{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T21:15:15Z","timestamp":1784495715473,"version":"3.55.0"},"reference-count":36,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2021,9,28]],"date-time":"2021-09-28T00:00:00Z","timestamp":1632787200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Romanian National Authority for Scientific Reasearch CNCS-UEFISCDI","award":["5348PED\/03.08.2020"],"award-info":[{"award-number":["5348PED\/03.08.2020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Exogenous factors (such as sun exposure, smoking habits, and diet) and endogenous (inflammatory status, general diseases) have a direct influence on skin and soft tissue characteristics. The study\u2019s objective was to assess the impact of metabolic syndrome (MS) on characteristics of skin layers in sun-exposed and non-exposed maxillofacial tissues evaluated by high-frequency ultrasound (HFU), as a potential diagnosis and monitoring tool for the aging process. Material and methods: The present study included 102 subjects (24 with MS; 78 without MS). Anthropometric parameters and disease history were recorded, and blood samples were harvested in order to assess biochemical parameters of MS. Sun-exposed skin (zygomatic region) and non-exposed oral mucosa of the lower lip were assessed using HFU (DUB\u00ae cutis, Taberna Pro Medicum) with a 22 MHz probe. Results: Patients with cardiac disease had significantly lower values for epidermis density (p = 0.002). Gender was independently linked to the aged dermis depth (p &lt; 0.001), aged dermis no. of px (pixels) (p &lt; 0.001), dermis depth (p &lt; 0.001), dermis no. of px (p &lt; 0.001), and subcutaneous tissue density (p &lt; 0.001). Patients with MS had thinner epidermis (p = 0.008) and thinner aged dermis (p = 0.037) when compared to non-MS subjects. Conclusion: Patients with MS had thinner epidermis and a lower epidermis number of pixels in sun-exposed skin. Women had lower epidermis density and thicker dermis in sun-exposed skin. Our study showed that HFU, as a non-invasive investigation approach, is useful to diagnose and monitor the aging process in skin and oral mucosa, correlated with skin phenotype pathological conditions.<\/jats:p>","DOI":"10.3390\/jcm10194461","type":"journal-article","created":{"date-parts":[[2021,9,28]],"date-time":"2021-09-28T21:38:09Z","timestamp":1632865089000},"page":"4461","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["High-Frequency Ultrasound Assessment of Skin and Oral Mucosa in Metabolic Syndrome Patients\u2014A Cross-Sectional Study"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0070-4991","authenticated-orcid":false,"given":"Anida Maria","family":"B\u0103b\u021ban","sequence":"first","affiliation":[{"name":"Oral Rehabilitation Department, Faculty of Dentistry, \u201cIuliu Ha\u0163ieganu\u201d University of Medicine and Pharmacy Cluj-Napoca, Babe\u0219 Street No. 15, 400012 Cluj-Napoca, Cluj County, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4549-3526","authenticated-orcid":false,"given":"\u0218tefan Cristian","family":"Vesa","sequence":"additional","affiliation":[{"name":"Pharmacology, Toxicology and Clinical Pharmacology Department, Faculty of Medicine, \u201cIuliu Ha\u0163ieganu\u201d University of Medicine and Pharmacy Cluj-Napoca, Marinescu Street No. 23, 400337 Cluj-Napoca, Cluj County, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3835-2090","authenticated-orcid":false,"given":"Bianca Adina","family":"Bo\u0219ca","sequence":"additional","affiliation":[{"name":"Histology Department, Faculty of Medicine, \u201cIuliu Ha\u0163ieganu\u201d University of Medicine and Pharmacy Cluj-Napoca, Pasteur Street No. 4, 400349 Cluj-Napoca, Cluj County, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Cri\u0219an","sequence":"additional","affiliation":[{"name":"Histology Department, Faculty of Medicine, \u201cIuliu Ha\u0163ieganu\u201d University of Medicine and Pharmacy Cluj-Napoca, Pasteur Street No. 4, 400349 Cluj-Napoca, Cluj County, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen Mihaela","family":"Mihu","sequence":"additional","affiliation":[{"name":"Histology Department, Faculty of Medicine, \u201cIuliu Ha\u0163ieganu\u201d University of Medicine and Pharmacy Cluj-Napoca, Pasteur Street No. 4, 400349 Cluj-Napoca, Cluj County, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihaela Felicia","family":"B\u0103ciu\u021b","sequence":"additional","affiliation":[{"name":"Maxillofacial Surgery and Implantology Department, Faculty of Dentistry, \u201cIuliu Ha\u0163ieganu\u201d University of Medicine and Pharmacy Cluj-Napoca, Cardinal Iuliu Hossu Street No. 37, 400029 Cluj-Napoca, Cluj County, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristian","family":"Dinu","sequence":"additional","affiliation":[{"name":"Maxillofacial Surgery and Implantology Department, Faculty of Dentistry, \u201cIuliu Ha\u0163ieganu\u201d University of Medicine and Pharmacy Cluj-Napoca, Cardinal Iuliu Hossu Street No. 37, 400029 Cluj-Napoca, Cluj County, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bogdan","family":"Cri\u0219an","sequence":"additional","affiliation":[{"name":"Maxillofacial Surgery and Implantology Department, Faculty of Dentistry, \u201cIuliu Ha\u0163ieganu\u201d University of Medicine and Pharmacy Cluj-Napoca, Cardinal Iuliu Hossu Street No. 37, 400029 Cluj-Napoca, Cluj County, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radu Septimiu","family":"C\u00e2mpian","sequence":"additional","affiliation":[{"name":"Oral Rehabilitation Department, Faculty of Dentistry, \u201cIuliu Ha\u0163ieganu\u201d University of Medicine and Pharmacy Cluj-Napoca, Babe\u0219 Street No. 15, 400012 Cluj-Napoca, Cluj County, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia Nicoleta","family":"Feurdean","sequence":"additional","affiliation":[{"name":"Oral Rehabilitation Department, Faculty of Dentistry, \u201cIuliu Ha\u0163ieganu\u201d University of Medicine and Pharmacy Cluj-Napoca, Babe\u0219 Street No. 15, 400012 Cluj-Napoca, Cluj County, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anca","family":"Ionel","sequence":"additional","affiliation":[{"name":"Oral Rehabilitation Department, Faculty of Dentistry, \u201cIuliu Ha\u0163ieganu\u201d University of Medicine and Pharmacy Cluj-Napoca, Babe\u0219 Street No. 15, 400012 Cluj-Napoca, Cluj County, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Artur","family":"Bezugly","sequence":"additional","affiliation":[{"name":"Dermatology and Cosmetology Department, Academy of Postgraduate Education of the Russian Federal Medical-Biological Agency, 123098 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7166-9949","authenticated-orcid":false,"given":"Ioana Roxana","family":"Bordea","sequence":"additional","affiliation":[{"name":"Oral Health Department, Faculty of Dentistry, \u201cIuliu Ha\u0163ieganu\u201d University of Medicine and Pharmacy Cluj-Napoca, Babe\u0219 Street No. 15, 400012 Cluj-Napoca, Cluj County, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1033-0906","authenticated-orcid":false,"given":"Aranka","family":"Ilea","sequence":"additional","affiliation":[{"name":"Oral Rehabilitation Department, Faculty of Dentistry, \u201cIuliu Ha\u0163ieganu\u201d University of Medicine and Pharmacy Cluj-Napoca, Babe\u0219 Street No. 15, 400012 Cluj-Napoca, Cluj County, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,28]]},"reference":[{"key":"ref_1","first-page":"212","article-title":"Formulation and evaluation of a water-in-oil cream containing herbal active ingredients and ferulic acid","volume":"90","author":"Moldovan","year":"2017","journal-title":"Clujul Med."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Hjerrild, J.N., Wobbe, A., Stausholm, M.B., Larsen, A.E., Josefsen, C.O., Malmgaard-Clausen, N.M., Dela, F., Kjaer, M., Magnusson, S.P., and Hansen, M. (2019). Effects of Long-Term Physical Activity and Diet on Skin Glycation and Achilles Tendon Structure. Nutrients, 11.","DOI":"10.3390\/nu11061409"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.mad.2016.09.006","article-title":"Effect of glycation inhibitors on aging and age-related diseases","volume":"160","author":"Bartosz","year":"2016","journal-title":"Mech. Ageing Dev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1111\/j.1600-0846.2004.00056.x","article-title":"Ultrasonographic subepidermal low-echogenic band, dependence of age and body site","volume":"10","author":"Wulf","year":"2004","journal-title":"Ski. Res. Technol."},{"key":"ref_5","first-page":"106","article-title":"Accumulation of N-epsilon carboxymethyl lysine in various tissues and organs related to diet-induced aging process. State of the art and experimental animal study","volume":"11","author":"Petrescu","year":"2017","journal-title":"HVM Bioflux"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"7","DOI":"10.2147\/CCID.S25840","article-title":"Ultrasonographic assessment of the cutaneous changes induced by topical flavonoid therapy","volume":"5","author":"Moldovan","year":"2012","journal-title":"Clin. Cosmet. Investig. Dermatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"7","DOI":"10.4103\/2230-8210.91175","article-title":"Changing definitions of metabolic syndrome","volume":"16","author":"Parikh","year":"2012","journal-title":"Indian J. Endocrinol. Metab."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1186\/1741-7015-9-48","article-title":"Metabolic syndrome: Definitions and controversies","volume":"9","author":"Kassi","year":"2011","journal-title":"BMC Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1111\/ics.12145","article-title":"Structural changes in dermal collagen and oxidative stress levels in the skin of Japanese overweight males","volume":"36","author":"Matsumoto","year":"2014","journal-title":"Int. J. Cosmet. Sci."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"50","DOI":"10.4329\/wjr.v8.i1.50","article-title":"Review on the applications of ultrasonography in dentomaxillofacial region","volume":"8","author":"Evirgen","year":"2016","journal-title":"World J. Radiol."},{"key":"ref_11","first-page":"S20","article-title":"Periodontal evaluation using a non-invasive imaging method (ultrasonography)","volume":"92","author":"Chifor","year":"2019","journal-title":"Med. Pharm. Rep."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1007\/s00403-013-1321-1","article-title":"Ultrasonographic staging of cutaneous malignant tumors: An ultrasonographic depth index","volume":"305","author":"Crisan","year":"2013","journal-title":"Arch. Dermatol. Res."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Vergilio, M.M., Vasques, L.I., and Leonardi, G.R. (2021). Characterization of skin aging through high-frequency ultrasound imaging as a technique for evaluating the effectiveness of anti-aging products and procedures: A review. Ski. Res. Technol.","DOI":"10.1111\/srt.13033"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"475","DOI":"10.11152\/mu-1633","article-title":"Ultrasonographic features of superficial and nodular basal cell carcinoma","volume":"20","author":"Khlebnikova","year":"2018","journal-title":"Med. Ultrason."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/j.jaad.2009.06.016","article-title":"Clinical usefulness of variable-frequency ultrasound in localized lesions of the skin","volume":"62","author":"Wortsman","year":"2010","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1111\/j.1365-2133.2003.05558.x","article-title":"Pulsed ultrasound measurements of depth and regression of basal cell carcinomas after photodynamic therapy: Relationship to probability of 1-year local control","volume":"149","author":"Moore","year":"2003","journal-title":"Br. J. Dermatol."},{"key":"ref_17","first-page":"52","article-title":"Assessments of carotid adventitial remodeling in metabolic syndrome patients using high-frequency ultrasound","volume":"95","author":"Li","year":"2015","journal-title":"Zhonghua Yi Xue Za Zhi"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1046\/j.0022-202x.2001.01337.x","article-title":"Topographic Variations in Normal Skin, as Viewed by In Vivo Reflectance Confocal Microscopy","volume":"116","author":"Huzaira","year":"2001","journal-title":"J. Investig. Dermatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1039\/C6AN02278B","article-title":"Depth-selective photothermal IR spectroscopy of skin: Potential application for non-invasive glucose measurement","volume":"142","author":"Hertzberg","year":"2017","journal-title":"Analyst"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"12217","DOI":"10.1038\/s41598-019-48698-w","article-title":"Advancement through epidermis using tape stripping technique and Reflectance Confocal Microscopy","volume":"9","author":"Olesen","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1177\/016173460602800103","article-title":"Ultrasonic Backscatter and Attenuation (11\u201327 MHz) Variation with Collagen Fiber Distribution in Ex Vivo Human Dermis","volume":"28","author":"Bridal","year":"2006","journal-title":"Ultrason. Imaging"},{"key":"ref_22","first-page":"1","article-title":"Multicriteria Optimization Model for the Study of the Efficacy of Skin Antiaging Therapy","volume":"2012","author":"Cappare","year":"2012","journal-title":"Comput. Math. Methods Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1111\/srt.12294","article-title":"The influence of gender and age on the thickness and echo-density of skin","volume":"23","author":"Firooz","year":"2016","journal-title":"Ski. Res. Technol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"463","DOI":"10.2147\/CCID.S84903","article-title":"The role of vitamin C in pushing back the boundaries of skin aging: An ultrasonographic approach","volume":"8","author":"Crisan","year":"2015","journal-title":"Clin. Cosmet. Investig. Dermatol."},{"key":"ref_25","first-page":"427","article-title":"Standardized Ultrasound Measurement of Subcutaneous Fat Patterning: High Reliability and Accuracy in Groups Ranging from Lean to Obese","volume":"43","author":"Sengeis","year":"2016","journal-title":"Ultrasound Med. Biol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"50","DOI":"10.4085\/1062-6050-46.1.50","article-title":"Subcutaneous Thigh Fat Assessment: A Comparison of Skinfold Calipers and Ultrasound Imaging","volume":"46","author":"Selkow","year":"2011","journal-title":"J. Athl. Train."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1111\/srt.12858","article-title":"Age-dependent facial subcutaneous fat thickness by high-frequency medical diagnostic ultrasound system","volume":"26","author":"Kim","year":"2020","journal-title":"Ski. Res. Technol."},{"key":"ref_28","first-page":"79","article-title":"Adipose tissue density, estimated adipose lipid fraction and whole body adiposity in male cadavers","volume":"18","author":"Martin","year":"1994","journal-title":"Int. J. Obes. Relat. Metab. Disord."},{"key":"ref_29","first-page":"109","article-title":"Adipose Tissue Density, a Novel Biomarker Predicting Mortality Risk in Older Adults","volume":"69","author":"Murphy","year":"2013","journal-title":"J. Gerontol. Ser. A Boil. Sci. Med. Sci."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"629","DOI":"10.2147\/IJN.S30599","article-title":"The physiology of cardiovascular disease and innovative liposomal platforms for therapy","volume":"8","author":"Serda","year":"2013","journal-title":"Int. J. Nanomed."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Gill, V., Kumar, V., Singh, K., Kumar, A., and Kim, J.-J. (2019). Advanced Glycation End Products (AGEs) May Be a Striking Link Between Modern Diet and Health. Biomolecules, 9.","DOI":"10.3390\/biom9120888"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1177\/1099800411401013","article-title":"Aging-Like Skin Changes Induced by Ultraviolet Irradiation in an Animal Model of Metabolic Syndrome","volume":"14","author":"Akase","year":"2011","journal-title":"Biol. Res. Nurs."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"545","DOI":"10.3390\/biom5020545","article-title":"Oxidative Stress in Aging Human Skin","volume":"5","author":"Rinnerthaler","year":"2015","journal-title":"Biomolecules"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Del Bino, S., Duval, C., and Bernerd, F. (2018). Clinical and Biological Characterization of Skin Pigmentation Diversity and Its Consequences on UV Impact. Int. J. Mol. Sci., 19.","DOI":"10.3390\/ijms19092668"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Barsh, G.S. (2003). What Controls Variation in Human Skin Color?. PLoS Biol., 1.","DOI":"10.1371\/journal.pbio.0000027"},{"key":"ref_36","first-page":"31","article-title":"Aging Differences in Ethnic Skin","volume":"9","author":"Vashi","year":"2016","journal-title":"J. Clin. Aesthetic Dermatol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/19\/4461\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:06:14Z","timestamp":1760166374000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/19\/4461"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,28]]},"references-count":36,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2021,10]]}},"alternative-id":["jcm10194461"],"URL":"https:\/\/doi.org\/10.3390\/jcm10194461","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,28]]}}}