Relationship between oral frailty and body composition or neuroimaging biomarkers in patients with cerebral small vessel disease

doi:10.3877/cma.j.issn.1673-9248.2026.03.003

Abstract

Abstract:

Objective

To investigate the relationship between oral frailty (OF) in patients with cerebral small vessel disease (CSVD) and body composition, as well as neuroimaging biomarkers.

Methods

The study included patients with CSVD hospitalized in the Department of Neurology at the Seventh Medical Center of the Chinese People's Liberation Army General Hospital from January 2022 to June 2023. OF was assessed by the oral frailty index-8 (OFI-8), with patients stratified into a low-risk group (score ≤3) and a high-risk group (score ≥4). Data collected encompassed body fat percentage (BF), appendicular skeletal muscle mass index (ASMI), and basal metabolic rate (BMR). Cognitive function was also evaluated, alongside neuroimaging markers of CSVD, including white matter hyperintensities (WMH), lacunes, cerebral microbleeds (CMBs), and CSVD composite score. Variables conforming to a normal distribution were compared using the Student's t-test, while those not following a normal distribution were analyzed with the Mann-Whitney U test. Categorical data were compared using the Chi-square test. Binary Logistic regression was employed to identify independent risk factors associated with OF.

Results

This study enrolled a total of 95 patients, comprising 48 males (31 in the low-risk group and 17 in the high-risk group) and 47 females (33 in the low-risk group and 14 in the high-risk group). Among male CSVD patients, individuals in the high-risk group exhibited a significant reduction in ASMI (OR=0.058, P=0.002) and a marked increase in BF (OR=1.331, P=0.002). Even after adjusting for confounding factors, both ASMI and BF remained independently associated with oral frailty (ASMI: OR=0.038, P=0.003; BF: OR=1.359, P=0.005). Gender differences were observed, with female CSVD patients showing a significant increase in BF exclusively within the high-risk group (OR=1.274, P=0.023). After adjusting for confounding variables, BF remained an independent risk factor for oral frailty (OR=1.308, P=0.028). Moreover, the high-risk group exhibited a significantly higher CSVD composite score (OR=6.532, P=0.004). After adjusting for potential confounders, the CSVD composite score remained an independent predictor of oral frailty risk (OR=5.898, P=0.008).

Conclusion

Among patients with CSVD, body composition is significantly associated with oral frailty, with this relationship exhibiting notable gender differences. Additionally, the overall burden of CSVD plays a crucial role in the onset and progression of oral frailty, with a higher CSVD composite score serving as a key risk factor for its development.

Key words: Cerebral small vessel disease, Body composition, Oral frailty, Neuroimaging

Wei Wei, Hongyang Xie, Cuiqiao Xia, Zhenxi Xia, Nan Zhang, Junjie Cao, Hongyi Zhao, Yonghua Huang. Relationship between oral frailty and body composition or neuroimaging biomarkers in patients with cerebral small vessel disease[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2026, 20(03): 250-257.

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Figures/Tables 6

序号	问题	回答	得分
1	与6个月前相比，您在咀嚼硬质食物时是否遇到困难？	是	2
1	与6个月前相比，您在咀嚼硬质食物时是否遇到困难？	否	0
2	最近喝茶或喝汤的时候是否呛到？	是	2
2	最近喝茶或喝汤的时候是否呛到？	否	0
3	是否佩戴义齿？	是	2
3	是否佩戴义齿？	否	0
4	您是否经常感到口干？	是	1
4	您是否经常感到口干？	否	0
5	您出门的频率比去年减少了吗？	是	1
5	您出门的频率比去年减少了吗？	否	0
6	您能吃鱿鱼干或泡菜萝卜等质硬食物吗？	否	1
6	您能吃鱿鱼干或泡菜萝卜等质硬食物吗？	是	0
7	您是否每年至少去1次牙科诊所？	否	1
7	您是否每年至少去1次牙科诊所？	是	0
8	您每天刷牙几次？（＜3次/天）	是	1
8	您每天刷牙几次？（＜3次/天）	否	0

项目	男性（n=48）				女性（n=47）
项目	低风险组（n=31）	高风险组（n=17）	统计值	P值	低风险组（n=33）	高风险组（n=14）	统计值	P值
教育程度[年，M（Q₁，Q₃）]	12.00（9.00，12.00）	12.00（9.00，12.00）	U=-0.384	0.701	12.00（9.00，12.00）	12.00（11.25，12.00）	U=-0.788	0.431
年龄（岁， $x ¯$ ±s）	62.73±6.21	65.92±9.08	t=-1.460	0.151	68.46±9.01	65.21±9.43	t=1.112	0.272
MMSE评分[分，M（Q₁，Q₃）]	29.00（27.00，30.00）	28.00（27.00，30.00）	U=-0.803	0.422	28.00（27.50，29.00）	28.00（27.00，29.25）	U=-0.072	0.943
共病数量[种，M（Q₁，Q₃）]	2.00（1.00，2.00）	2.00（1.00，2.50）	U=-0.103	0.918	2.00（2.00，2.50）	2.00（1.75，3.00）	U=-0.051	0.959
VFT（个， $x ¯$ ±s）	17.57±4.21	16.44±3.76	t=1.001	0.322	16.41±3.98	17.07±4.21	t=-0.499	0.620
CDT[分，M（Q₁，Q₃）]	12.00（11.00，13.00）	11.00（10.00，12.00）	U=-1.985	0.047	12.00（11.00，13.00）	12.00（10.75，12.25）	U=-0.096	0.924
TMT-B（s， $x ¯$ ±s）	72.14±20.27	86.83±19.89	t=-2.400	0.021	75.43±21.77	89.92±18.41	t=-2.172	0.035
ASMI（kg/m²， $x ¯$ ±s）	7.91±0.56	7.48±0.62	t=2.648	0.011	6.21±0.66	5.69±0.63	t=2.458	0.018
BF（%， $x ¯$ ±s）	25.62±7.57	33.31±6.94	t=-3.488	0.001	32.51±6.68	38.61±4.13	t=-3.160	0.003
蛋白质（g， $x ¯$ ±s）	10.71±0.87	10.22±0.99	t=1.731	0.090	8.02±0.81	7.29±0.92	t=2.745	0.009
BMR（kcal/d， $x ¯$ ±s）	1549.43±97.51	1495.24±109.28	t=1.765	0.084	1258.47±100.13	1160.54±80.16	t=3.241	0.002

项目	男性（n=48）				女性（n=47）
项目	低风险组（n=31）	高风险组（n=17）	统计值	P值	低风险组（n=33）	高风险组（n=14）	统计值	P值
教育程度[年，M（Q₁，Q₃）]	12.00（9.00，12.00）	12.00（9.00，12.00）	U=-0.384	0.701	12.00（9.00，12.00）	12.00（11.25，12.00）	U=-0.788	0.431
年龄（岁， $x ¯$ ±s）	62.73±6.21	65.92±9.08	t=-1.460	0.151	68.46±9.01	65.21±9.43	t=1.112	0.272
MMSE评分[分，M（Q₁，Q₃）]	29.00（27.00，30.00）	28.00（27.00，30.00）	U=-0.803	0.422	28.00（27.50，29.00）	28.00（27.00，29.25）	U=-0.072	0.943
共病数量[种，M（Q₁，Q₃）]	2.00（1.00，2.00）	2.00（1.00，2.50）	U=-0.103	0.918	2.00（2.00，2.50）	2.00（1.75，3.00）	U=-0.051	0.959
VFT（个， $x ¯$ ±s）	17.57±4.21	16.44±3.76	t=1.001	0.322	16.41±3.98	17.07±4.21	t=-0.499	0.620
CDT[分，M（Q₁，Q₃）]	12.00（11.00，13.00）	11.00（10.00，12.00）	U=-1.985	0.047	12.00（11.00，13.00）	12.00（10.75，12.25）	U=-0.096	0.924
TMT-B（s， $x ¯$ ±s）	72.14±20.27	86.83±19.89	t=-2.400	0.021	75.43±21.77	89.92±18.41	t=-2.172	0.035
ASMI（kg/m²， $x ¯$ ±s）	7.91±0.56	7.48±0.62	t=2.648	0.011	6.21±0.66	5.69±0.63	t=2.458	0.018
BF（%， $x ¯$ ±s）	25.62±7.57	33.31±6.94	t=-3.488	0.001	32.51±6.68	38.61±4.13	t=-3.160	0.003
蛋白质（g， $x ¯$ ±s）	10.71±0.87	10.22±0.99	t=1.731	0.090	8.02±0.81	7.29±0.92	t=2.745	0.009
BMR（kcal/d， $x ¯$ ±s）	1549.43±97.51	1495.24±109.28	t=1.765	0.084	1258.47±100.13	1160.54±80.16	t=3.241	0.002

变量	模型1						模型2
变量	β值	SE值	Wald χ²值	OR值	95%CI	P值	β值	SE值	Wald χ²值	OR值	95%CI	P值
ASMI	-2.853	0.918	9.666	0.058	0.010~0.348	0.002	-3.257	1.106	8.678	0.038	0.004~0.336	0.003
BF	0.286	0.093	9.362	1.331	1.108~1.598	0.002	0.307	0.108	7.995	1.359	1.099~1.681	0.005
CDT							0.607	0.622	0.951	1.835	0.542~6.213	0.329
TMT-B							0.075	0.042	3.251	1.078	0.993~1.172	0.071

变量	模型1						模型2
变量	β值	SE值	Wald χ²值	OR值	95%CI	P值	β值	SE值	Wald χ²值	OR值	95%CI	P值
ASMI	-0.204	1.112	0.034	0.815	0.092~7.208	0.854	0.457	1.269	0.130	1.579	0.131~18.991	0.719
BF	0.242	0.106	5.200	1.274	1.035~1.569	0.023	0.268	0.122	4.845	1.308	1.030~1.660	0.028
蛋白质	-0.074	0.584	0.016	0.928	0.296~2.917	0.899	-0.566	0.690	0.674	0.568	0.147~2.194	0.412
BMR	-0.010	0.008	1.414	0.990	0.975~1.006	0.234	-0.012	0.010	1.578	0.988	0.969~1.007	0.209
TMT-B							0.053	0.027	3.740	1.055	0.999~1.113	0.053

项目	低风险组（n=64）	高风险组（n=31）	χ²值	P值
CSVD综合评分（分）			26.250	＜0.001
0	18（28.13）	3（9.68）
1	24（37.50）	4（12.90）
2	22（34.38）	24（77.42）
WMH评分（分）			8.732	0.033
0	15（23.44）	1（3.23）
1	18（28.13）	6（19.35）
2	18（28.13）	14（45.16）
3	13（20.31）	10（32.26）
CMBs			0.196	0.658
无	32（50.00）	14（45.16）
有	32（50.00）	17（54.84）
腔隙			11.872	0.001
无	29（45.31）	3（9.68）
有	35（54.69）	28（90.32）

变量	模型1						模型2
变量	β值	SE值	Wald χ²值	OR值	95%CI	P值	β值	SE值	Wald χ²值	OR值	95%CI	P值
CSVD综合评分	1.877	0.649	8.361	6.532	1.831~23.307	0.004	1.775	0.666	7.108	5.898	1.600~21.745	0.008
WMH	-0.112	0.311	0.130	0.894	0.486~1.643	0.718	-0.143	0.316	0.205	0.867	0.466~1.610	0.651
腔隙（参考组）	0			1.000			0			1.000
腔隙	0.743	0.803	0.855	2.102	0.435~10.153	0.355	0.653	0.817	0.639	1.922	0.387~9.533	0.424
TMT-B							0.020	0.013	2.389	1.020	0.995~1.047	0.122

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