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Complex interplay of oral health, muscle and bone metabolism, and frailty in older individuals

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Abstract

Objectives

To investigate molecular and clinical background of associations among oral health, muscle and bone metabolism, and frailty incidence in patients with fall and fracture history.

Materials and methods

In total, 88 elderly participants (mean age 71.9 ± 5.8 years) with the distal radius fractures were included. Participants were divided into three groups based on an Oral Health Assessment Tool score. Fried criteria and Mini-nutritional assessments were adopted to diagnose frailty and malnutrition, respectively. Blood samples were collected and analyzed for serum levels of bone turnover markers, proteins, insulin-like growth factor-1, 25-hydroxyvitamin D, and inflammatory cytokines. The mRNA levels of markers of inflammation, muscle synthesis and wasting, and muscle homeostasis regulator in the pronator quadratus muscle were analyzed.

Results

Patients with deteriorated oral health demonstrated a higher prevalence of frailty and malnutrition. Significantly lower serum levels of total protein and higher concentrations of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) were detected in patients with poor oral health. Significant interaction effects between oral health and frailty level in gait speed, serum TNF-α, IL-1β, and total protein levels were exhibited. Significantly different mRNA expression levels in the pronator quadratus muscle of TNF-α, IL-1β, NF kB, MYOG, and FOXO1 following the oral health were detected.

Conclusion

This study highlights relationship between oral health, nutritional uptake, systemic inflammation, and their combined impact on muscle and bone metabolism, ultimately affecting frailty development in the aging populations.

Clinical relevance

A comprehensive understanding of mutual interactions among oral health, nutrition, and inflammation is essential for managing frailty.

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Data availability

The data of this study are available from the corresponding author upon reasonable request.

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Funding

This research was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (No. 2020R1I1A1A01071537).

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29, Saemunan-Ro, Jongno-Gu, Seoul, 03181, Republic of Korea

    Seok Woo Hong & Kwangyeon Kim

  2. Department of Molecular Genetics, School of Dentistry and Dental Research Institute, Seoul National University, Gwanak-Ro, Gwanak-Gu, Seoul, 08826, Republic of Korea

    Jeong-Hwa Baek

  3. Clinic of Oral Medicine and Orofacial Pain, Institute of Oral Health Science, Ajou University School of Medicine, 164, Worldcup-Ro, Yeongtong-Gu, Suwon, Gyeonggi-Do, 16499, Republic of Korea

    Jeong-Hyun Kang

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Contributions

Conceptualization: SWH, JHK; data curation: SWH, KK; formal analysis: JHB, JHK; funding acquisition: JHK; investigation: SWH, JHK; methodology: JHB, JHK; software: KK; validation: SWH, JHK; visualization: SWH, KK; writing—original draft: SWH, JHK; writing—review and editing: all authors.

Corresponding author

Correspondence to Jeong-Hyun Kang.

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The authors declare no competing interests.

Ethics approval

The Institutional Review Board of the University Hospital approved the research protocol (KBSMC-2022–01-006). All participants provided informed consents.

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Hong, S.W., Baek, JH., Kim, K. et al. Complex interplay of oral health, muscle and bone metabolism, and frailty in older individuals. Clin Oral Invest 28, 116 (2024). https://doi.org/10.1007/s00784-024-05521-9

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