Association between glycemia, serum lipoproteins, and the risk of oral leukoplakia: the population-based Study of Health in Pomerania (SHIP).

OBJECTIVE: Oral leukoplakia is an oral lesion with a premalignant character. Besides smoking and alcohol, diabetes could be a risk factor. The aim is to search for such an association. RESEARCH DESIGN AND METHODS: Subjects with leukoplakia (N = 123) from the population-based Study of Health in Pomerania (SHIP) were matched 1:2 for age and sex with unaffected control subjects. Behavioral and lifestyle factors were assessed by a questionnaire. Lipoprotein concentrations, glycemia, and inflammation parameters were determined. RESULTS Subjects with oral leukoplakia showed higher levels of diabetes-related metabolites, a higher LDL/HDL cholesterol ratio (P = 0.004), and higher A1C (P = 0.002), and they were more frequently smokers (P < 0.001). Assessed by conditional logistic regression, the probability of leukoplakia increases with current smoking (odds ratio 2.20 [95% CI 1.16-4.17]) and higher levels of A1C (1.51 [95% CI 1.08-2.12]), revealing interaction between both factors (P = 0.012). CONCLUSIONS: Diabetes is associated with the risk of oral leukoplakia, which is exaggerated by smoking. The risk is positively correlated with A1C concentrations.

Prevalence of oral mucosal lesions in a representative population.

OBJECTIVE: The aim of this study was to assess the prevalence and intraoral distribution of oral mucosal lesions in a representative adult population (Study of Health in Pomerania/Germany). METHOD AND MATERIALS: The study sample comprised 6267 randomly selected subjects who were scheduled for examination from 1997 to 2001 (population-based cross-sectional study; response rate: 69%; age range 20 to 81 years). RESULTS: The prevalence of oral mucosal lesions was age dependent (5.56% in 20- to 29-year-olds to 19.55% in 70- to 81-year-olds) with an overall prevalence of 11.83%. The prevalence in men (12.20%) was slightly higher than in women (11.40%). Exophytic neoplasia was the most prevalent alteration (3.00%), followed by leukoplakia simplex (prevalence 2.85%). Premalignant lesions were found in 0.57% of the participants, with lichen ruber mucosae contributing the major part (0.48%). Exophytic neoplasia was most often situated in the buccal mucosa, the hard palate, or the mucosa of the lower lip. CONCLUSION: These data stress the importance of screening for oral mucosal lesions, especially because of a predicted increase in the number of elderly persons in industrialized countries.