Association of Hyper-Low-Density Lipoprotein and Hypo-High-Density Lipoprotein Cholesterolemia with Low Saliva Flow Rates in Japanese Community-Dwelling Elders

Mizoguchi, Nana; Nohno, Kaname; Yoshihara, Akihiro; Ito, Kayoko; Funayama, Saori; Ogawa, Hiroshi

doi:10.1055/s-0042-1744167

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Original Research • iao 27 (1) • Jan-Mar 2023 • https://doi.org/10.1055/s-0042-1744167 copy

Association of Hyper-Low-Density Lipoprotein and Hypo-High-Density Lipoprotein Cholesterolemia with Low Saliva Flow Rates in Japanese Community-Dwelling Elders

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction

The associations of low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein (HDL-C) with reduced saliva flow rates have not been previously reported.

Objective

The present study aimed to assess the association of cholesterolemia with reduced saliva flow rates in community-dwelling elderly subjects.

Methods

The present study analyzed 342 participants (170 males and 172 females aged between 78 and 79 years old). Unstimulated salivary flow rate (USFR) was assessed using a cotton roll method. Low-USFR was defined as 0.10 g/30 seconds. Stimulated salivary flow rate (SSFR) was assessed by having the participants chew tasteless gum for 3minutes. Low-SSFR was defined as 1.0 mL/minute. Blood samples were collected for the measurement of LDL-C, HDL-C, rheumatoid factor, hemoglobin A1c, and creatinine. To assess depression, the General Health Questionnaire 30 was used. A standardized questionnaire was completed, covering the current and previous medications of the participants and smoking status. We stratified the serum LDL-C levels of the participants as normal, moderate or severe hyper-LDL cholesterolemia and serum HDL-C levels as normal or hypo-HDL cholesterolemia. Multivariate logistic regression models were established and low-USFR or low-SSFR were set as dependent variables in the aforementioned models.

Results

After controlling for the effects of the other variables, the odds ratios (ORs) (95% confidence intervals [CIs]) for low-USFR were 2.25 (1.10–4.61) for moderate and 5.69 (1.55–20.8) for severe hyper-LDL cholesterolemia, while that of hypo-HDL cholesterolemia was 3.40 (1.33–8.69). Severe hyper-LDL cholesterolemia was also associated with low-SSFR with an OR of 3.89 (1.39–10.88).

Conclusion

Elderly patients with cholesterolemia have a risk of reduced salivary flow rate.

Keywords
cholesterol; saliva; aged

Variable	n (%) or mean ± SD
Gender: female	172 (50.3)
Unstimulated flow rate (g/30 seconds)	0.139±0.130
Low-USFR (= 0.10 g/30 seconds)	175 (51.2)
Stimulated flow Rate (mL/minute)	1.45 ± 0.86
Low-SSFR (= 1.0mL/minute)	118 (34.5)
Serum LDL level (mg/dL)	115.6±26.2
Moderate hyper-LDL (140–159 mg/dL)	41 (12.0)
Severe hyper-LDL (= 160mg/dL)	19 (5.6)
Serum HDL level (mg/dL)	59.3 ± 14.5
Hypo-HDL-C (= 40mg/dL)	25 (7.3)
Serum rheumatoid ator (IU/mL)	9.81 ± 63.6
Rheumatoid arthritis (= 15)	21 (6.1)
HbA1C (%)	5.36 ± 0.69
Diabetes mellitus (HbA1c = 6.5)	21 (6.1)
eGFR (mL/minute/1.73 m²)	68.4 ±16.4
Reduced kidney function (< 60)	102 (29.8)
GHQ score	4.95 ± 5.28
Depression (GHQ score = 7)	103 (30.1)
Antihypertensive agent intake	157 (45.9)
Diuretic agent intake	17 (5.0)
Antidepressant agent intake	58 (17.0)
Anticholinergic agent intake	18 (5.3)
Number of medications	3.06±3.01
Number of remaining teeth	15.7 ±9.2
Body mass index	21.9±3.07
Current smoker	30 (8.8)

Variable	Normal		Low		p-value
Variable	n = 167	(48.8%)	n = 175	(51.2%)	p-value
LDL-C
Moderate hyper	15	(36.6)	26	(63.4)	0.002	^a
Severe hyper	3	(15.8)	16	(84.2)
HDL-C
Hypo	7	(28.0)	18	(72.0)	0.030	^a
Gender
Female	74	(43.0)	98	(57.0)	0.031	^a
Rheumatoid arthritis
Yes	13	(61.9)	8	(31.8)	0.216	^a
Diabetes mellitus
Yes	8	(38.1)	13	(61.9)	0.310	^a
Reduced kidney function
Yes	55	(53.9)	47	(46.1)	0.219	^a
Depressive symptoms
Yes	41	(39.8)	62	(60.2)	0.018	^a
Antihypertensive agent
Yes	70	(44.6)	87	(55.4)	0.148	^a
Diuretic agent
Yes	6	(35.3)	11	(64.7)	0.257	^a
Antidepressant agent
Yes	28	(48.3)	30	(51.7)	0.834	^a
Anticholinergic agent
Yes	11	(61.1)	7	(38.9)	0.284	^a
Number of medications
Mean ± SD	2.86 ±3.1		3.26± 3.0		0.083	^b
Number of remaining teeth
Mean ± SD	15.2 ±9.2		1 6.9 ± 9.0		0.134	^b
Body mass Index
Mean ± SD	21.9 ±3.0		22.1 ± 3.1		0.800	^b
Smoking
Current smoker	17	(56.7)	13	(43.3)	0.369	^a

Variables	Normal		Low		p-value
Variables	n = 224	(65.5%)	n = 118	(34.5%)	p-value
LDL-C
Moderate hyper	27	(65.9)	14	(34.1)	0.006	^a
Severe hyper	6	(31.6)	13	(68.4)
HDL-C
Hypo	17	(68.0)	8	(32.0)	0.785	^a
Gender
Female	99	(57.6)	73	(42.4)	0.002	^a
Rheumatoid arthritis
Yes	13	(61.9)	8	(38.1)	0.721	^a
Diabetes mellitus
Yes	12	(57.1)	9	(42.9)	0.406	^a
Reduced kidney function
Yes	72	(70.6)	30	(29.4)	0.197	^a
Depressive symptoms
Yes	66	(64.1)	37	(35.9)	0.717	^a
Antihypertensive agent
Yes	96	(61.1)	61	(38.9)	0.119	^a
Diuretic agent
Yes	8	(47.1)	9	(52.9)	0.101	^a
Antidepressant agent
Yes	39	(67.2)	19	(32.7)	0.759	^a
Anticholinergic agent
Yes	11	(61.1)	7	(38.9)	0.688	^a
Number of medications
Mean ±SD	2.88± 2.92		3.40 ±3.17		0.131	^b
Number of remaining teeth
Mean ± SD	16.2 ± 9.4		1 5.9±8.6		0.431	^b
Body mass index
Mean ±SD	21.85 ±3.03		22.2 ±3.13		0.312	^b
Smoking
Current smoker	22	(73.3)	8	(26.4)	0.345	^a

Independent variables	Dependent variable
	Low-USFR			Low-SSFR
	Odds ratio	95% CI		Odds ratio	95% CI
LDL-C (ref: normal)
Moderate hyper (140–159 mg/dL)	2.25	1.10–4.61	*	0.97	0.47–1.98
Severe hyper (= 160 mg/dL)	5.69	1.55–20.8	**	3.89	1.39–10.88	**
HDL-C (ref: normal)
Hypoã (< 40 mg/dL)	3.40	1.33–8.69	*
Gender (ref: male)
Female	1.32	0.83–2.08		1.88	1.17–3.03	**
Rheumatoid Arthritis (ref: no)
Yes	0.48	0.18–1.28
Reduced kidney function (ref: no)
Yes	0.62	0.38–1.03		0.61	0.35–1.04
Depressive symptoms (ref: no)
Yes	1.64	0.98–2.71
Antihypertensive agent (ref: no)
Yes	1.48	0.88–2.48		1.31	0.77–2.25
Diuretic agent (ref: no)
Yes				2.53	0.88–7.26
Number of medications (continuous)	1.00	0.92–1.10		1.02	0.93–1.12
Number of remainingteeth (continuous)	1.02	1.00–1.05
Constant	0.31			0.17

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[1] Address for correspondence Kaname Nohno, PhD, Preventive Dentistry, Medical and Dental Hospital, Niigata University, 754, Ichibancho, Asahimachidori, Chuo-ku, Niigata-shi, Niigata, Japan (e-mail: no2@dent.niigata-u.ac.jp).