Faculty Profiles - YOSHIHARA Akihiro

Papers - YOSHIHARA Akihiro

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Tooth loss, periodontal disease, and mineral content of calcium and magnesium in the diet or urine in the elderly Reviewed

A Yoshihara, R Watanabe, M Nishimuta, H Miyazaki

The Journal of Aging Research & Clinical Practice 2 126 - 130 2013

自立高齢者の加齢による現在歯数と食事のエネルギー密度の関連

安藝真里子, 渡邊令子, 村松芳多子, 葭原明弘, 宮崎秀夫

新潟歯学会雑誌 42 ( 2 ) 137 - 137 2012.12

Serum Antibody to Porphyromonas gingivalis in Chronic Kidney Disease Reviewed

M. Iwasaki, G. W. Taylor, M. C. Manz, N. Kaneko, S. Imai, A. Yoshihara, H. Miyazaki

JOURNAL OF DENTAL RESEARCH 91 ( 9 ) 828 - 833 2012.9

Language：English Publishing type：Research paper (scientific journal) Publisher：SAGE PUBLICATIONS INC

Potentially significant associations between periodontal disease and chronic kidney disease (CKD) have been reported in recent studies. The aim of this cross-sectional study was to investigate the association between serum antibody to the periodontal pathogen Porphyromonas gingivalis (P. gingivalis) and CKD in 215 Japanese individuals, aged 79 yrs. Serum antibody levels to P. gingivalis were measured by enzyme-linked immunosorbent assay. An elevated serum antibody response was defined as the upper quartile and was compared with the bottom three quartiles. Participants were classified as having CKD when their glomerular filtration rate was between 15 and 59 mL/min/1.73 m(2). A multivariable logistic regression model was used to evaluate the association between elevated antibody status and the presence of CKD. Study participants with an elevated serum antibody to P. gingivalis were 2.6 times more likely to have CKD. The adjusted odds ratio of CKD for participants in the highest quartile of serum antibody to P. gingivalis was 2.59 (95% confidence interval, 1.05-6.34) when compared with others in lower quartiles after simultaneous adjustment for other covariates. In conclusion, the present study suggests that elevated serum antibody to P. gingivalis was significantly associated with decreased kidney function in a community-based cohort of elderly Japanese.

DOI： 10.1177/0022034512455063

Change in bone mineral density and tooth loss in Japanese community-dwelling postmenopausal women: a 5-year cohort study

Masanori Iwasaki, Kazutoshi Nakamura, Akihiro Yoshihara, Hideo Miyazaki

JOURNAL OF BONE AND MINERAL METABOLISM 30 ( 4 ) 447 - 453 2012.7

Language：English Publishing type：Research paper (scientific journal) Publisher：SPRINGER TOKYO

The aim of this longitudinal study was to investigate the association between the change in bone mineral density (BMD) and tooth loss in Japanese community-dwelling postmenopausal women. The subjects were 404 women. At baseline (2005) and follow-up (2010), BMDs of the lumbar spine and right femoral neck were measured using dual-energy X-ray absorptiometry (QDR4500a) and participants were classified by tertiles of the annual percentage change in BMD. The number of teeth was counted at the baseline and follow-up to calculate the number of lost teeth over 5 years. Poisson regression analysis was conducted with tertiles of the changes in BMDs of the lumbar spine and femoral neck as the main exposures to estimate their influence on the number of lost teeth. Participants in the tertile with a greater decrease in BMD at each skeletal site (lumbar spine and femoral neck, respectively) had a larger number of lost teeth, controlling for possible confounders. The adjusted relative risks (95% confidence interval) for the mean number of lost teeth in the first, second, and third tertiles were 1.00, 1.15 (0.91-1.45), and 1.38 (1.11-1.72) for the lumbar spine and 1.00, 1.17 (0.93-1.47), and 1.27 (1.01-1.59) for the femoral neck, respectively. In conclusion, a significant relationship exists between a change in BMD and the number of lost teeth during 5-year study period in Japanese community-dwelling postmenopausal women.

DOI： 10.1007/s00774-011-0337-x

Change in bone mineral density and tooth loss in Japanese community-dwelling postmenopausal women: a 5-year cohort study Reviewed

Masanori Iwasaki, Kazutoshi Nakamura, Akihiro Yoshihara, Hideo Miyazaki

JOURNAL OF BONE AND MINERAL METABOLISM 30 ( 4 ) 447 - 453 2012.7

Language：English Publishing type：Research paper (scientific journal) Publisher：SPRINGER TOKYO

The aim of this longitudinal study was to investigate the association between the change in bone mineral density (BMD) and tooth loss in Japanese community-dwelling postmenopausal women. The subjects were 404 women. At baseline (2005) and follow-up (2010), BMDs of the lumbar spine and right femoral neck were measured using dual-energy X-ray absorptiometry (QDR4500a) and participants were classified by tertiles of the annual percentage change in BMD. The number of teeth was counted at the baseline and follow-up to calculate the number of lost teeth over 5 years. Poisson regression analysis was conducted with tertiles of the changes in BMDs of the lumbar spine and femoral neck as the main exposures to estimate their influence on the number of lost teeth. Participants in the tertile with a greater decrease in BMD at each skeletal site (lumbar spine and femoral neck, respectively) had a larger number of lost teeth, controlling for possible confounders. The adjusted relative risks (95% confidence interval) for the mean number of lost teeth in the first, second, and third tertiles were 1.00, 1.15 (0.91-1.45), and 1.38 (1.11-1.72) for the lumbar spine and 1.00, 1.17 (0.93-1.47), and 1.27 (1.01-1.59) for the femoral neck, respectively. In conclusion, a significant relationship exists between a change in BMD and the number of lost teeth during 5-year study period in Japanese community-dwelling postmenopausal women.

DOI： 10.1007/s00774-011-0337-x

Physical performance and 10-year mortality in a 70-year-old community-dwelling population

Yutaka Takata, Mieko Shimada, Toshihiro Ansai, Yutaka Yoshitake, Mamoru Nishimuta, Naoki Nakagawa, Masaharu Ohashi, Akihiro Yoshihara, Hideo Miyazaki

AGING CLINICAL AND EXPERIMENTAL RESEARCH 24 ( 3 ) 257 - 264 2012.6

Language：English Publishing type：Research paper (scientific journal) Publisher：SPRINGER

Background and aims: Poor physical performance is known to be inversely related to mortality. The purpose of the present study was to determine whether an association between physical performance and 10-year mortality could be extended to a Japanese 70-year-old community-dwelling population, and to compare findings with those found in an octogenarian population. Methods: Seventy-year-old subjects residing in Niigata city, Japan, participated. Baseline examinations, including a physical performance test of four tests of muscle strength, one test of balance, and one test of agility, were carried out in June 1998 for 600 participants, and these individuals were then followed for 10 years. Results: During the 10-year follow up, 80 subjects died. Cox regression analysis with adjustment for confounding factors showed that high scores in muscle strength tests for lower extremities, such as single-leg and double-leg extensor strength and isokinetic leg extensor power, were found to be related to decreases in total cause mortality. Conclusions: In an elderly 70-year-old Japanese community-dwelling population, poor muscle strength was found to be an independent predictor of total mortality. Together with our previous findings in an 80-year-old population, the association between poor strength and high mortality may have effects at 70 but not 80 years of age. (C)2012, Editrice Kurtis

The association between renal function and tooth loss in Japanese community-dwelling postmenopausal women Reviewed

Akihiro Yoshihara, Kazutoshi Nakamura, Hideo Miyazaki

GERODONTOLOGY 29 ( 2 ) E363 - E367 2012.6

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-BLACKWELL

Objectives: This study examined whether low renal function is associated with the number of remaining teeth among community-dwelling elderly Japanese.
Background data: Many elderly individuals display both low renal function and tooth loss.
Materials and Methods: Subjects comprised 405 randomly selected women (55-74 years old). Serum cystatin C level was used to assess renal dysfunction. Multiple linear regression analysis was used to evaluate the relationship between number of remaining teeth and serum cystatin C level, with number of remaining teeth as the dependent variable. Six variables were selected as independent variables in the final model: serum cystatin C; age; mean clinical attachment level; serum cross-linked N-telopeptide of type I collagen level; body mass index and smoking habits.
Results: Multiple linear regression analysis revealed a significant relationship between number of remaining teeth and serum cystatin C level. The beta value for serum cystatin C level for the number of remaining teeth was -0.11 (p = 0.018).
Conclusion: This study indicates a relationship between serum cystatin C level and number of remaining teeth, suggesting that low renal function could be associated with tooth loss.

DOI： 10.1111/j.1741-2358.2011.00481.x

The association between renal function and tooth loss in Japanese community-dwelling postmenopausal women

Akihiro Yoshihara, Kazutoshi Nakamura, Hideo Miyazaki

GERODONTOLOGY 29 ( 2 ) E363 - E367 2012.6

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-BLACKWELL

Objectives: This study examined whether low renal function is associated with the number of remaining teeth among community-dwelling elderly Japanese.
Background data: Many elderly individuals display both low renal function and tooth loss.
Materials and Methods: Subjects comprised 405 randomly selected women (55-74 years old). Serum cystatin C level was used to assess renal dysfunction. Multiple linear regression analysis was used to evaluate the relationship between number of remaining teeth and serum cystatin C level, with number of remaining teeth as the dependent variable. Six variables were selected as independent variables in the final model: serum cystatin C; age; mean clinical attachment level; serum cross-linked N-telopeptide of type I collagen level; body mass index and smoking habits.
Results: Multiple linear regression analysis revealed a significant relationship between number of remaining teeth and serum cystatin C level. The beta value for serum cystatin C level for the number of remaining teeth was -0.11 (p = 0.018).
Conclusion: This study indicates a relationship between serum cystatin C level and number of remaining teeth, suggesting that low renal function could be associated with tooth loss.

DOI： 10.1111/j.1741-2358.2011.00481.x

Physical performance and 10-year mortality in a 70-year-old community-dwelling population Reviewed

Yutaka Takata, Mieko Shimada, Toshihiro Ansai, Yutaka Yoshitake, Mamoru Nishimuta, Naoki Nakagawa, Masaharu Ohashi, Akihiro Yoshihara, Hideo Miyazaki

AGING CLINICAL AND EXPERIMENTAL RESEARCH 24 ( 3 ) 257 - 264 2012.6

Language：English Publishing type：Research paper (scientific journal) Publisher：SPRINGER

Background and aims: Poor physical performance is known to be inversely related to mortality. The purpose of the present study was to determine whether an association between physical performance and 10-year mortality could be extended to a Japanese 70-year-old community-dwelling population, and to compare findings with those found in an octogenarian population. Methods: Seventy-year-old subjects residing in Niigata city, Japan, participated. Baseline examinations, including a physical performance test of four tests of muscle strength, one test of balance, and one test of agility, were carried out in June 1998 for 600 participants, and these individuals were then followed for 10 years. Results: During the 10-year follow up, 80 subjects died. Cox regression analysis with adjustment for confounding factors showed that high scores in muscle strength tests for lower extremities, such as single-leg and double-leg extensor strength and isokinetic leg extensor power, were found to be related to decreases in total cause mortality. Conclusions: In an elderly 70-year-old Japanese community-dwelling population, poor muscle strength was found to be an independent predictor of total mortality. Together with our previous findings in an 80-year-old population, the association between poor strength and high mortality may have effects at 70 but not 80 years of age. (C)2012, Editrice Kurtis

地域在住高齢者におけるメタボリックシンドロームと歯周病の関連

坂入久美子, 岩崎正則, 小川祐司, 葭原明弘, 宮崎秀夫

新潟歯学会雑誌 42 ( 1 ) 63 - 64 2012.6

Association Between Volatile Sulfur Compounds and Periodontal Disease Progression in Elderly Non-Smokers Reviewed

Yuka Makino, Takayuki Yamaga, Akihiro Yoshihara, Kaname Nohno, Hideo Miyazaki

JOURNAL OF PERIODONTOLOGY 83 ( 5 ) 635 - 643 2012.5

Language：English Publishing type：Research paper (scientific journal) Publisher：AMER ACAD PERIODONTOLOGY

Background: Periodontal pathogenic microorganisms produce volatile sulfur compounds (VSCs), such as hydrogen sulfide, methyl mercaptan, and dimethyl sulfide. VSCs are toxic to periodontal tissue. Therefore, there is a relationship between periodontitis and the VSC level of mouth air. However, the association between VSC and periodontal disease progression has not been investigated in a longitudinal study. The purpose of this study is to evaluate the association between VSCs in mouth air and periodontal disease progression among elderly dentulous non-smokers.
Methods: Two hundred forty-one dentulous non-smokers (103 males and 138 females; all 70 years old) had their VSC levels examined with a portable sulfide monitor, and their periodontal status was assessed. Periodontal examinations were performed at baseline and once a year for 3 years to investigate the clinical attachment levels of all teeth. Participants were classified by membership in tertile groups (lowest, middle, and highest) according to the value of baseline VSC measurements.
Results: In negative binomial regression analysis, the number of teeth with periodontal disease progression for participants in the highest tertile of VSC measurement was greater (incidence rate ratio of 1.33, P = 0.011) than for the reference group (lowest tertile of VSC measurement) after simultaneously adjusting for sex, number of remaining teeth, and maximum clinical attachment level.
Conclusions: VSC measurements were significantly associated with periodontal disease progression in a non-smoking dentulous elderly population. This suggests that VSC measurements are useful for the diagnosis of periodontal disease progression. J Periodontol 2012;83:635-643.

DOI： 10.1902/jop.2011.110275

Association Between Volatile Sulfur Compounds and Periodontal Disease Progression in Elderly Non-Smokers

Yuka Makino, Takayuki Yamaga, Akihiro Yoshihara, Kaname Nohno, Hideo Miyazaki

JOURNAL OF PERIODONTOLOGY 83 ( 5 ) 635 - 643 2012.5

Language：English Publishing type：Research paper (scientific journal) Publisher：AMER ACAD PERIODONTOLOGY

Background: Periodontal pathogenic microorganisms produce volatile sulfur compounds (VSCs), such as hydrogen sulfide, methyl mercaptan, and dimethyl sulfide. VSCs are toxic to periodontal tissue. Therefore, there is a relationship between periodontitis and the VSC level of mouth air. However, the association between VSC and periodontal disease progression has not been investigated in a longitudinal study. The purpose of this study is to evaluate the association between VSCs in mouth air and periodontal disease progression among elderly dentulous non-smokers.
Methods: Two hundred forty-one dentulous non-smokers (103 males and 138 females; all 70 years old) had their VSC levels examined with a portable sulfide monitor, and their periodontal status was assessed. Periodontal examinations were performed at baseline and once a year for 3 years to investigate the clinical attachment levels of all teeth. Participants were classified by membership in tertile groups (lowest, middle, and highest) according to the value of baseline VSC measurements.
Results: In negative binomial regression analysis, the number of teeth with periodontal disease progression for participants in the highest tertile of VSC measurement was greater (incidence rate ratio of 1.33, P = 0.011) than for the reference group (lowest tertile of VSC measurement) after simultaneously adjusting for sex, number of remaining teeth, and maximum clinical attachment level.
Conclusions: VSC measurements were significantly associated with periodontal disease progression in a non-smoking dentulous elderly population. This suggests that VSC measurements are useful for the diagnosis of periodontal disease progression. J Periodontol 2012;83:635-643.

DOI： 10.1902/jop.2011.110275

縦断調査からみた地域高齢者の歯列欠損形態と咀嚼能力の経年変化

佐藤直子, 野村修一, 昆はるか, 櫻井直樹, 葭原明弘, 宮崎秀夫, 河野正司

日本補綴歯科学会誌 4 ( 特別号 ) 255 - 255 2012.5

Tooth-related risk factors for tooth loss in community-dwelling elderly people Reviewed

Toshinobu Hirotomi, Akihiro Yoshihara, Hiroshi Ogawa, Hideo Miyazaki

COMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY 40 ( 2 ) 154 - 163 2012.4

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-BLACKWELL

Objectives: To appropriately explore risk factors for tooth loss operating at the tooth-level, subject-related factors and a hierarchical data structure have to be considered. The purpose of this study was to evaluate tooth-related and subject-related risk factors affecting tooth loss. Methods: A 10-year longitudinal survey was carried out on 286 elderly subjects. At baseline, the prosthodontic status and abutment function of the 5574 teeth were recorded. Tooth loss was defined as the main outcome variable, and a multilevel logistic regression model considering subject and tooth levels was applied. Results: Tooth loss was found in 75% of subjects and most frequently in molars. A multivariable, multilevel logistic regression revealed that the following tooth-related variables were significantly related to tooth loss over 10 years: maxillary teeth, multirooted teeth, single crowns, abutment teeth for a fixed/removable partial denture (FPD/RPD), and periodontally involved teeth. Among them, single crowns, abutment teeth for an FPD, and teeth with severe periodontal disease at baseline had the highest odds of 5.1, 6.0, and 7.1, respectively. Conclusion: The findings of this study suggest that tooth loss is the result of complex interactions of tooth-related factors. Several tooth-related variables including multirooted teeth, abutments, and single crowns were found to be possible risk factors for tooth loss. Thus, these findings confirm and underline the potential benefit of minimizing prosthetic treatment of molars.

DOI： 10.1111/j.1600-0528.2011.00648.x

Tooth-related risk factors for tooth loss in community-dwelling elderly people

Toshinobu Hirotomi, Akihiro Yoshihara, Hiroshi Ogawa, Hideo Miyazaki

COMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY 40 ( 2 ) 154 - 163 2012.4

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-BLACKWELL

Objectives: To appropriately explore risk factors for tooth loss operating at the tooth-level, subject-related factors and a hierarchical data structure have to be considered. The purpose of this study was to evaluate tooth-related and subject-related risk factors affecting tooth loss. Methods: A 10-year longitudinal survey was carried out on 286 elderly subjects. At baseline, the prosthodontic status and abutment function of the 5574 teeth were recorded. Tooth loss was defined as the main outcome variable, and a multilevel logistic regression model considering subject and tooth levels was applied. Results: Tooth loss was found in 75% of subjects and most frequently in molars. A multivariable, multilevel logistic regression revealed that the following tooth-related variables were significantly related to tooth loss over 10 years: maxillary teeth, multirooted teeth, single crowns, abutment teeth for a fixed/removable partial denture (FPD/RPD), and periodontally involved teeth. Among them, single crowns, abutment teeth for an FPD, and teeth with severe periodontal disease at baseline had the highest odds of 5.1, 6.0, and 7.1, respectively. Conclusion: The findings of this study suggest that tooth loss is the result of complex interactions of tooth-related factors. Several tooth-related variables including multirooted teeth, abutments, and single crowns were found to be possible risk factors for tooth loss. Thus, these findings confirm and underline the potential benefit of minimizing prosthetic treatment of molars.

DOI： 10.1111/j.1600-0528.2011.00648.x

Association between periodontitis and systemic bone mineral density in Japanese community-dwelling postmenopausal women

Osamu Takahashi, Akihiro Yoshihara, Kazutoshi Nakamura, Hideo Miyazaki

JOURNAL OF DENTISTRY 40 ( 4 ) 304 - 311 2012.4

Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCI LTD

Objective: The purpose of this cross-sectional study was to evaluate the association between loss of attachment (LA) which is clinical index of periodontitis and bone mineral density (BMD) of the lumbar vertebrae and femur measured with dual energy X-ray absorptiometry (DXA) in Japanese community-dwelling postmenopausal women.
Subjects and methods: Subjects were 347 women aged 55-74. The oral cavity was divided into 6 areas according to the WHO's method for the determination of the clinical attachment level score (CALscore); the LA was measured at 6 sites using a WHO probe in 17, 16, 11, 26, 27, 37, 36, 31, 46, and 47, and the values were recorded in mm. Then, we assessed BMD of the lumbar vertebrae (L2-L4) and femur (femoral neck, proximal part) by DXA. Based on these data, analysis of covariance was used to estimate relation between periodontitis and systemic BMD status excluding effect of age. Multiple linear regression analysis was used to estimate relation between periodontitis and BMD adjusted for 17 variables.
Results: Significant differences were observed in the mean value between the mean CALscore = 0 and CALscore >= 1 groups in the Z value in lumbar vertebrate (106.9 +/- 18.7 vs. 102.3 +/- 1.0, p < 0.05, t-test). Multiple regression analysis was conducted using the mean LA as dependent variable. Lumbar vertebral BMD (regression coefficient: B = -1.039 +/- 0.379, p = 0.007), femoral neck BMD (B = -1.332 +/- 0.627, p = 0.034), and proximal femoral BMD (B = -1.329 +/- 0.536, p = 0.014) all exhibited a significant negative correlation with the mean LA.
Conclusion: A significant negative correlation was observed between periodontal disease and truncal bone BMD in this study. (C) 2012 Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.jdent.2012.01.005

Association between periodontitis and systemic bone mineral density in Japanese community-dwelling postmenopausal women Reviewed

Osamu Takahashi, Akihiro Yoshihara, Kazutoshi Nakamura, Hideo Miyazaki

JOURNAL OF DENTISTRY 40 ( 4 ) 304 - 311 2012.4

Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCI LTD

Objective: The purpose of this cross-sectional study was to evaluate the association between loss of attachment (LA) which is clinical index of periodontitis and bone mineral density (BMD) of the lumbar vertebrae and femur measured with dual energy X-ray absorptiometry (DXA) in Japanese community-dwelling postmenopausal women.
Subjects and methods: Subjects were 347 women aged 55-74. The oral cavity was divided into 6 areas according to the WHO's method for the determination of the clinical attachment level score (CALscore); the LA was measured at 6 sites using a WHO probe in 17, 16, 11, 26, 27, 37, 36, 31, 46, and 47, and the values were recorded in mm. Then, we assessed BMD of the lumbar vertebrae (L2-L4) and femur (femoral neck, proximal part) by DXA. Based on these data, analysis of covariance was used to estimate relation between periodontitis and systemic BMD status excluding effect of age. Multiple linear regression analysis was used to estimate relation between periodontitis and BMD adjusted for 17 variables.
Results: Significant differences were observed in the mean value between the mean CALscore = 0 and CALscore >= 1 groups in the Z value in lumbar vertebrate (106.9 +/- 18.7 vs. 102.3 +/- 1.0, p < 0.05, t-test). Multiple regression analysis was conducted using the mean LA as dependent variable. Lumbar vertebral BMD (regression coefficient: B = -1.039 +/- 0.379, p = 0.007), femoral neck BMD (B = -1.332 +/- 0.627, p = 0.034), and proximal femoral BMD (B = -1.329 +/- 0.536, p = 0.014) all exhibited a significant negative correlation with the mean LA.
Conclusion: A significant negative correlation was observed between periodontal disease and truncal bone BMD in this study. (C) 2012 Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.jdent.2012.01.005

地域在住高齢者におけるメタボリックシンドロームと歯周病の関連

坂入久美子, 岩崎正則, 小川祐司, 葭原明弘, 宮崎秀夫

口腔衛生学会雑誌 62 ( 2 ) 217 - 217 2012.4

Periodontal Disease and Decreased Kidney Function in Japanese Elderly Reviewed

Masanori Iwasaki, George W. Taylor, Willem Nesse, Arjan Vissink, Akihiro Yoshihara, Hideo Miyazaki

AMERICAN JOURNAL OF KIDNEY DISEASES 59 ( 2 ) 202 - 209 2012.2

Language：English Publishing type：Research paper (scientific journal) Publisher：W B SAUNDERS CO-ELSEVIER INC

Background: Early detection of decreased kidney function can help prevent the progression of kidney disease to kidney failure and cardiovascular events. Potentially significant associations between kidney function and periodontal disease have been reported in cross-sectional studies. However, no longitudinal study has been performed and no study has been performed in Japan. The aim of this longitudinal study was to investigate the effect of periodontal disease on kidney function in community-dwelling Japanese elderly.
Study Design: Retrospective cohort.
Setting & Participants: Members of this cohort were drawn from a longitudinal interdisciplinary study of aging. Included for this analysis were 317 participants (166 men, 151 women) aged 75 years in 2003.
Predictor: The periodontal inflamed surface area (PISA), reflecting the amount of inflamed periodontal tissue, was calculated for each participant. Participants were classified in quartile groups according to PISA, then divided into 2 groups (highest quartile vs the other 3 groups combined).
Outcomes: The primary outcome for the analysis was decreased kidney function, defined as a decrease in estimated glomerular filtration rate at follow-up.
Measurements: Multivariable logistic regression analyses were performed to predict decreased kidney function on the basis of periodontal status, risk factors for kidney disease, and other potentially relevant covariates.
Results: During the 2-year follow-up (2003-2005), 45 participants (14.2%) developed decreased kidney function. The highest PISA quartile was associated significantly with a greater cumulative incidence of decreased kidney function (OR, 2.24; 95% CI, 1.05-4.79) than the referent group (the other 3 quartiles) after adjusting for covariates.
Limitations: Extension of interpreting the findings to other age groups is limited.
Conclusion: These results suggest that periodontal disease may be a risk factor for decreased kidney function in Japanese elderly. Am J Kidney Dis. 59(2):202-209. (C) 2012 by the National Kidney Foundation, Inc.

DOI： 10.1053/j.ajkd.2011.08.027

Relations of Serum Ascorbic Acid and alpha-tocopherol to Periodontal Disease Reviewed

M. Iwasaki, M. C. Manz, G. W. Taylor, A. Yoshihara, H. Miyazaki

JOURNAL OF DENTAL RESEARCH 91 ( 2 ) 167 - 172 2012.2

Language：English Publishing type：Research paper (scientific journal) Publisher：SAGE PUBLICATIONS INC

Low concentrations of serum anti-oxidants, including ascorbic acid and alpha-tocopherol, are associated with higher risks of many inflammatory diseases that interrelate with oral health. The present study examined the longitudinal relationship of serum ascorbic acid and alpha-tocopherol to periodontal disease in 224 Japanese individuals, aged 71 yrs, for whom data were available for the years 1999-2007. Participants were classified by tertiles of serum ascorbic acid and of alpha-tocopherol. Full-mouth periodontal status, measured as clinical attachment level (CAL), was recorded at baseline and annual follow-up examinations. The number of teeth with a loss of CAL >= 3 mm at any site over the study period was calculated as 'periodontal disease events'. Poisson regression analysis was conducted to assess predictors of periodontal disease events, with serum ascorbic acid and alpha-tocopherol as the primary predictors of interest. The multivariate adjusted relative risks (95% confidence intervals) in the highest, middle, and lowest tertiles were 1.00 (reference), 1.12 (1.01-1.26), and 1.30 (1.16-1.47) for ascorbic acid and 1.00 (reference), 1.09 (0.98-1.21), and 1.15 (1.04-1.28) for alpha-tocopherol, respectively. Our findings support the hypothesis that low serum levels of ascorbic acid and alpha-tocopherol may be a risk factor for periodontal disease in Japanese elderly.

DOI： 10.1177/0022034511431702

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