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Effect of tooth loss and nutritional status on outcomes after ischemic stroke

志賀 裕二 広島大学

2021.03.23

概要

The prevalence of malnutrition has been reported to range from 8%
to 34% among patients with acute ischemic stroke [14]. Nutritional
status is strongly associated with poor stroke outcomes. The maintenance of adequate nutrition is essential in patients with acute stroke.
A recent meta-analysis showed that malnutrition in stroke patients is
associated with a higher frequency of dysphagia, previous stroke, diabetes mellitus, tube feeding, and reduced level of consciousness [5].
Oral health is important to consider in improving the status of
nutrition. Impaired oral health status, including periodontal disease and tooth loss, may have an adverse effect on systemic health
[6,7]. Periodontal disease is associated with chronic systemic
inflammation and may lead to progressive atherosclerosis and cardiovascular disease (CVD) [8]. Tooth loss also has been considered
This study was supported by research grants from Japan Society for the Promotion
of Science KAKENHI (grant nos. 17K17350, 17K17907, and 18K10746). HM received
grants from Daiichi Sankyo Co., Ltd., which are unrelated to the submitted work. All
other authors have no conflicts of interest to declare.
*Corresponding author: Tel: +81 82 257 5201; Fax: +81 82 505 0490.
E-mail address: tomonezu@hiroshima-u.ac.jp (T. Nezu).
https://doi.org/10.1016/j.nut.2019.110606
0899-9007/© 2019 Elsevier Inc. All rights reserved. ...

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Supplement table 1.

Scoring system for the CONUT score [11]

Parameter

None

Light

Moderate

Severe

Serum albumin (g/dL)

≥3.50

3.00–3.49

2.50–2.99

<2.50

score

≥1600

1200–1599

800–1199

<800

Total cholesterol (mg/dL)

≥180

140–179

100–139

<100

score

score

Total lymphocyte count (/mm )

Supplemental Table 2. Baseline chracteristics at admission and univariate analysis to determine the

factors associated with evaluated the number of teeth loss

All

Evaluated the number of

Non-evaluated

(n = 274)

teeth loss

(n = 79)

(n = 195)

Age (y)

71.2 ± 11.8

72.5 ± 11.0

67.8 ± 13.6

0.008

Female

96 (35.0%)

71 (36.4%)

25 (31.7%)

0.487

Body mass index, kg/m2

22.6 ± 3.9 (n = 273)

22.5 ± 3.9 (n = 194)

23.0 ± 3.8

0.296

Hypertension

206 (75.2 %)

145 (74.4 %)

61 (77.2 %)

0.647

Diabetes mellitus

96 (35.2 %) (n = 273)

57 (29.2 %)

39 (50.0 %) (n = 78)

0.002

Dyslipidemia

154 (56.4 %) (n = 273)

107 (54.9 %)

47 (60.3 %) (n = 78)

0.500

Daily alcohol intake

83 (32.8%) (n = 253)

57 (31.7%) (n = 180)

26 (35.6%) (n = 73)

0.557

Current or past smoking

132 (52.2%) (n = 253)

97 (54.2%) (n = 179)

35 (47.3%) (n = 74)

0.336

Atrial fibrillation

73 (26.8 %) (n = 272)

57 (29.5 %) (n = 193)

16 (20.3%)

0.133

Chronic heart failure

55 (20.1%)

43(22.1%)

12(15.2%)

0.245

Chronic kidney disease

113 (41.2%)

82 (42.1%)

31 (39,2%)

0.687

Previous stroke

64 (23.4%) (n = 273)

43 (22.2%) (n = 194)

21(26.6%)

0.490

NIHSS score at admission

4 [2-12]

5 [2-15]

3 [1-6]

<.001

CONUT score

2 [1-3] (n = 258)

2 [1-4] (n = 185)

2 [0-3] (n = 73)

0.184

CONUT, Controlling Nutritional Status; NIHSS, National Institutes of Health Stroke Scale.

Data are presented as the means ± SD for age and body mass index; as median (interquartile range) for

baseline NIHSS score and CONUT score; and as number of patients (%) for others.

...

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