assessed using mixed models. The age-adjusted and sex-adjusted mean number of missing teeth decreased with time (6.80 in 2007, 6.01 in 2012 and 4.99 in 2017). The mean clinical attachment level (CAL), prevalence of periodontitis and dental plaque index decreased over the study period, while dental caries experience slightly increased. The level of oral health behaviour increased over time. Poisson mixed models showed that changes in mean CAL and dental caries experience were positively associated with the change in the number of missing teeth over time. Linear mixed models showed that changes in dental plaque index and no regular dental visit were positively associated with changes in mean CAL. These findings suggest that a decreasing trend regarding the number of missing teeth in Japan might be associated with improvements in the periodontal condition due to changes in oral hygiene level and oral health behaviour.
Shino Suma, Michiko Furuta, Kenji Takeuchi, Mikiko Tomioka, Yasuyuki Iwasa and Yoshihisa Yamashita : Number of teeth, denture wearing and cognitive function in relation to nutritional status in residents of nursing homes, Gerodontology, 39, 2, 197-203, 2021.
(要約)
Although statistical associations between tooth loss and cognitive decline have been reported, there are few previous studies on denture wearing. Additionally, it remains unclear whether nutritional status mediates this association. Our purpose was to test for the hypothesis that the association between the number of teeth and denture wearing with cognitive function is mediated by nutritional status in residents of nursing homes. We enrolled 162 participants who required long-term care (mean age: 87.7 ± 7.5 years, 26 men and 136 women) and were admitted to eight nursing homes in Fukuoka city, from September 2013 to March 2014. A trained dentist conducted dental and swallowing examinations, and the care-staff assessed nutritional status, comorbid conditions and cognitive function using the Clinical Dementia Rating (CDR). Poisson regression analysis showed that 0-19 teeth without dentures were associated with severe cognitive impairment (CDR 3) (prevalence ratio = 2.00; 95% confidence interval: 1.13-3.55) after adjustment for sex, age, suspected swallowing dysfunction and comorbid conditions. Mediation analysis confirmed that the nutritional status as a mediator of this association (the percentage mediated effect through nutritional status was 23.1%). There is an association between dental status and cognitive impairment in elder individuals, and dentures and poor nutrition are involved in this association. However, due to the cross-sectional design of this study, there is a possibility that this association is bidirectional.
(キーワード)
cognitive function / denture wearing / elders requiring long-term care / nutritional status
Kei Kuroe, Michiko Furuta, Kenji Takeuchi, Toru Takeshita, Shino Suma, Takashi Shinagawa, Yoshihiro Shimazaki and Yoshihisa Yamashita : Association between periodontitis and fibrotic progression of non-alcoholic fatty liver among Japanese adults, Journal of Clinical Periodontology, 48, 3, 368-377, 2021.
(要約)
Non-alcoholic fatty liver (NAFL) is known to develop into liver fibrosis, which increases the risk of liver cirrhosis and liver cancer. The association between periodontal condition and fibrotic progression of NAFL is unclear. This study aimed to clarify this longitudinal association. Among 4812 participants aged 35-64 years undergoing annual health check-ups between 2003 and 2004, and follow-up 5 years later, 392 participants were diagnosed with NAFL. After excluding participants with liver fibrosis at baseline, 341 participants were followed up for 5 years. NAFL disease fibrosis score of ≥-1.455 was used to evaluate the probability of the presence of liver fibrosis. During the follow-up period, 10.6% of participants progressed to liver fibrosis. A higher clinical attachment level (CAL) tended to be associated with the incidence of liver fibrosis in the logistic regression analysis (odds ratio [OR] 1.82, 95% confidence interval [CI], 0.94-3.49, p = .074). The stratified analysis by obesity revealed a significant association with higher CAL in obese participants (OR 2.87, 95% CI, 1.23-6.69, p = .015), but not in non-obese participants. Higher CAL was associated with an increased probability of liver fibrosis in obese adults with NAFL.
Michiko Furuta, Kenji Takeuchi, Toru Takeshita, Akihiko Tanaka, Shino Suma, Takashi Shinagawa, Yoshihiro Shimazaki and Yoshihisa Yamashita : Longitudinal associations of toothbrushing with obesity and hyperglycemia, Journal of Epidemiology, 30, 12, 556-565, 2020.
(要約)
Toothbrushing is a health-related lifestyle habit and has been reported to contribute not only to oral health but also to some parameters of general health; however, little research has been conducted to understand the association of the frequency and timing of toothbrushing with the development of comprehensive metabolic abnormalities, with consideration of oral health condition. In this study, using longitudinal data, we examined this association in Japanese adults, adjusting for periodontal condition. A 5-year longitudinal study was performed with 4,537 participants between 35 and 64 years old who underwent an annual dental examination in both 2003 and 2008. Data about toothbrushing habits and metabolic abnormalities, such as obesity, hyperglycemia, diabetes, hypertension, hypertriglyceridemia, and low levels of high-density lipoprotein-cholesterol, were analyzed using Poisson regression analysis. The percentage of participants with a toothbrushing frequency ≤1 time/day was 29.4%, and that for those not brushing their teeth at night was 21.4%. The incidences of obesity and hyperglycemia after 5 years were 5.5% and 28.4%, respectively. A toothbrushing frequency ≤1 time/day was associated with development of obesity (prevalence rate ratio [PRR] 1.77; 95% confidence interval [CI], 1.12-2.80), after adjusting for periodontal condition and potential risk factors. A significant association between not brushing teeth at night and hyperglycemia (PRR 1.30; 95% CI, 1.02-1.66) was observed in participants with toothbrushing frequency of 1 time/day. No association was found between toothbrushing habits and other metabolic abnormalities. This study suggests that toothbrushing habits are associated with the development of obesity and hyperglycemia.
K. Takeuchi, K. Matsumoto, M. Furuta, S. Fukuyama, T. Takeshita, H. Ogata, Shino Suma, Y. Shibata, Y. Shimazaki, J. Hata, T. Ninomiya, Y. Nakanishi, H. Inoue and Y. Yamashita : Periodontitis Is Associated with Chronic Obstructive Pulmonary Disease, Journal of Dental Research, 98, 5, 534-540, 2019.
(要約)
Although they are known to share pathophysiological processes, the relationship between periodontitis and chronic obstructive pulmonary disease (COPD) is not fully understood. The aim of the present study was to test the hypothesis that periodontitis is associated with a greater risk of development of COPD, when smoking is taken into account. The analysis in a 5-y follow-up population-based cohort study was based on 900 community-dwelling Japanese adults (age: 68.8 ± 6.3 [mean ± SD], 46.0% male) without COPD aged 60 or older with at least 1 tooth. Participants were classified into 3 categories according to baseline periodontitis severity (no/mild, moderate, and severe). COPD was spirometrically determined by a fixed ratio of <0.7 for forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) and by FEV1/FVC below the lower limit of normal. Poisson regression was used to calculate the relative risk (RR) of developing COPD according to the severity of periodontitis. The population attributable fraction (PAF) was also calculated. During follow-up, 22 (2.4%) subjects developed COPD. Compared with no/mild periodontitis subjects, a significantly increased risk of COPD occurred among severe periodontitis subjects (RR = 3.55; 95% confidence interval [CI], 1.18 to 10.67), but no significant differences were observed between the no/mild and moderate categories (RR = 1.48; 95% CI, 0.56 to 3.90). After adjustment for potential confounders, including smoking intensity, the relationship between severe periodontitis and risk of COPD remained significant (RR = 3.51; 95% CI, 1.15 to 10.74). Likewise, there was a positive association of periodontitis severity with risk of COPD ( P for trend = 0.043). The PAF for COPD due to periodontitis was 22.6%. These data highlight the potential importance of periodontitis as a risk factor for COPD.
(キーワード)
community dentistry / dental health survey(s) / epidemiology / periodontal medicine / risk factor(s) / tobacco
Kenji Takeuchi, Koichiro Matsumoto, Michiko Furuta, Satoru Fukuyama, Toru Takeshita, Hiroaki Ogata, Shino Suma, Yukie Shibata, Yoshihiro Shimazaki, Jun Hata, Toshiharu Ninomiya, Yoichi Nakanishi, Hiromasa Inoue and Yoshihisa Yamashita : Periodontal status and lung function decline in the community: the Hisayama study, Scientific Reports, 8, 1, 13354, 2018.
(要約)
This study aimed to determine whether periodontal status is related to a decline in lung function in a general Japanese population. We followed a total of 1,650 community-dwelling individuals (≥40 years) without chronic obstructive pulmonary disease, with at least one teeth, for 3 years. Periodontal status was assessed at baseline by clinical attachment loss (CAL) and probing pocket depth (PPD) at two sites for each tooth, and the mean values were calculated for each subject. Lung function was measured at baseline and follow-up using spirometry, and longitudinal decline in forced expiratory volume in one second (FEV1) was calculated. Multivariate Poisson regression with robust error variance was used to estimate risk ratio (RR). After adjusting for potential confounders including smoking status, there was a tendency for the adjusted RR of developing rapid lung function decline (≥160 mL/3years, the highest quartile of the distribution of FEV1 declines) to increase as mean CAL levels increased (P trend = 0.039). Likewise, a positive association was observed between mean PPD levels and RR of developing rapid lung function decline (P trend = 0.047). Our findings suggest deterioration of periodontal status could be a risk factor for rapid lung function decline in the general Japanese population.
Naoko Yatabe, Kenji Takeuchi, Maya Izumi, Michiko Furuta, Toru Takeshita, Yukie Shibata, Shino Suma, Shinya Kageyama, Seijun Ganaha, Haruka Tohara and Yoshihisa Yamashita : Decreased cognitive function is associated with dysphagia risk in nursing home older residents, Gerodontology, 35, 4, 376-381, 2018.
(要約)
To examine the association between cognitive function and dysphagia risk among Japanese nursing home residents. Reduction in cognitive function can influence the intake of food during swallowing, and may be an aggravating factor in dysphagia. This cross-sectional study included 236 residents aged ≥60 years from eight nursing homes. Screening of dysphagia, especially aspiration risk, was conducted using the Modified Water Swallow Test, whose scores from one to three were classified as at risk of dysphagia. Cognitive function was evaluated using Mini-Mental State Examination (MMSE). Number of teeth and occlusal support were evaluated by clinical examination. The participants were stratified into dentulous and edentulous groups, because the number of teeth could influence swallowing function. The odds ratio (OR) and 95% confidence interval (CI) for dysphagia risk based on the scores of MMSE were calculated using logistic regression. Demographic characteristics, activity of daily living, comorbidities, health behaviour and occlusal support were used as covariates. Among the 236 participants (111 dentulous participants and 125 edentulous participants) included in our analysis, 16.9% belonged to risk of dysphagia. Dentulous participants with higher scores of MMSE tended to have significantly lower odds of dysphagia risk after adjusting for covariates (OR = 0.87, 95% CI = 0.80-0.96). Despite the lack of significant differences, edentulous participants with higher score of MMSE tended to have lower odds of dysphagia risk (OR = 0.92, 95% CI = 0.83-1.00). Decreased cognitive function may be an independent predictor of dysphagia among dentulous and edentulous adults.
(キーワード)
cognition / deglutition / long-term care facilities / swallowing
Shinya Kageyama, Toru Takeshita, Michiko Furuta, Mikiko Tomioka, Mikari Asakawa, Shino Suma, Kenji Takeuchi, Yukie Shibata, Yasuyuki Iwasa and Yoshihisa Yamashita : Relationships of variations in the tongue microbiota and pneumonia mortality in nursing home residents, Journals of Gerontology Series A Biological Sciences and Medical Sciences, 73, 8, 1097-1102, 2018.
(要約)
Aspiration of oral debris, containing dense oral bacteria, is a major cause of pneumonia in elderly adults. This study investigated the relationship between tongue microbiota composition and incidence of pneumonia-related deaths, in nursing home residents. The subjects were assessed for health conditions, including their tongue microbiota, at baseline. We determined tongue microbiota profiles by 16S ribosomal RNA gene sequencing and clustering approach. All subjects (n = 173) were followed prospectively for a median of 19 months to assess the incidence of all-cause death, including pneumonia-related death. We evaluated risk estimates of microbiota effects on death using multivariate Cox proportional hazards regression analysis. Tongue microbiota were classified into two community types: type I was dominated by Prevotella and Veillonella species, while type II was dominated by Neisseria and Fusobacterium species. The subjects with type I microbiota exhibited a significantly greater risk of all-cause death (adjusted hazard ratio [aHR] = 3.79, 95% confidence interval [CI] = 1.38-10.39) and pneumonia-related death (aHR = 13.88, 95% CI = 1.64-117.21), than those with type II microbiota. There was no significant association between microbiota type and other-cause death. The tongue microbiota type was significantly associated with an increased mortality risk from pneumonia in nursing home residents.
Shino Suma, Yutaka Watanabe, Hirohiko Hirano, Ai Kimura, Ayako Edahiro, Shuichi Awata, Yoshihisa Yamashita, Kenji Matsushita, Hidenori Arai and Takashi Sakurai : Factors affecting the appetites of persons with Alzheimer's disease and mild cognitive impairment, Geriatrics and Gerontology International, 18, 8, 1236-1243, 2018.
(要約)
Appetite loss has been associated with Alzheimer's disease (AD) and mild cognitive impairment (MCI). Among older people, decreased appetite can result in poor nutrition and subsequent loss of independent living. We examined the factors related to appetite loss in persons with AD and MCI to provide evidence for countermeasures to prevent appetite loss and progression of cognitive impairment. We included 1238 older adults undergoing outpatient treatment at the Center for Comprehensive Care and Research on Memory Disorders (Medical Center for Dementia) at the National Center for Geriatrics and Gerontology in Obu, Japan. The Council on Nutrition Appetite Questionnaire, an appetite questionnaire for older people, was used to evaluate appetite. Appetite loss in persons diagnosed with AD or MCI was divided into two groups according to the Council on Nutrition Appetite Questionnaire scores, and logistic regression analysis was carried out to identify independent factors associated with appetite loss. The following variables were used to evaluate for covariates: general information, functional evaluation and medications. The AD and MCI groups contained 853 and 385 individuals, respectively. In both groups, depression and difficulty in maintaining attention while eating were significantly associated with poor appetite. Among persons with AD, lower vitality, more comorbidities, non-use of antidementia drugs and use of psychotropic drugs were also significantly associated with poor appetite. The present study recognized possible factors individually associated with appetite loss among persons with AD or MCI. Future studies are required to examine supportive strategies to treat poor appetite in these populations. Geriatr Gerontol Int 2018; 18: 1236-1243.
Akihiko Tanaka, Kenji Takeuchi, Michiko Furuta, Toru Takeshita, Shino Suma, Takashi Shinagawa, Yoshihiro Shimazaki and Yoshihisa Yamashita : Relationship of toothbrushing to metabolic syndrome in middle-aged adults, Journal of Clinical Periodontology, 45, 5, 538-547, 2018.
(要約)
To examine the effect of toothbrushing on the development of metabolic syndrome (MetS), including assessment of periodontal status, in middle-aged adults. This 5-year follow-up retrospective study was performed in 3,722 participants (2,897 males and 825 females) aged 35-64 years who underwent both medical check-ups and dental examinations. Metabolic components included obesity, elevated triglycerides, blood pressure, fasting glucose and reduced high-density lipoprotein. Toothbrushing frequency was assessed using a questionnaire. Periodontal disease was defined as having at least one site with a pocket depth of ≥4 mm. Logistic regression analysis was performed to evaluate the relationship between toothbrushing frequency at the baseline examination and the development of MetS (≥3 components). During follow-up, 11.1% of participants developed MetS. After adjusting for potential confounders including periodontal disease, participants with more frequent daily toothbrushing tended to have significantly lower odds of developing MetS (p for trend = .01). The risk of development of MetS was significantly lower in participants brushing teeth ≥3 times/day than in those brushing teeth ≤1 time/day (odds ratio = 0.64, 95% confidence interval = 0.45-0.92). Frequent daily toothbrushing was associated with lower risk of development of MetS.
(キーワード)
epidemiology / lifestyle-related diseases / oral health behaviour / oral hygiene / periodontitis / retrospective cohort study
Shino Suma, Mariko Naito, Kenji Wakai, Toru Naito, Masaaki Kojima, Osami Umemura, Makoto Yokota, Nobuhiro Hanada and Takashi Kawamura : Tooth loss and pneumonia mortality: A cohort study of Japanese dentists, Plos One, 13, 4, e0195813, 2018.
(要約)
Although associations between oral health and pneumonia have been reported in previous studies, particularly in the institutionalized elderly, few prospective studies have investigated the association between oral condition and pneumonia among community-dwelling people and whether the findings among inpatients or patients in nursing homes are applicable to the general population is still unclear. The oral bacteria propagated in the periodontal regions may drop into the lung and increase the risk of pneumonia. We, therefore, investigated the association of tooth loss with mortality from pneumonia in a cohort study of Japanese dentists. Members of the Japan Dental Association (JDA) participated in the LEMONADE (Longitudinal Evaluation of Multi-phasic, Odontological and Nutritional Associations in Dentists) Study. From 2001 to 2006, they completed a baseline questionnaire on lifestyle and health factors including the number of teeth lost (excluding third molars). We followed 19,775 participants (mean age ± standard deviation, 51.4 ± 11.7 years; 1,573 women [8.0%] and 18,202 men [92.0%]) for mortality from pneumonia (ICD-10, J12-J18). Mortality data were collected via the fraternal insurance program of the JDA. The hazard ratios (HRs) were estimated with adjustment for sex, age, body mass index, smoking status, physical activity and diabetes history. During the median follow-up period of 9.5 years, we documented 68 deaths from pneumonia. Participants who were edentulous at baseline were at significantly increased risk of mortality from pneumonia. The multivariable-adjusted HRs were 2.07 (95% confidence interval [CI], 1.09-3.95) for the edentulous and 1.60 (95% CI, 0.83-3.10) for loss of 15-27 teeth relative to loss of 0-14 teeth (trend p = 0.026). The HR per one tooth loss was also significant; 1.031 (95% CI, 1.004-1.060). In conclusion, a large number of teeth lost may indicate an increased risk of mortality from pneumonia in community-dwelling populations.
(キーワード)
Adult / Aged / Aged, 80 and over / Cohort Studies / Comorbidity / Dentists / Female / Humans / Male / Middle Aged / Pneumonia / Proportional Hazards Models / Public Health Surveillance / Risk Factors / Tooth Loss
K. Takeuchi, M. Furuta, Y. Okabe, Shino Suma, T. Takeshita, S. Akifusa, M. Adachi, T. Kinoshita, T. Kikutani and Y. Yamashita : Swallowing disorders and 1-year functional decline in community-dwelling older adults receiving home care, Journal of Oral Rehabilitation, 44, 12, 982-987, 2017.
(要約)
The purpose of this study was to clarify the effect of swallowing disorders on functional decline in community-dwelling older adults receiving home care. This was a 1-year follow-up survey of 176 individuals ≥60 years living at home and receiving homecare services, without total dependence in basic daily living activities, in two mid-sized municipalities in Fukuoka, Japan. Functional decline was measured using the Barthel index (BI), and the primary outcome was total dependence in basic daily living activities (BI ≤ 20 points). Swallowing function was assessed using cervical auscultation, and the primary predictor was swallowing disorders. Logistic regression models were used to assess univariate and multivariate associations between baseline swallowing function and functional decline during follow-up. During follow-up 16 (9.1%), the participants became totally dependent in basic daily living activities. The participants with swallowing disorders had 6.41 times higher odds of total dependence in basic daily living activities compared to participants with normal swallowing function. After adjusting for potential confounders, swallowing disorders were significantly associated with higher odds of total dependence in basic daily living activities (odds ratio = 5.21, 95% confidence interval = 1.33-20.44). Regarding swallowing disorders, the corresponding population attributable fraction (%) of the incidence of total dependence in basic daily living activities was 50.4%. The current findings demonstrated that swallowing disorders were associated with greater risk of functional decline in basic daily living activities among older adults living at home and receiving home nursing care. Maintenance and improvement of swallowing function may prevent late-life functional decline.
(キーワード)
Barthel Index / dysphagia / elderly / physical decline / prospective study
Yuta Hattori, Mariko Naito, Masahiko Satoh, Masahiro Nakatochi, Hisao Naito, Masashi Kato, Sahoko Takagi, Takashi Matsunaga, Toshio Seiki, Tae Sasakabe, Shino Suma, Sayo Kawai, Rieko Okada, Asahi Hishida, Nobuyuki Hamajima and Kenji Wakai : Metallothionein MT2A A-5G polymorphism as a risk factor for chronic kidney disease and diabetes: Cross-sectional and cohort studies, Toxicological Sciences, 152, 1, 181-193, 2016.
(要約)
Metallothioneins (MTs) are proteins that protect cells from toxic agents such as heavy metal ions or reactive oxygen species. MT2A A-5G is a single nucleotide polymorphism in the promoter region of the MT2A gene, and the minor G allele results in lower transcription efficiency. We aimed to elucidate associations between MT2A A-5G and risks of 2 diseases potentially related to lowered MT expression, chronic kidney disease (CKD), and diabetes mellitus (DM), in a community-dwelling population. Study subjects were Nagoya city residents participating in the Japan Multi-Institutional Collaborative Cohort Study (J-MICC) Daiko Study, comprised 749 men and 2,025 women, aged 39-75 years. CKD (>stage 3) and DM were defined by standard guidelines. Associations were evaluated using logistic regression models with adjustments for age, sex and potential confounders in a cross-sectional study, and verified in a 5-year longitudinal study. Odds ratios (OR [95% confidence interval]) were calculated relative to the AA genotype. Serum MT (I + II), Cd and zinc levels were also determined by genotype. The OR of the GG genotype for CKD risk was 3.98 (1.50, 10.58) in the cross-sectional study and 5.17 (1.39, 19.28) in the longitudinal study. The OR of the GA genotype for DM was 1.86 (1.26, 2.75) in the cross-sectional study and 2.03 (1.19, 3.46) in the longitudinal study. MT2A A-5G may be associated with CKD and DM risks. This polymorphism is a promising target for evaluations of CKD and DM risks with possible involvement of low-dose chronic exposure to environmental pollutants.
Masayuki Sakiyama, Hirotaka Matsuo, Seiko Shimizu, Hiroshi Nakashima, Takahiro Nakamura, Akiyoshi Nakayama, Toshihide Higashino, Mariko Naito, Shino Suma, Asahi Hishida, Takahiro Satoh, Yutaka Sakurai, Tappei Takada, Kimiyoshi Ichida, Hiroshi Ooyama, Toru Shimizu and Nariyoshi Shinomiya : The effects of URAT1/SLC22A12 nonfunctional variants,R90H and W258X, on serum uric acid levels and gout/hyperuricemia progression, Scientific Reports, 6, 20148, 2016.
(要約)
Urate transporter 1 (URAT1/SLC22A12), a urate transporter gene, is a causative gene for renal hypouricemia type 1. Among several reported nonsynonymous URAT1 variants, R90H (rs121907896) and W258X (rs121907892) are frequent causative mutations for renal hypouricemia. However, no case-control study has evaluated the relationship between gout and these two variants. Additionally, the effect size of these two variants on serum uric acid (SUA) levels remains to be clarified. Here, 1,993 primary gout patients and 4,902 health examination participants (3,305 males and 1,597 females) were genotyped with R90H and W258X. These URAT1 variants were not observed in any gout cases, while 174 subjects had the URAT1 variant in 2,499 health examination participants, respectively (P = 8.3 × 10(-46)). Moreover, in 4,902 health examination participants, the URAT1 nonfunctional variants significantly reduce the risk of hyperuricemia (P = 6.7 × 10(-19); risk ratio = 0.036 in males). Males, having 1 or 2 nonfunctional variants of URAT1, show a marked decrease of 2.19 or 5.42 mg/dl SUA, respectively. Similarly, females, having 1 or 2 nonfunctional variants, also evidence a decrease of 1.08 or 3.89 mg/dl SUA, respectively. We show that URAT1 nonfunctional variants are protective genetic factors for gout/hyperuricemia, and also demonstrated the sex-dependent effect size of these URAT1 variants on SUA (P for interaction = 1.5 × 10(-12)).
Takashi Tamura, Emi Morita, Sayo Kawai, Tae Sasakabe, Yuka Sugimoto, Nana Fukuda, Shino Suma, Hiroko Nakagawa, Rieko Okada, Asahi Hishida, Mariko Naito, Nobuyuki Hamajima and Kenji Wakai : No association between Helicobacter pylori infection and diabetes mellitus among a general Japanese population: a cross-sectional study, Springerplus, 4, 1, 2015.
(キーワード)
Cross-sectional study / Diabetes mellitus / East Asian CagA / Helicobacter pylori / Japan
Miwa Yamaguchi, Hirokazu Uemura, Kokichi Arisawa, Sakurako Katsuura-Kamano, Nobuyuki Hamajima, Asahi Hishida, Shino Suma, Isao Oze, Kazuyo Nakamura, Naoyuki Takashima, Sadao Suzuki, Rie Ibusuki, Haruo Mikami, Keizo Ohnaka, Nagato Kuriyama, Michiaki Kubo and Hideo Tanaka : Association between brain-muscle-ARNT-like protein-2 (BMAL2) gene polymorphism and type 2 diabetes mellitus in obese Japanese individuals: A cross-sectional analysis of the Japan Multi-institutional Collaborative Cohort Study, Diabetes Research and Clinical Practice, 110, 3, 301-308, 2015.
(要約)
Brain-muscle-Arnt-like protein-1 (BMAL1) and BMAL2 genes are essential components of the circadian clock, and are considered to be involved in glucose homeostasis. We examined whether single nucleotide polymorphisms (SNPs) of BMAL1 and BMAL2 were associated with the prevalence of type 2 diabetes (T2DM) in the general Japanese population. We studied 2467 subjects (1232 men and 1235 women, 35-69 years old), including 105 men and 57 women with T2DM, from the participants of the Japan Multi-institutional Collaborative Cohort Study. The association between SNPs in the BMAL1 (rs11022775 and rs2290035) and BMAL2 (rs7958822) genes and T2DM were analyzed by multiple logistic regression after adjustment for potential confounders. Analysis was also performed after stratification by body mass index (≥25 kg/m(2) and <25 kg/m(2)) to investigate an interaction between genotypes and obesity. The A/G and A/A genotypes of BMAL2 rs7958822 showed significantly higher adjusted odds ratios (OR) for T2DM than the G/G genotype among obese men (OR=2.2, 95% confidence intervals [CI] 1.1, 4.6, P for interaction=0.0495) and obese women (OR=2.7, 95% CI 1.1, 6.7, P for interaction=0.199). There were no significant associations between BMAL1 rs11022775 or rs2290035 genotypes and T2DM. To the best of our knowledge, this is the first study to show the significant association between BMAL2 rs7958822 genotype and T2DM among obese subjects.
(キーワード)
Brain-muscle-Arnt-like protein / Gene-environment interaction / Obesity / Single nucleotide polymorphisms / Type 2 diabetes
Shino Suma, M. Naito, K. Wakai, T. Sasakabe, Y. Hattori, R. Okada, S. Kawai, A. Hishida, E. Morita, H. Nakagawa, T. Tamura and N. Hamajima : Effects of IL6 C-634G polymorphism on tooth loss and their interaction with smoking habits, Oral Diseases, 21, 6, 807-813, 2015.
(要約)
To examine the association between an IL6 (Interleukin-6) polymorphism (C-634G or rs1800796) and tooth loss, and an interaction between the polymorphism and smoking habits for the loss. Our subjects were 4917 check-up examinees ages 35-69. They reported tooth loss and lifestyle in a questionnaire. We regressed the number of teeth on the IL6 genotype, gender, age, smoking, drinking, diabetes, hypertension, physical activity, energy intake, education, and brushing. We further estimated multivariate-adjusted odds ratios (ORs) for having <20 teeth. Participants with a GG genotype tended to have less teeth than those with CC; β = -0.798 (95% confidence interval [CI] = -1.501--0.096). Subjects with a GG genotype were more likely to have <20 teeth than those with CC; OR was 1.56 (95% CI = 1.08-2.25). Association between current smoking and tooth loss was stronger among those with GG than among those with CC. In a multiple regression analysis, a significant interaction was found between GG genotype and current smoking in the prediction of tooth loss (P = 0.018). The IL6 C-634G polymorphism was significantly associated with tooth loss. Our results suggest greater effects of smoking on tooth loss in GG genotype individuals.
(キーワード)
Interleukin-6 / Polymorphism / Smoking / Tooth loss
Junichiro Mokuno, Asahi Hishida, Emi Morita, Tae Sasakabe, Yuta Hattori, Shino Suma, Rieko Okada, Sayo Kawai, Mariko Naito and Kenji Wakai : ATP-binding cassette transporter A1 (ABCA1) R219K (G1051A, rs2230806) polymorphism and serum high-density lipoprotein cholesterol levels in a large Japanese population: Cross-sectional data from the Daiko study, Endocrine Journal, 62, 6, 543-549, 2015.
(要約)
Among polymorphisms in ATP-binding cassette transporter A1 (ABCA1) gene, the available evidence demonstrates that the ABCA1 R219K polymorphism (G1051A, rs2230806) K allele is associated with a higher high-density lipoprotein cholesterol (HDL- C) level and may play a protective role against coronary artery disease (CAD) risk in Asians and Caucasians. The findings from many underpowered studies from Asian countries (n=71-597), however, still remain inconsistent. The objective of this study was to overcome the limitations of previous studies in Asia and provide solid epidemiologic evidence. Subjects were participants of a cohort study, who visited the Daiko Medical Center in Nagoya, Japan. The cohort study belongs to the Japan Multi-Institutional Collaborative Cohort Study (J-MICC Study). In the Daiko Study, 5,133 participants (1,458 men and 3,675 women) aged 35-69 years enrolled from 2008 through 2010 were eligible for the analyses. The ABCA1 polymorphism was genotyped by the polymerase chain reaction with confronting two-pair primers (PCR-CTPP) method. Among all the subjects, the genotype frequencies were 23.9% (n=1,225) for RR, 49.3% (n=2,532) for RK, and 26.8% (n=1,376) for KK, which was in Hardy-Weinberg's equilibrium (P =0.36). Background characteristics did not significantly differ among the genotypes including alcohol and tobacco use. The mean ± SD of HDL-C concentration was higher in men and women with RK or KK genotype than those with RR, although the difference between these genotypes was not statistically significant in both sexes (P =0.31 in men and 0.26 in women by ANOVA). In the multiple linear regression analysis to estimate the independent effects of the R219K polymorphism on HDL-C level, however, the number of K allele was significantly correlated with an increased level of HDL-C (trend P=0.033). Those with the KK genotype showed a significantly higher HDL-C concentration compared with those with the RR genotype by a mean of 1.18 mg/dL. The R219K polymorphism of ABCA1 independently associated with serum level of HDL-C in a large Japanese population.
Toshinori Chiba, Hirotaka Matsuo, Yusuke Kawamura, Shushi Nagamori, Takashi Nishiyama, Ling Wei, Akiyoshi Nakayama, Takahiro Nakamura, Masayuki Sakiyama, Tappei Takada, Yutaka Taketani, Shino Suma, Mariko Naito, Takashi Oda, Hiroo Kumagai, Yoshinori Moriyama, Kimiyoshi Ichida, Toru Shimizu, Yoshikatsu Kanai and Nariyoshi Shinomiya : NPT1/SLC17A1 is a renal urate exporter in humans and its common gain-of-function variant decreases the risk of renal underexcretion gout, Arthritis and Rheumatology, 67, 1, 281-287, 2015.
(要約)
Serum uric acid (SUA) levels in humans are mainly regulated by urate transporters. Recent genome-wide association studies suggested that common variants of the human sodium-dependent phosphate cotransporter type 1 gene (NPT1/SLC17A1) influence SUA. NPT1 has been reported to mediate urate transport, but its physiologic role in regulating SUA in humans remains unclear. Furthermore, the findings of replication studies of the relationship between NPT1 variants and gout have been inconsistent. The aims of this study were to investigate the effect of NPT1 on gout and to determine its physiologic role. Five hundred forty-five male Japanese patients with gout and 1,115 male Japanese control subjects were genotyped for rs1165196 (I269T), a common missense variant in NPT1. Analyses of the association between rs1165196 and gout were then conducted, focusing especially on renal underexcretion (RUE) gout. Immunohistochemical analysis and functional analysis using Xenopus oocytes were also performed. Single-nucleotide polymorphism rs1165196 significantly decreased the risk of RUE gout (odds ratio 0.73, P = 0.031) but did not confer a risk for all gout (P = 0.123). The immunohistochemical analysis revealed that human NPT1 is localized to the apical membrane of the renal proximal tubule. The functional analysis using Xenopus oocyte expression systems showed that rs1165196 increases NPT1-mediated urate export. This study showed that NPT1 is a urate exporter located in the renal proximal tubule in humans, and that its common gain-of-function variant, rs1165196, causes RUE gout, a major subtype of gout. These findings enable us to deepen our understanding of the physiologic role of NPT1 as a renal urate exporter as well as its pathophysiologic role in gout.
(キーワード)
Amino Acid Sequence / Animals / Case-Control Studies / Female / Gene Frequency / Genetic Predisposition to Disease / Genotype / Gout / Humans / Kidney / Kidney Tubules, Proximal / Male / Molecular Sequence Data / Mutation, Missense / Oocytes / Polymorphism, Single Nucleotide / Risk Factors / Sodium-Phosphate Cotransporter Proteins, Type I / Uric Acid / Xenopus
Yuka Sugimoto, Kenji Wakai, Hiroko Nakagawa, Shino Suma, Tae Sasakabe, Tatsuhiko Sakamoto, Naoyuki Takashima, Sadao Suzuki, Shin Ogawa, Keizo Ohnaka, Nagato Kuriyama, Kokichi Arisawa, Haruo Mikami, Michiaki Kubo, Satoyo Hosono, Nobuyuki Hamajima and Hideo Tanaka : Associations between polymorphisms of interleukin-6 and related cytokine genes and serum liver damage markers: A cross-sectional study in the Japan Multi-Institutional Collaborative Cohort (J-MICC) Study, Gene, 557, 2, 158-162, 2014.
(要約)
Cytokines, including interleukin-6 (IL-6), play an important role in the liver. The aim of this study was to investigate associations between common polymorphisms in potential functional promoters of cytokine genes and liver damage markers among enrollees of a large Japanese cohort study. Subjects included 3257 Japanese individuals (1608 men and 1649 women, aged 35-69 years). Six single nucleotide polymorphisms (SNPs) in the promoter regions of five cytokine genes, IL1B (T-31C), IL6 (C-634G), IL8 (T-251A), IL10 (T-819C), tumor necrosis factor-A (TNFA) (T-1031C), and TNFA (C-857T), were genotyped by polymerase chain reaction. Information regarding alcohol intake, smoking habits, height, and weight was collected by a self-administered questionnaire. Serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were measured during a routine health check-up. Of the six SNPs genotyped, an IL6 polymorphism (rs1800796, C-634G) was most strongly associated with a liver damage marker, AST. Mean serum AST was significantly different among the three genotypes (mean ± SD, 22.7 ± 7.3 IU/L for CC, 22.8 ± 7.7 IU/L for CG, and 24.3 ± 8.6 IU/L for GG, p=0.011 by analysis of variance). The differences remained significant after adjustment for potential confounders by general linear models. The variations in mean serum AST and ALT levels were marked especially among men. Thus, the functional polymorphism IL6 C-634G may affect serum AST and ALT levels, possibly through different IL-6 production.
Toshinori Chiba, Hirotaka Matsuo, Masayuki Sakiyama, Akiyoshi Nakayama, Seiko Shimizu, Kenji Wakai, Shino Suma, Hiroshi Nakashima, Yutaka Sakurai, Toru Shimizu, Kimiyoshi Ichida and Nariyoshi Shinomiya : Common variant of ALPK1 is not associated with gout: a replication study, Human Cell, 28, 1, 1-4, 2014.
(要約)
Gout is one of the most kinds of common inflammatory arthritis as a consequence of hyperuricemia. Alpha-protein kinase 1 (ALPK1) gene locates in a gout-susceptibility locus on chromosome 4q21-31, and encodes ALPK1 protein which plays a pivotal role in the phosphorylation of myosin 1. In the previous genetic study of Taiwanese populations, 3 single nucleotide polymorphisms (SNPs), rs11726117, rs231247 and rs231253, in ALPK1 gene were reported to have a significant association with gout. However, no replication study has been performed to confirm this association. Therefore, we first conducted a replication study with clinically defined gout patients in a different population. Linkage disequilibrium (LD) analyzes of the 3 SNPs in ALPK1 revealed that these SNPs are in strong LD in a Japanese population. Among the 3 SNPs of ALPK1, rs11726117 (M861T) is the only missense SNP. Therefore, rs11726117 was genotyped in a Japanese population of 903 clinically defined gout cases and 1,302 controls, and was evaluated for a possible association with gout. The minor allele frequencies of rs11726117 were 0.26 and 0.25 in the case and control groups, respectively. The association analysis has not detected a significant association between rs11726117 and gout susceptibility in a Japanese population (p = 0.44). Because ABCG2, a major causative gene for gout, also locates in the gout-susceptibility locus on chromosome 4q, these findings suggest that among genes in a gout-susceptibility locus, not ALPK1 but ABCG2 could be important as a gout-susceptible gene.
Asahi Hishida, Kenji Wakai, Mariko Naito, Shino Suma, Tae Sasakabe, Nobuyuki Hamajima, Satoyo Hosono, Mikako Horita, Chowdhury Tanvir Turin, Sadao Suzuki, Sefanya Tara Kairupan, Haruo Mikami, Keizo Ohnaka, Isao Watanabe, Hirokazu Uemura, Michiaki Kubo and Hideo Tanaka : Polymorphisms of genes involved in lipid metabolism and risk of chronic kidney disease in Japanese - Cross-sectional data from the J-MICC study, Lipids in Health and Disease, 13, 1, 162, 2014.
(要約)
Chronic kidney disease (CKD) is known to be one of the causes of cardiovascular disease and end-stage renal disease. Among the several treatable risk factors of CKD, that of dyslipidemia is relatively controversial. To clarify the association of polymorphisms in genes involved in lipid metabolism with the risk of CKD in the Japanese population, we used cross-sectional data from the Japan Multi-Institutional Collaborative Cohort (J-MICC) Study. A total of 3,268 men and women, aged 35-69 years, were selected from J-MICC Study participants for inclusion in this study. Twenty-eight candidate single nucleotide polymorphisms (SNPs) were selected in 17 genes associated with the risk of lipid metabolism disorders, and genotyping of the subjects was conducted using the multiplex PCR-based invader assay. The prevalence of CKD was determined for stages 3-5 (defined as estimated glomerular filtration rate <60 ml/min/1.73 m2). Logistic regression analysis revealed that SNPs APOA5 T - 1131C (rs662799), APOA5 T1259C (rs2266788), TOMM40 A/G (rs157580), and CETP TaqIB (rs708272) were significantly associated with CKD risk in those individuals genotyped, with age- and sex-adjusted odds ratios (ORs) per minor allele (and 95% confidence intervals (CIs)) of OR 1.22 (95% CI: 1.06-1.39), 1.19 (1.03-1.37), 1.27 (1.12-1.45), and 0.81 (0.71-0.92), respectively. Analysis of the gene-environment interaction revealed that body mass index (BMI) was a significant effect modifier for APOA5 T - 1131C (rs662799) and a marginally significant effect modifier for APOA5 T/C (rs2266788), with the interaction between BMI ≥30 and individuals with at least one minor allele of each genotype of OR 10.43 (95% CI: 1.29-84.19) and 3.36 (0.87-13.01), respectively. Four polymorphisms in APOA5, TOMM40, and CETP were shown to be significantly associated with CKD risk, and a significant interaction between the two APOA5 SNPs and BMI on CKD risk was also demonstrated. This suggests the future possibility of personalized risk estimation for this life-limiting disease.
(キーワード)
Chronic kidney disease / Lipid metabolism / Single nucleotide polymorphism
Shino Suma, Mariko Naito, Rieko Okada, Sayo Kawai, Guang Yin, Emi Morita, Kenji Wakai, Hirotaka Matsuo and Nobuyuki Hamajima : Associations between body mass index and serum uric acid levels in a Japanese population were significantly modified by LRP2 rs2544390, Nagoya Journal of Medical Science, 76, 3-4, 333-339, 2014.
(キーワード)
Body mass index / LRP2 rs2544390 / Serum uric acid levels
Shino Suma, Michiko Furuta, Yoshihisa Yamashita and Kenji Matsushita : Aging, Mastication, and Malnutrition and Their Associations with Cognitive Disorder: Evidence from Epidemiological Data, Current Oral Health Reports, 6, 2, 89-99, Jun. 2019.
(キーワード)
Cognitive function / Dementia / Elderly people / Malnutrition / Mastication
Misaki Ichinomiya, Shino Suma, Mio Kitamura, Fujiwara Shinji, Yasuhiko Shirayama and Kosuke Kataoka : Relationship between Oral Health Literacy and Social Frailty, International Association for Dental Research(IADR), Jun. 2025.
(キーワード)
Oral health literacy (OHL) / Social frailty (SF) / Oral health condition / Depopulated area / Older adults
2.
Kosuke Kataoka, Shino Suma, Misaki Ichinomiya, Tomoko Sumitomo and Kawabata Shigetada : D-psicose, a rare sugar down-regulate development of Candida albicans hyphae, IUMS2024, Oct. 2024.