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Background <p>Aging affects oral health and skeletal muscle, but the associations between oral diseases and possible sarcopenia remain understudied, especially in low-income regions. Thus, the study aimed to explore this relationship and potential mediating pathways.</p> Methods <p>Data were from the 2021–2022 follow-up of the West China Health and Aging Trend study. Assessments included questionnaires, oral examinations, muscle strength tests, physical performance tests, and routine blood tests. Logistic regression analyses, subgroup analyses, and mediation analyses were conducted.</p> Results <p>A total of 532 participants aged ≥ 60 years were included, with a possible sarcopenia prevalence of 50.4%. After adjusting for confounders, those with decayed and filled roots (DFRoot) had a 46% higher risk of possible sarcopenia than those without DFRoot, while those with a number of remaining natural teeth (NRT) ≥ 20 had a 53% lower risk. Participants with number of functional tooth loss (NFTL) &gt; 16 had an 83% higher risk of possible sarcopenia than those with ≤ 16. Mediation analyses indicated that impaired chewing ability, systemic inflammation, and impaired liver function partially explain the oral–sarcopenia nexus. Subgroup analyses showed significant associations between NRT ≥ 20 (OR 0.49, 95% CI 0.27 to 0.89), NFTL &gt; 16 (1.90, 1.05 to 3.43), and possible sarcopenia in adults aged ≥ 70 years.</p> Conclusions <p>Oral health emerged as a modifiable risk factor for sarcopenia in vulnerable older adults, with chewing impairment, systemic inflammation, and liver dysfunction partly explaining this association. These findings support integrating oral healthcare into sarcopenia prevention strategies, particularly in resource-limited settings. However, given the cross-sectional design, causal interpretations remain limited, and the identified mediation analyses should be viewed as associative rather than causal. Further longitudinal investigations are warranted to confirm these mechanisms and to evaluate whether oral health interventions can effectively reduce sarcopenia risk.</p> Trial registration <p>ChiCTR1800018895.</p>

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Oral–Sarcopenia nexus in health disparities: chewing and blood mediated pathways in a Chinese aging cohort

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月31日

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  • Yong Xiang,
  • Guosong Wang,
  • Yiting Cheng,
  • Yuhan Zhang,
  • Jialiang Zhao,
  • Birong Dong,
  • He Cai,
  • Li Cheng,
  • Tao Hu

摘要

Background

Aging affects oral health and skeletal muscle, but the associations between oral diseases and possible sarcopenia remain understudied, especially in low-income regions. Thus, the study aimed to explore this relationship and potential mediating pathways.

Methods

Data were from the 2021–2022 follow-up of the West China Health and Aging Trend study. Assessments included questionnaires, oral examinations, muscle strength tests, physical performance tests, and routine blood tests. Logistic regression analyses, subgroup analyses, and mediation analyses were conducted.

Results

A total of 532 participants aged ≥ 60 years were included, with a possible sarcopenia prevalence of 50.4%. After adjusting for confounders, those with decayed and filled roots (DFRoot) had a 46% higher risk of possible sarcopenia than those without DFRoot, while those with a number of remaining natural teeth (NRT) ≥ 20 had a 53% lower risk. Participants with number of functional tooth loss (NFTL) > 16 had an 83% higher risk of possible sarcopenia than those with ≤ 16. Mediation analyses indicated that impaired chewing ability, systemic inflammation, and impaired liver function partially explain the oral–sarcopenia nexus. Subgroup analyses showed significant associations between NRT ≥ 20 (OR 0.49, 95% CI 0.27 to 0.89), NFTL > 16 (1.90, 1.05 to 3.43), and possible sarcopenia in adults aged ≥ 70 years.

Conclusions

Oral health emerged as a modifiable risk factor for sarcopenia in vulnerable older adults, with chewing impairment, systemic inflammation, and liver dysfunction partly explaining this association. These findings support integrating oral healthcare into sarcopenia prevention strategies, particularly in resource-limited settings. However, given the cross-sectional design, causal interpretations remain limited, and the identified mediation analyses should be viewed as associative rather than causal. Further longitudinal investigations are warranted to confirm these mechanisms and to evaluate whether oral health interventions can effectively reduce sarcopenia risk.

Trial registration

ChiCTR1800018895.