Genotoxicity in the oral cells of older people from a Brazilian rural area: a population-based study

Abstract The purpose of this population-based, observational, and cross-sectional study was to evaluate alterations in the oral cells of a population of older people from a Brazilian rural area, using the micronucleus technique to investigate possible associated genotoxic factors. A questionnaire was applied and clinical examination and collection of oral mucosal cells were performed for all older people (≥ 60 years) from a town in southern Brazil. Demographic and socioeconomic variables, deleterious habits (drinking and tobacco use), presence of gastro-oesophageal reflux disease (GERD), and the use of proton pump inhibitors (PPIs) were considered the exposure variables, whereas metanuclear changes (MCs) and the prevalence of cell micronuclei (MN) were considered outcomes. Out of 489 older people, 447 were included in the study, among whom 50.8% were men with a mean age of 70.9 years and 83.9% had a monthly family income greater than US$ 500.00. GERD symptoms were present in 36.2% of the individuals, and 29.1% used PPIs daily, 53.3% consumed alcoholic beverages, and 46.7% used tobacco. The analysis of 1,000 oral mucosal cells per subject showed a MN frequency of 0–2 per individual, and MCs were detected with an average of 15 units per individual (median = 11 per individual). Poisson regression did not show statistical association between the exposure variables and the outcomes (presence of MN and MCs), except for the use of PPIs, which was a protective factor for the prevalence of MN [PR 0.6 (CI 0.3–0,9)]. Age, sex, family income, tobacco use and drinking, and GERD were not associated with the number of MN and MCs in oral mucosal cells of the investigated older people.

摘要 本项基于人群的观察性横断面研究旨在评估巴西农村地区老年人群口腔细胞的改变，采用微核技术（micronucleus technique）探究潜在相关的遗传毒性因素。本研究对巴西南部某城镇所有≥60岁的老年人开展了问卷调查、临床检查及口腔黏膜细胞采集工作。研究将人口学与社会经济变量、有害习惯（饮酒与吸烟）、胃食管反流病（gastro-oesophageal reflux disease, GERD）的患病情况以及质子泵抑制剂（proton pump inhibitors, PPIs）的使用情况设为暴露变量；将核异常变化（metanuclear changes, MCs）与细胞微核（cell micronuclei, MN）的检出率作为结局指标。本研究共招募489名老年人，最终纳入447人，其中男性占比50.8%，平均年龄70.9岁，83.9%的受试者家庭月收入高于500美元。36.2%的受试者存在胃食管反流病症状，29.1%每日使用质子泵抑制剂，53.3%有饮酒习惯，46.7%有吸烟史。对每名受试者的1000个口腔黏膜细胞进行分析后发现，个体的细胞微核计数为0~2个，核异常变化的平均检出量为15个/个体（中位数为11个/个体）。泊松回归（Poisson regression）分析显示，除质子泵抑制剂的使用为细胞微核检出率的保护因素[患病率比（prevalence ratio, PR）=0.6，置信区间（confidence interval, CI）：0.3~0.9]外，其余暴露变量与结局指标均未呈现统计学关联。年龄、性别、家庭收入、烟酒使用情况及胃食管反流病均与受试老年人口腔黏膜细胞的微核计数及核异常变化数量无统计学关联。