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Association Between Oral Health and Airflow Limitation: Analysis Using a Nationwide Survey in Korea
Kim Sun-Hyung,Gu Seonhye,Kim Jung-Ae,Im YoHan,Cho Jun Yeun,Kim Youlim,Shin Yoon Mi,Kim Eung-Gook,Lee Ki Man,Choe Kang Hyeon,Lee Hyun,Yang Bumhee 대한의학회 2023 Journal of Korean medical science Vol.38 No.31
Background: Although poor oral health is a common comorbidity in individuals with airflow limitation (AFL), few studies have comprehensively evaluated this association. Furthermore, the association between oral health and the severity of AFL has not been well elucidated. Methods: Using a population-based nationwide survey, we classified individuals according to the presence or absence of AFL defined as pre-bronchodilator forced expiratory volume in 1 second/forced vital capacity < 0.7. Using multivariable logistic regression analyses, we evaluated the association between AFL severity and the number of remaining teeth; the presence of periodontitis; the Decayed, Missing, and Filled Teeth (DMFT) index; and denture wearing. Results: Among the 31,839 participants, 14% had AFL. Compared with the control group, the AFL group had a higher proportion of periodontitis (88.8% vs. 79.4%), complete denture (6.2% vs. 1.6%), and high DMFT index (37.3% vs. 27.8%) (P < 0.001 for all). In multivariable analyses, denture status: removable partial denture (adjusted odds ratio [aOR], 1.12; 95% confidence interval [95% CI], 1.04–1.20) and complete denture (aOR, 1.52; 95% CI, 1.01– 2.05), high DMFT index (aOR, 1.13; 95% CI, 1.02–1.24), and fewer permanent teeth (0–19; aOR, 1.32; 95% CI, 1.12–1.52) were significantly associated with AFL. Furthermore, those with severe to very severe AFL had a significantly higher proportion of complete denture (aOR, 2.41; 95% CI, 1.11–3.71) and fewer remaining teeth (0–19; aOR, 2.29; 95% CI, 1.57–3.01). Conclusion: Denture wearing, high DMFT index, and fewer permanent teeth are significantly associated with AFL. Furthermore, a reduced number of permanent teeth (0–19) was significantly related to the severity of AFL. Therefore, physicians should pay attention to oral health in managing patients with AFL, such as chronic obstructive pulmonary disease.
Nonalcoholic Fatty Liver Disease and Progression of Coronary Artery Calcification: A Cohort Study
( Dong Hyun Sinn ),( Danbee Kang ),( Yoosoo Chang ),( Seungho Ryu ),( Seonhye Gu ),( Hyunkyoung Kim ),( Donghyeong Seong ),( Soo Jin Cho ),( Byoung-kee Yi ),( Hyung-doo Park ),( Seung Woon Paik ),( Yo 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1
Aims: Nonalcoholic fatty liver disease (NAFLD), a hepatic manifestationof the metabolic syndrome, was associated with subclinical atherosclerosis atherosclerosisin many crosssectional studies, but the prospective associationbetween NAFLD and the progression of atherosclerosis has not beenevaluated. This study was conducted to evaluate the association betweenNAFLD and the progression of coronary atherosclerosis.Methods: This cohort study included 4,731 adult men and womenwith no history of CVD, liver disease or cancer at baseline who participatedin a repeated regular health screening exam between 2004and 2013. Fatty liver was diagnosed by ultrasound based on standardcriteria, including parenchymal brightness, liver-to-kidney contrast,deep beam attenuation and bright vessel walls. Progression of coronaryartery calcium (CAC) scores was measured using multidetectorCT scanners.Results: The annual rate of CAC progression in participants with andwithout NAFLD were 22% (95% confidence interval 20 - 23%) and17% (16 - 18%), respectively (p<0.001). The multivariable ratio ofprogression rates comparing participants with NAFLD to those withoutNAFLD was 1.04 (1.02 - 1.05; p<0.001). The association betweenNAFLD and CAC progression was similar in most subgroups analyzed,including in participants with CAC 0 and in those with CAC > 0at baseline.Conclusions: In this large cohort study of adult men and womenwith no history of CVD, NAFLD was significantly associated with thedevelopment of CAC independently of cardiovascular and metabolicrisk factors. NAFLD may play a pathophysiologic role in atherosclerosisdevelopment and may be useful to identify subjects with a higherrisk of subclinical disease progression.
Nonalcoholic Fatty Liver Disease and Development of Chronic Kidney Disease: A Cohort Study
( Dong Hyun Sinn ),( Danbee Kang ),( Hye Ryoun Jang ),( Seonhye Gu ),( Soo Jin Cho ),( Seung Woon Paik ),( Seungho Ryu ),( Yoosoo Chang ),( Mariana Lazo ),( Eliseo Guallar ),( Juhee Cho ),( Geum-youn 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: Nonalcoholic fatty liver disease (NAFLD) has been associated with chronic kidney disease (CKD), but cohort studies are limited. We investigated the longitudinal association of NAFLD and its severity with the development of CKD. Methods: We performed a retrospective cohort study of 41,430 adult men and women (average age, 48.9 y) without CKD at baseline who underwent repeated health check-up examinations from January 1, 2003, through December 31, 2013. NAFLD status was assessed by ultrasonography, and NAFLD severity was assessed by the NAFLD fibrosis score (NFS). Results: The outcome was an incident CKD, defined as an estimated glomerular filtration rate less than 60 mL/min/1.73 m<sup>2</sup>. During 200,790 person-years of follow-up (median 4.15 years), we identified 691 incident CKD cases. The multivariable-adjusted hazard ratio for CKD comparing participants with and without NAFLD was 1.22 (95% confidence interval [CI], 1.04-1.43). The risk of CKD increased progressively with increased NAFLD severity. The multivariable-adjusted hazard ratios for CKD comparing participants with NFS < -1.455 and those with NFS ≥ -1.455 to participants without NAFLD were 1.09 (0.91-1.32) and 1.58 (1.30-1.92), respectively. The association was consistent across clinically relevant subgroups. Conclusions: In a large cohort of adult men and women without CKD, NAFLD was associated with an increased risk of CKD development. NAFLD may adversely affect renal function and may need careful attention for an increased risk of CKD.