Noriyuki Sugino

Associations of self-reported height loss and kyphosis with vertebral fractures in Japanese women 60 years and older: a cross-sectional survey

Some vertebral fractures come to clinical attention but most do not. This cross-sectional survey aimed to clarify the associations of self-reported height loss and kyphosis with vertebral fractures. We enrolled 407 women aged 60–92 years who visited our orthopaedic clinic between June and August 2014 in our study. Inclusion criteria were lateral radiography followed by completion of a structured questionnaire in this study. The primary outcome was vertebral fracture diagnosed on lateral radiography and graded using a semiquantitative grading method, from SQ0 (normal) to SQ3 (severe). Self-reported kyphosis was defined as none, mild to moderate, severe. Self-reported height loss was defined as <4 cm or ≥4 cm. Number of SQ1 fracture was associated only with kyphosis. Self-reported severe kyphosis was significantly associated with increased numbers of ≥SQ2 vertebral fractures (p = 0.007). Height loss ≥4 cm was significantly associated with increased ≥SQ2 grade fractures (p < 0.001). Odds ratios (ORs) for fractures associated with mild-to-moderate and severe kyphosis were 2.1 [95% confidence interval 1.4 to 3.3) and 4.2 (1.8 to 9.5), respectively. OR for fractures associated with height loss ≥4 cm was 2.3 (1.4 to 3.7). Self-reported kyphosis may be useful for identifying Japanese women aged ≥60 years who have undetected vertebral fractures.

Association of Self-reported Height Loss and Kyphosis with Loss of Teeth in Japanese Elderly

Study background: Height loss and kyphosis are useful surrogate markers of osteoporotic vertebral fractures in the elderly. Loss of teeth in the elderly also is associated with osteoporosis. These imply the possibility that self-reported these indices may be associated with loss of teeth in the elderly. This study aimed to clarify the associations of self-reported height loss and kyphosis with number of teeth lost in Japanese elderly. Subjects and Methods: Among patients who visited dispensing pharmacies in Matsumoto, Japan, 307 patients (75 men and 232 women) aged 50–97 years participated in the study. They completed a structured questionnaire including covariates related to loss of teeth. Self-reported height loss and kyphosis were simply defined as three categories: no; mild-to-moderate; severe. Results: Analyses of covariance adjusted for covariates revealed that there were no significant differences in the numbers of teeth lost in total, or during the past 1 year among the three self-reported height loss categories. Significant differences were observed in the total numbers of teeth lost among the three self-reported kyphosis categories (p<0.001). Subjects who were conscious of severe kyphosis had significantly larger number of teeth lost (mean ± SEM, 16.1 ± 1.8) than those who were conscious of no kyphosis (8.7 ± 0.6, p<0.001) and mild-to-moderate kyphosis (8.3 ± 0.7, p<0.001). Furthermore, there were significant differences in the number of teeth lost during the past 1 year among the three self-reported kyphosis categories (p=0.031). Subjects who were conscious of severe kyphosis had significantly greater number of teeth lost during the past 1 year (0.9 ± 0.2) than those who were conscious of no kyphosis (0.3 ±0.1, p=0.03). Conclusions: Our results suggest that Japanese elderly with self-reported severe kyphosis may lost more teeth than those without self-reported severe kyphosis.

Delayed wound healing after tooth extraction and self-reported kyphosis in Japanese men and women

It is unclear whether osteoporosis itself is a main risk factor for delayed wound healing after tooth extraction in humans. In this study, we evaluated the association between experience of delayed wound healing after last tooth extraction and self-reported kyphosis, with the possibility of having vertebral fractures, in Japanese patients. Among the 1,504 patients who responded to the structured questionnaire survey, 518 patients (134 men and 384 women) aged 55–97 years finally participated in this study. Patients who self-reported mild-moderate kyphosis were more likely to have problematic delayed wound healing after last tooth extraction than those who reported severe kyphosis (odds ratio [OR] 4.98; 95% confidence interval [CI], 1.86–13.38 and OR 2.30; 95% CI, 0.52–10.22, respectively) (p for trend = 0.005). Japanese patients with vertebral fractures may have a higher risk of having problematic delayed wound healing after tooth extraction.

Osteoporosis, osteoporotic fractures, and carotid artery calcification detected on panoramic radiographs in Japanese men and women

OBJECTIVES We investigated the association among diagnosed osteoporosis, osteoporotic fractures, and carotid artery calcification (CAC) detected on panoramic radiographs. Additionally, we assessed whether osteoporosis or fractures could be predicted by an incidental finding of CAC. STUDY DESIGN One thousand twenty-one patients participated in this study. Patients completed a structured questionnaire. Logistic regression analysis adjusted for covariates was used to calculate the odds ratio (95% confidence interval) for diagnosed osteoporosis or fractures according to the presence of CAC. Extended receiver operating characteristic (ROC) curve analysis was used to clarify whether osteoporosis or fractures were predicted by the detection of CAC. RESULTS The odds ratios for diagnosed osteoporosis or fracture associated with CAC were 1.82 (1.02-3.24) and 0.77 (0.33-1.77), respectively. The areas under the ROC curves for identifying patients with osteoporosis or fractures according to the detection of CAC were 0.54 and 0.50, respectively. CONCLUSIONS CAC may not be useful for identifying Japanese individuals with osteoporosis or those at risk of fracture, although the presence of CAC was significantly associated with a history of diagnosed osteoporosis without osteoporotic fractures.

Association between number of teeth present and mandibular cortical erosion in Japanese men and women aged 40 years and older: A cross-sectional study

Mandibular cortical erosion detected on dental panoramic radiographs is associated with increased risk of osteoporosis in older adults. Additionally, many reports have demonstrated an association between decreased number of teeth present and osteoporosis. However, whether mandibular cortical erosion is associated with a decreased number of teeth remains unclear. The purpose of this study, therefore, was to clarify the association between mandibular cortical erosion and number of teeth present in Japanese men and women aged 40 years and older. Among patients who visited our university hospital and underwent dental panoramic radiography for the diagnosis of dental diseases, 839 patients (293 men and 546 women) aged 40–89 years (mean [SD], 63.7 [10.6] years) participated in this study. Multiple regression analysis revealed that mildly to moderately eroded cortex (p = 0.007) and severe eroded cortex (p < 0.001) were significantly associated with a decreased number of teeth present. Analysis of covariance adjusted for covariates revealed a significant association between mandibular cortical erosion category and number of teeth present (p < 0.001). Subjects with a severely eroded cortex had significantly fewer teeth present than those with a normal cortex (mean [SE], 20.7 [0.5] vs. 23.4 [0.3], p < 0.001) or mildly to moderately eroded cortex (22.2 [0.4], p = 0.04). Subjects with a mildly to moderately eroded cortex had significantly fewer teeth present than those with a normal cortex (p = 0.033). Our results suggest the significant association between mandibular cortical erosion and number of teeth present in Japanese men and women aged 40 years and older.