title: Examination of the Relationship between Oral Health and Arterial Sclerosis without Genetic Confounding through the Study of Older Japanese Twins.
abstract: OBJECTIVE
  Although researchers have recently demonstrated a relationship between oral health and arterial sclerosis, the genetic contribution to this relationship has been ignored even though genetic factors are expected to have some effect on various diseases. The aim of this study was to evaluate oral health as a significant risk factor related to arterial sclerosis after eliminating genetic confounding through study of older Japanese twins.
  
  
  METHODS
  Medical and dental surveys were conducted individually for 106 Japanese twin pairs over the age of 50 years. Maximal carotid intima-media thickness (IMT-Cmax) was measured as a surrogate marker of arterial sclerosis. IMT-Cmax > 1.0 mm was diagnosed as arterial sclerosis. All of the twins were examined for the number of remaining teeth, masticatory performance, and periodontal status. We evaluated each measurement related with IMT-Cmax and arterial sclerosis using generalized estimating equations analysis adjusted for potential risk factors. For non-smoking monozygotic twins, a regression analysis using a "between within" model was conducted to evaluate the relationship between IMT-Cmax and the number of teeth as the environmental factor controlling genetic and familial confounding.
  
  
  RESULTS
  We examined 91 monozygotic and 15 dizygotic twin pairs (males: 42, females: 64) with a mean (± standard deviation) age of 67.4 ± 10.0 years. Out of all of the oral health-related measurements collected, only the number of teeth was significantly related to arterial sclerosis (odds ratio: 0.72, 95% confidence interval: 0.52-0.99 per five teeth). Regression analysis showed a significant association between the IMT-Cmax and the number of teeth as an environmental factor (p = 0.037).
  
  
  CONCLUSIONS
  Analysis of monozygotic twins older than 50 years of age showed that having fewer teeth could be a significant environmental factor related to arterial sclerosis, even after controlling for genetic and familial confounding.
authors.affiliation: Osaka University Graduate School of Dentistry, Department of Prosthodontics, Gerodontology, and Oral Rehabilitation, Suita, Osaka, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kurushima
authors.affiliation: Osaka University Graduate School of Dentistry, Department of Prosthodontics, Gerodontology, and Oral Rehabilitation, Suita, Osaka, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Ikebe
authors.affiliation: Osaka University Graduate School of Dentistry, Department of Prosthodontics, Gerodontology, and Oral Rehabilitation, Suita, Osaka, Japan.
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Matsuda
authors.affiliation: Osaka University Graduate School of Dentistry, Department of Prosthodontics, Gerodontology, and Oral Rehabilitation, Suita, Osaka, Japan.
authors.forename: Kaori
authors.initials: K
authors.lastname: Enoki
authors.affiliation: Osaka University Graduate School of Medicine, Center for Twin Research, Suita, Osaka, Japan.
authors.forename: Soshiro
authors.initials: S
authors.lastname: Ogata
authors.affiliation: Osaka University Graduate School of Dentistry, Department of Periodontology, Suita, Osaka, Japan.
authors.forename: Motozo
authors.initials: M
authors.lastname: Yamashita
authors.affiliation: Osaka University Graduate School of Dentistry, Department of Periodontology, Suita, Osaka, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Murakami
authors.affiliation: Osaka University Graduate School of Dentistry, Department of Prosthodontics, Gerodontology, and Oral Rehabilitation, Suita, Osaka, Japan.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Maeda
mesh_terms: D000368:Aged; D001161:Arteriosclerosis / Q000453:epidemiology* / Q000209:etiology / Q000235:genetics; D015986:Confounding Factors, Epidemiologic; D003430:Cross-Sectional Studies; D004200:Diseases in Twins / Q000453:epidemiology* / Q000235:genetics; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009909:Oral Health / Q000145:classification / Q000706:statistics & numerical data*; D012307:Risk Factors; D014429:Twins, Dizygotic / Q000235:genetics / Q000706:statistics & numerical data; D014430:Twins, Monozygotic / Q000235:genetics / Q000706:statistics & numerical data