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Title: 色素を用いた唾液量の簡便スクリーニングシートの開発
Other Titles: A simple screening test for evaluation of resting and stimulated saliva using pigment
Authors: 稲垣, 友理奈 Browse this author
竹原, 順次 Browse this author →KAKEN DB
本郷, 博久 Browse this author →KAKEN DB
公也, 公也 Browse this author
兼平, 孝 Browse this author →KAKEN DB
Keywords: dry mouth
food pigment
saliva secretion
cutoff value
Issue Date: Sep-2016
Publisher: 北海道歯学会
Journal Title: 北海道歯学雑誌
Volume: 37
Issue: 1
Start Page: 25
End Page: 39
Abstract: 高齢者において,口腔乾燥症を早期に診断し適切に対処することは,健康維持増進および健康寿命の延伸に重要である.口腔乾燥症の診断においては,安静時唾液量の評価は必須である.  我々はすでにペーパークロマトグラフィーの原理を利用した簡便診断用シートを考案し,口腔乾燥症のスクリーニングに利用できることを報告した.しかし,このシートはいくつか改良すべき点があった.今回シートに吸着させた色素を唾液の浸透により移動させることに着目し,その目的に適した色素を見つけるために,食品添加物を中心に様々な色素を用いて評価を行った.また,その中で評価に最適と評価された色素を吸収させたシートを用いて,外来受診者を被験者として,安静時唾液量を評価した.  今回,評価に供した色素は食品色素を中心に,赤色3,黄色2,青色1,緑色1,紫色2,褐色2の計11種である.短冊状濾紙(21mm×70mm)の先端部に50μLの各色素溶液を浸透させ,乾燥後,評価用シートとした.50~600μLの唾液をシャーレに取り,各色素を吸着させた評価シートに唾液を2分間吸収させた後,色素の伸展距離(mm)を測定し,最適な色素を決定した.その結果,最適な色素は褐色のメラノイジンであることが明らかとなった.  次に北海道大学病院歯科診療センターの受診者で本研究への協力の得られた被験者111名の舌下部にメラノイジンを吸着させた評価シートを2分間挿入し,唾液によるメラノイジンの伸展距離(mm)を測定した.また,安静時唾液量(10分間)を測定し,1ml/10分以下の者を口腔乾燥症と判定した.安静時唾液量と色素の伸展距離の間には,高い正の相関(Spearmanの相関係数,r=0.738,p<0.05)が認められた.次に最適なカットオフ値を決定するために,色素の伸展距離0~10mmにおける,それぞれのスクリーニング感度と特異度からROC曲線ならびに 陽性尤度比,Youden’s IndexおよびROC曲線上における各スポットと点(0,1)との距離を求めた.  その結果,口腔乾燥症をスクリーニングする上での最適なカットオフ値は4mmであることが明らかとなった. また,同時に作成したカプサイシンまたはクエン酸溶液をメラノイジンと同時に浸透させた刺激時唾液診断用シートにより,刺激時唾液の評価も可能であることが示唆された.
The early diagnosis and appropriate treatment of dry mouth in the elderly is important for health promotion and the extension of healthy life expectancy. The diagnosis of dry mouth requires an evaluation of the amount of saliva at rest.  Previously, we reported the invention of a simple screening paper, which uses the principles of paper chromatography for use in the screening of dry mouth. However, there were a number of issues with the paper that required improvement. In the present study, we focused on the transfer of pigment absorbed into the sheet due to the permeation of saliva and, to find a pigment suited to this purpose, we evaluated various pigments, particularly food additives. Additionally, the pigment that was evaluated as optimal was absorbed into the paper and used with outpatients as test subjects to evaluate the volume of resting saliva.  In the present study, we evaluated 11 pigments, which were mainly food pigments, including 3 red pigments, 2 yellow pigments, 1 blue pigments, 1 green pigments, 2 purple pigments, and 2 brown pigments. A total of 50 μL of pigment solutions were absorbed into the tips of the chromatography paper by permeation and used for evaluation after drying. The evaluation papers for each of the absorbed pigments were allowed to absorb from dishes of 0-600 μL of saliva for 2 minutes, after which the migration length (mm) for the pigment was measured and the optimum pigment determined. As a result, it was found that the optimum pigment was melanoidin.  Next, 111 participants, which were patients of the Department of Preventive Dentistry of Dental Clinical Division of Hokkaido University Hospital, and from whom we received cooperation were selected. We inserted melanoidin-absorbed evaluation papers into the sublingual region for 2 minutes and measured the migration length (mm) of the melanoidin due to the saliva. Additionally, the volume of resting saliva (over 10 minutes) was measured, those with a volume of 1 ml/10 minutes or less were judged as having dry mouth. A high, positive correlation was found between the volume of resting saliva and migration length of the pigment (Spearman’s rank correlation coefficient : r=0.738, p<0.05). Next, to determine the optimal cutoff value, an ROC curve was constructed from the sensitivity and specificity for the migration lengths of the pigment between 0 mm-10 mm. Additionally, the positive likelihood ratio, the Youden Index, and the distance of each spot and from point (0, 1) were calculated. As a result, the optimal cutoff for screening for dry mouth was found to be 4 mm. Additionally, using simple stimulated saliva screening paper, onto which solutions of capsicin and citric acid were absorbed at the same time as the melanoidin, it was suggested that it was also possible to evaluate stimulated saliva.
Type: article
Appears in Collections:北海道歯学雑誌 = Hokkaido Journal of Dental Science > 第37巻 第1号

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