Tooth Loss Strongly Associates With Malnutrition in Chronic Kidney Disease
Identifieur interne : 001721 ( Pmc/Checkpoint ); précédent : 001720; suivant : 001722Tooth Loss Strongly Associates With Malnutrition in Chronic Kidney Disease
Auteurs : E. Ioannidou [États-Unis] ; H. Swede ; G. Fares [États-Unis] ; J. Himmelfarb [États-Unis]Source :
- Journal of periodontology [ 0022-3492 ] ; 2013.
Abstract
In chronic kidney disease (CKD), inadequate nutritional intake, inflammation, and increased oxidative stress have been the major contributing factors in malnutrition pathogenesis. However, there is still a paucity of evidence assessing the magnitude of the effect of tooth loss on malnutrition in CKD populations. The authors hypothesize that among patients with CKD, tooth loss may affect nutritional status, using the National Health and Nutrition Examination Survey 1988 to 1994 (NHANES III).
Glomerular filtration rate (GFR) was estimated based on cystatin C levels using the relevant equation. Urinary albumin-to-creatinine ratio (albuminuria) was calculated in milligrams per gram with a cutoff point of 30 mg/g. CKD was defined based on estimated GFR <60 mL/minute/1.73m2 and albuminuria ≥30 mg/g. The cutoff point for serum albumin was set at 3.7 g/dL. Tooth loss categories were based on the number of missing and replaced teeth.
A total of 2,749 patients was included and stratified based on their oral health status. There was a statistically significant correlation between tooth loss and the proportion of patients with low protein and caloric intake (
Tooth loss independently predicts low energy and protein intake, as well as serum albumin levels, biomarkers of malnutrition in CKD.
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DOI: 10.1902/jop.2013.130347
PubMed: 24215204
PubMed Central: 4469954
Affiliations:
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<author><name sortKey="Ioannidou, E" sort="Ioannidou, E" uniqKey="Ioannidou E" first="E." last="Ioannidou">E. Ioannidou</name>
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<wicri:cityArea>Division of Periodontology, School of Dental Medicine, University of Connecticut Health Center, Farmington</wicri:cityArea>
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<author><name sortKey="Swede, H" sort="Swede, H" uniqKey="Swede H" first="H." last="Swede">H. Swede</name>
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<author><name sortKey="Fares, G" sort="Fares, G" uniqKey="Fares G" first="G." last="Fares">G. Fares</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Tooth Loss Strongly Associates With Malnutrition in Chronic Kidney Disease</title>
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<affiliation wicri:level="2"><nlm:aff id="A1">Division of Periodontology, School of Dental Medicine, University of Connecticut Health Center, Farmington, CT</nlm:aff>
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<author><name sortKey="Swede, H" sort="Swede, H" uniqKey="Swede H" first="H." last="Swede">H. Swede</name>
<affiliation><nlm:aff id="A2">Division of Epidemiology and Biostatistics, School of Medicine, University of Connecticut Health Center</nlm:aff>
<wicri:noCountry code="subfield">University of Connecticut Health Center</wicri:noCountry>
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<author><name sortKey="Fares, G" sort="Fares, G" uniqKey="Fares G" first="G." last="Fares">G. Fares</name>
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<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Massachusetts</region>
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<author><name sortKey="Himmelfarb, J" sort="Himmelfarb, J" uniqKey="Himmelfarb J" first="J." last="Himmelfarb">J. Himmelfarb</name>
<affiliation wicri:level="2"><nlm:aff id="A4">University of Washington, School of Medicine, Division of Nephrology, Seattle, WA</nlm:aff>
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<series><title level="j">Journal of periodontology</title>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">In chronic kidney disease (CKD), inadequate nutritional intake, inflammation, and increased oxidative stress have been the major contributing factors in malnutrition pathogenesis. However, there is still a paucity of evidence assessing the magnitude of the effect of tooth loss on malnutrition in CKD populations. The authors hypothesize that among patients with CKD, tooth loss may affect nutritional status, using the National Health and Nutrition Examination Survey 1988 to 1994 (NHANES III).</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">Glomerular filtration rate (GFR) was estimated based on cystatin C levels using the relevant equation. Urinary albumin-to-creatinine ratio (albuminuria) was calculated in milligrams per gram with a cutoff point of 30 mg/g. CKD was defined based on estimated GFR <60 mL/minute/1.73m<sup>2</sup>
and albuminuria ≥30 mg/g. The cutoff point for serum albumin was set at 3.7 g/dL. Tooth loss categories were based on the number of missing and replaced teeth.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">A total of 2,749 patients was included and stratified based on their oral health status. There was a statistically significant correlation between tooth loss and the proportion of patients with low protein and caloric intake (<italic>P</italic>
= 0.02 and 0.01, respectively). Serum albumin reached a frequency peak in the fully edentulous group without dentures (group 4, 19.2%). In the same group, individuals had lower protein (30.1%) and caloric intake (30.2%) (<italic>P</italic>
= 0.01 and 0.02, respectively). Furthermore, logistic regression analysis confirmed the significant role of tooth loss on serum albumin and protein and energy intake in this population even after adjusting for confounding variables.</p>
</sec>
<sec id="S4"><title>Conclusion</title>
<p id="P4">Tooth loss independently predicts low energy and protein intake, as well as serum albumin levels, biomarkers of malnutrition in CKD.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">8000345</journal-id>
<journal-id journal-id-type="pubmed-jr-id">5144</journal-id>
<journal-id journal-id-type="nlm-ta">J Periodontol</journal-id>
<journal-id journal-id-type="iso-abbrev">J. Periodontol.</journal-id>
<journal-title-group><journal-title>Journal of periodontology</journal-title>
</journal-title-group>
<issn pub-type="ppub">0022-3492</issn>
<issn pub-type="epub">1943-3670</issn>
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<article-meta><article-id pub-id-type="pmid">24215204</article-id>
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<article-id pub-id-type="doi">10.1902/jop.2013.130347</article-id>
<article-id pub-id-type="manuscript">NIHMS695999</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Tooth Loss Strongly Associates With Malnutrition in Chronic Kidney Disease</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Ioannidou</surname>
<given-names>E.</given-names>
</name>
<xref ref-type="aff" rid="A1">*</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Swede</surname>
<given-names>H.</given-names>
</name>
<xref ref-type="aff" rid="A2">†</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Fares</surname>
<given-names>G.</given-names>
</name>
<xref ref-type="aff" rid="A3">‡</xref>
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<contrib contrib-type="author"><name><surname>Himmelfarb</surname>
<given-names>J.</given-names>
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<xref ref-type="aff" rid="A4">§</xref>
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<aff id="A1"><label>*</label>
Division of Periodontology, School of Dental Medicine, University of Connecticut Health Center, Farmington, CT</aff>
<aff id="A2"><label>†</label>
Division of Epidemiology and Biostatistics, School of Medicine, University of Connecticut Health Center</aff>
<aff id="A3"><label>‡</label>
Pioneer Valley Nephrology, Springfield, MA</aff>
<aff id="A4"><label>§</label>
University of Washington, School of Medicine, Division of Nephrology, Seattle, WA</aff>
<author-notes><corresp id="FN1">Correspondence: Dr. Effie Ioannidou, 263 Farmington Ave., Farmington, CT 06030-1710. Fax: 860/679-1027; <email>ioannidou@uchc.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>3</day>
<month>6</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="epub"><day>11</day>
<month>11</month>
<year>2013</year>
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<pub-date pub-type="ppub"><month>7</month>
<year>2014</year>
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<pub-date pub-type="pmc-release"><day>17</day>
<month>6</month>
<year>2015</year>
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<volume>85</volume>
<issue>7</issue>
<fpage>899</fpage>
<lpage>907</lpage>
<pmc-comment>elocation-id from pubmed: 10.1902/jop.2013.130347</pmc-comment>
<abstract><sec id="S1"><title>Background</title>
<p id="P1">In chronic kidney disease (CKD), inadequate nutritional intake, inflammation, and increased oxidative stress have been the major contributing factors in malnutrition pathogenesis. However, there is still a paucity of evidence assessing the magnitude of the effect of tooth loss on malnutrition in CKD populations. The authors hypothesize that among patients with CKD, tooth loss may affect nutritional status, using the National Health and Nutrition Examination Survey 1988 to 1994 (NHANES III).</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">Glomerular filtration rate (GFR) was estimated based on cystatin C levels using the relevant equation. Urinary albumin-to-creatinine ratio (albuminuria) was calculated in milligrams per gram with a cutoff point of 30 mg/g. CKD was defined based on estimated GFR <60 mL/minute/1.73m<sup>2</sup>
and albuminuria ≥30 mg/g. The cutoff point for serum albumin was set at 3.7 g/dL. Tooth loss categories were based on the number of missing and replaced teeth.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">A total of 2,749 patients was included and stratified based on their oral health status. There was a statistically significant correlation between tooth loss and the proportion of patients with low protein and caloric intake (<italic>P</italic>
= 0.02 and 0.01, respectively). Serum albumin reached a frequency peak in the fully edentulous group without dentures (group 4, 19.2%). In the same group, individuals had lower protein (30.1%) and caloric intake (30.2%) (<italic>P</italic>
= 0.01 and 0.02, respectively). Furthermore, logistic regression analysis confirmed the significant role of tooth loss on serum albumin and protein and energy intake in this population even after adjusting for confounding variables.</p>
</sec>
<sec id="S4"><title>Conclusion</title>
<p id="P4">Tooth loss independently predicts low energy and protein intake, as well as serum albumin levels, biomarkers of malnutrition in CKD.</p>
</sec>
</abstract>
<kwd-group><kwd>Malnutrition</kwd>
<kwd>nutrition surveys</kwd>
<kwd>renal insufficiency</kwd>
<kwd>chronic</kwd>
<kwd>tooth loss</kwd>
</kwd-group>
</article-meta>
</front>
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<affiliations><list><country><li>États-Unis</li>
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<region><li>Connecticut</li>
<li>Massachusetts</li>
<li>Washington (État)</li>
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<tree><noCountry><name sortKey="Swede, H" sort="Swede, H" uniqKey="Swede H" first="H." last="Swede">H. Swede</name>
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<country name="États-Unis"><region name="Connecticut"><name sortKey="Ioannidou, E" sort="Ioannidou, E" uniqKey="Ioannidou E" first="E." last="Ioannidou">E. Ioannidou</name>
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<name sortKey="Fares, G" sort="Fares, G" uniqKey="Fares G" first="G." last="Fares">G. Fares</name>
<name sortKey="Himmelfarb, J" sort="Himmelfarb, J" uniqKey="Himmelfarb J" first="J." last="Himmelfarb">J. Himmelfarb</name>
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