Abstract：
OBJECTIVE: Although poor oral health has been a potentially modifiable risk for mortality, the precise association between functional tooth units (FTUs) and premature death as well as the underlying mechanisms remains unclear.
METHODS: This study used data from the National Health and Nutrition Examination Survey (NHANES) 2009-2018. Mortality details were obtained from the National Death Index (NDI). The number of FTUs was defined as pairs of opposing natural and artificial teeth in the premolar and molar area. Weighted logistic regression models were employed to assess the relationship between FTU and premature death. Demographic characteristics, lifestyle habits, and disease histories were adjusted as confounding factors. The propensity score matching (PSM) was conducted to further assess the association between FTU and premature death. Mediation analyses were conducted to assess the role of diet-related diseases in the association between FTU and premature death.
RESULTS: The analysis included 4169 individuals aged between 60 and 74 years. Participants with 0 ≤ FTUs ≤ 3 had a significantly higher odds of premature death compared to the 10 ≤ FTUs ≤ 12 group (OR = 2.142, 95% CI 1.091-4.208). After missing data imputation, 0 ≤ FTUs ≤ 3 was still significantly associated with increased odds of premature death (OR = 2.115, 95% CI 1.125-3.975). The relationship between 0 ≤ FTUs ≤ 3 and reference group persisted (OR = 2.196, 95% CI 1.296-3.721) after PSM analyses. For mechanism, mediation analysis showed that diet-related diseases, including diabetes and hypertension, partially mediated the association between FTU and premature death with proportions of 5.089% and 8.437%, respectively.
CONCLUSIONS: The findings revealed a link between impairment of masticatory function and a heightened odds of premature death among older adults. Notably, 0 ≤ FTUs ≤ 3 is significantly correlated to premature death among this demographic, with diabetes and hypertension partially mediating the effect of FTU on premature death. Further longitudinal studies are required to validate the findings.
METHODS: This study used data from the National Health and Nutrition Examination Survey (NHANES) 2009-2018. Mortality details were obtained from the National Death Index (NDI). The number of FTUs was defined as pairs of opposing natural and artificial teeth in the premolar and molar area. Weighted logistic regression models were employed to assess the relationship between FTU and premature death. Demographic characteristics, lifestyle habits, and disease histories were adjusted as confounding factors. The propensity score matching (PSM) was conducted to further assess the association between FTU and premature death. Mediation analyses were conducted to assess the role of diet-related diseases in the association between FTU and premature death.
RESULTS: The analysis included 4169 individuals aged between 60 and 74 years. Participants with 0 ≤ FTUs ≤ 3 had a significantly higher odds of premature death compared to the 10 ≤ FTUs ≤ 12 group (OR = 2.142, 95% CI 1.091-4.208). After missing data imputation, 0 ≤ FTUs ≤ 3 was still significantly associated with increased odds of premature death (OR = 2.115, 95% CI 1.125-3.975). The relationship between 0 ≤ FTUs ≤ 3 and reference group persisted (OR = 2.196, 95% CI 1.296-3.721) after PSM analyses. For mechanism, mediation analysis showed that diet-related diseases, including diabetes and hypertension, partially mediated the association between FTU and premature death with proportions of 5.089% and 8.437%, respectively.
CONCLUSIONS: The findings revealed a link between impairment of masticatory function and a heightened odds of premature death among older adults. Notably, 0 ≤ FTUs ≤ 3 is significantly correlated to premature death among this demographic, with diabetes and hypertension partially mediating the effect of FTU on premature death. Further longitudinal studies are required to validate the findings.
摘要：
目的：尽管口腔健康状况不佳可能会导致死亡，功能性牙齿单位(FTUs)与过早死亡之间的确切关联以及潜在机制尚不清楚.
方法：本研究使用了2009-2018年国家健康与营养调查（NHANES）的数据。死亡率详细信息来自国家死亡指数（NDI）。FTU的数量定义为前磨牙和磨牙区域中相对的天然和人造牙齿对。采用加权逻辑回归模型评估FTU与过早死亡之间的关系。人口特征，生活习惯,和疾病史被调整为混杂因素。进行倾向评分匹配（PSM）以进一步评估FTU与过早死亡之间的关联。进行中介分析以评估饮食相关疾病在FTU与过早死亡之间的关联中的作用。
结果：该分析包括4169名年龄在60至74岁之间的个体。与10≤FTUs≤12组相比，0≤FTUs≤3组的参与者过早死亡的几率明显更高（OR=2.142，95％CI1.091-4.208）。在缺少数据填补之后，0≤FTUs≤3仍与过早死亡几率增加相关(OR=2.115,95%CI1.125-3.975)。PSM分析后，0≤FTUs≤3与参考组之间的关系仍然存在（OR=2.196，95％CI1.296-3.721）。对于机制，调解分析表明，与饮食相关的疾病，包括糖尿病和高血压,部分介导FTU与过早死亡之间的关联，比例为5.089％和8.437％，分别。
结论：研究结果揭示了咀嚼功能受损与老年人过早死亡的可能性增加之间的联系。值得注意的是,0≤FTUs≤3与该人群中的过早死亡显着相关，糖尿病和高血压部分介导FTU对过早死亡的影响。需要进一步的纵向研究来验证研究结果。
方法：本研究使用了2009-2018年国家健康与营养调查（NHANES）的数据。死亡率详细信息来自国家死亡指数（NDI）。FTU的数量定义为前磨牙和磨牙区域中相对的天然和人造牙齿对。采用加权逻辑回归模型评估FTU与过早死亡之间的关系。人口特征，生活习惯,和疾病史被调整为混杂因素。进行倾向评分匹配（PSM）以进一步评估FTU与过早死亡之间的关联。进行中介分析以评估饮食相关疾病在FTU与过早死亡之间的关联中的作用。
结果：该分析包括4169名年龄在60至74岁之间的个体。与10≤FTUs≤12组相比，0≤FTUs≤3组的参与者过早死亡的几率明显更高（OR=2.142，95％CI1.091-4.208）。在缺少数据填补之后，0≤FTUs≤3仍与过早死亡几率增加相关(OR=2.115,95%CI1.125-3.975)。PSM分析后，0≤FTUs≤3与参考组之间的关系仍然存在（OR=2.196，95％CI1.296-3.721）。对于机制，调解分析表明，与饮食相关的疾病，包括糖尿病和高血压,部分介导FTU与过早死亡之间的关联，比例为5.089％和8.437％，分别。
结论：研究结果揭示了咀嚼功能受损与老年人过早死亡的可能性增加之间的联系。值得注意的是,0≤FTUs≤3与该人群中的过早死亡显着相关，糖尿病和高血压部分介导FTU对过早死亡的影响。需要进一步的纵向研究来验证研究结果。
