老年2型糖尿病合并牙健康患者肌少症的患病率及牙健康保护作用分析OA
Prevalence of sarcopenia and the protective effect of dental health in elderly patients with type 2 diabetes:An a-nalysis
目的:探讨老年 2 型糖尿病(type 2 diabetes mellitus,T2DM)患者牙健康状态与肌少症患病率的关系,分析牙健康的独立保护作用及其核心维度,并探讨其与运动、营养等因素的协同效应.方法:回顾性纳入 2020 年 1月～2024 年 12 月就诊的老年T2DM患者 402 例,根据口腔健康状态分为牙健康组(148 例)与牙不健康组(254 例).牙健康定义为无恒牙缺失、牙周健康(CPI<3)、咬合功能正常、无活动性龋齿.肌少症依据AWGS 2019 标准诊断.比较两组肌少症患病率及相关指标,采用多因素Logistic回归分析牙健康的独立保护效应,并探讨其与运动、营养的交互作用.结果:老年T2DM患者肌少症总患病率为 34.6%.牙健康组肌少症患病率(19.6%)显著低于牙不健康组(43.3%,P<0.001).多因素回归分析显示,牙健康(OR=0.421)、牙周健康(OR=0.455)、咬合正常(OR=0.510)为肌少症的独立保护因素.牙健康与每周运动≥3 次存在显著协同保护效应(交互项OR=0.300,P<0.001).牙健康对肌肉量减少的保护作用最强(OR=0.386),其次为握力下降(OR=0.492)和步速减退(OR=0.618).结论:老年T2DM合并牙健康患者肌少症患病率显著降低,牙周健康和咬合功能是肌少症的核心保护维度,并与运动干预具有协同效应.临床应重视口腔健康维护,结合运动与营养管理,构建"口腔-代谢-肌肉"协同防控策略.
Objective:To investigate the association between oral health status and sarcopenia prevalence in elderly patients with type 2 diabetes mellitus(T2DM),analyze the independent protective effect of oral health and its core dimen-sions,and explore its synergistic effects with exercise and nutrition.Methods:A retrospective study was conducted on 402 elderly T2DM patients from January 2020 to December 2024,divided into an oral health group(n=148)and an oral unhealthy group(n=254)based on oral health status.Oral health was defined as no permanent tooth loss,periodontal health(CPI<3),normal occlusal function,and no active caries.Sarcopenia was diagnosed according to AWGS 2019 criteria.Sarcopenia preva-lence and related indicators were compared between the two groups.Multivariate logistic regression was used to analyze the independent protective effect of oral health and its interaction with exercise and nutrition.Results:The overall prevalence of sarcopenia in elderly T2DM patients was 34.6%.The sarcopenia prevalence in the oral health group(19.6%)was significant-ly lower than that in the oral unhealthy group(43.3%,P<0.001).Multivariate regression showed that oral health(OR=0.421),periodontal health(OR=0.455),and normal occlusion(OR=0.510)were independent protective factors against sar-copenia.A significant synergistic protective effect was observed between oral health and exercise≥3 times per week(interac-tion OR=0.300,P<0.001).Oral health had the strongest protective effect on muscle mass reduction(OR=0.386),followed by grip strength decline(OR=0.492)and gait speed reduction(OR=0.618).Conclusion:Elderly T2DM patients with good oral health have a significantly lower prevalence of sarcopenia.Periodontal health and occlusal function are core protective di-mensions against sarcopenia and exhibit synergistic effects with exercise intervention.Clinical management should emphasize oral health maintenance,combined with exercise and nutritional support,to establish an integrated"oral-metabolic-muscle"prevention strategy.
曹国良;施惠华;朱珠;杜岑;汪海娅
上海交通大学医学院附属第九人民医院老年科 上海 201900上海交通大学医学院附属第九人民医院老年科 上海 201900上海交通大学医学院附属第九人民医院老年科 上海 201900上海交通大学医学院附属第九人民医院老年科 上海 201900上海交通大学医学院附属第九人民医院老年科 上海 201900
医药卫生
2型糖尿病老年牙健康肌少症牙周健康咬合功能
Type 2 diabetesElderlyOral healthSarcopeniaPeriodontal healthOcclusal function
《临床口腔医学杂志》 2026 (3)
163-168,6
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