口腔疾病防治 ›› 2022, Vol. 30 ›› Issue (2): 111-116.DOI: 10.12016/j.issn.2096-1456.2022.02.006

• 临床研究 • 上一篇    下一篇

维生素D水平与低龄儿童龋风险的相关性分析

秦秀荣1(), 韩靖2(), 张瑜2, 刘思雨3, 邵林琴1()   

  1. 1.济南市口腔医院儿童口腔1科,山东 济南(250001)
    2.济南市妇幼保健院儿童保健科,山东 济南(250000)
    3.滨州医学院附属济南市口腔医院,山东 济南(250001)
  • 收稿日期:2021-06-10 修回日期:2021-09-25 出版日期:2022-02-20 发布日期:2021-11-25
  • 通讯作者: 邵林琴
  • 作者简介:秦秀荣,主治医师,博士,Email: qinxiurong0531@163.com
    韩靖,共同第一作者,副主任医师,学士,Email: Hjing33@163.com
  • 基金资助:
    中华国际科学交流基金会项目(Z2018LSD011);济南市口腔医院院长助研基金项目(2019-05)

Correlation between vitamin D level and caries risk in early childhood caries

QIN Xiurong1(), HAN Jing2(), ZHANG Yu2, LIU Siyu3, SHAO Linqin1()   

  1. 1. Department of Pediatric Dentistry, Jinan Stomatological Hospital, Jinan 250001, China
    2. Department of Paediatrics and Child Health, Jinan Maternity and Child Care Hospital, Jinan 250000, China
    3. Jinan Stomatological Hospital Affiliated to Binzhou Medical University, Jinan 250001, China
  • Received:2021-06-10 Revised:2021-09-25 Online:2022-02-20 Published:2021-11-25
  • Contact: SHAO Linqin
  • Supported by:
    International Scientific Exchange Foundation of China(Z2018LSD011);Research Assistant Fund for the President of Jinan Stomatological Hospital(2019-05)

摘要:

目的 探讨维生素D水平与低龄儿童龋(early childhood caries,ECC)发生风险的相关性分析,为ECC儿童的一级预防提供依据。方法 收集389名6~48月龄儿童的月龄、喂养方式、口腔健康行为等资料,记录龋、失、补指数(decayed-missing-filled teeth,dmft),分为ECC组(n=146)和无龋组(n=243),采集指尖末梢血检测维生素D体内活性形式——25-羟维生素D[25(OH)D],采集牙菌斑行龋活跃性检验检测龋态(Cariostat)值,Logistic回归分析25(OH)D等龋相关因素与ECC发生风险的相关性。结果 25(OH)D缺乏、不足、正常的儿童的患龋率差异无统计学意义(χ2=2.320,P=0.313)。dmft与25(OH)D水平之间无相关(dmft=1~3,r < 0.001,P > 0.05;dmft > 3,r=0.009,P > 0.05)。而月龄(OR=1.082,95% CI:1.045~1.121,P<0.001)、出生后6个月内母乳喂养(OR=2.789,95% CI:1.581~4.921,P<0.001)、吃夜奶或含乳头睡(OR=4.187,95% CI:1.938~9.048,P<0.001)、1.5~3.0的高Cariostat值(OR=4.173,95% CI:2.014~8.646,P<0.001)是ECC的风险因素。结论 25(OH)D水平与6~48月龄儿童龋无相关性,而月龄、出生后6个月内母乳喂养、吃夜奶或含乳头睡、高龋活跃性(Cariostat值1.5~3.0)是ECC的风险因素,提倡母乳喂养的同时,应为幼儿树立良好的喂养习惯及口腔卫生习惯。

关键词: 龋病, 低龄儿童龋, 龋相关因素, 维生素D, 25-羟维生素D, 菌斑龋活跃性, 龋态

Abstract:

Objective To investigate the correlation between vitamin D levels and the risk of early childhood caries (ECC), and to provide a reference for the primary prevention of ECC in children. Methods A total of 389 children aged 6 months to 48 months were enrolled in this study. Data of feeding patterns and oral health behaviors were collected, and decayed-missing-filled teeth (dmft) were recorded. The children were divided into an ECC group (dmft > 0, n= 146) and a caries-free group (dmft=0, n=243). Peripheral blood of fingertips was collected to detect the active form of vitamin D--25(OH)D in vivo, and the cariogenic activity of dental plaque was analyzed with the Cariostat test. Logistic regression analysis was carried out to analyze the correlation among caries related factors such as 25(OH)D levels and caries risk in patients with ECC. Results There was no significant difference in the prevalence of dental caries among 25(OH)D deficiency, insufficiency and normal children (χ2=2.320, P=0.313). There was no correlation between dmft and 25(OH)D levels (dmft=1-3, r < 0.001, P > 0.05; dmft > 3, r= 0.009, P > 0.05). The risk factors for ECC were age (OR=1.082, 95% CI: 1.045-1.121, P < 0.001), breastfeeding within 6 months after birth (OR=2.789, 95% CI: 1.581-4.921, P < 0.001), nighttime milk consumption or sleeping with a nipple (OR=4.187, 95% CI: 1.938-9.048, P < 0.001), and a high Cariostat value of 1.5-3.0 (OR=4.173, 95% CI: 2.014-8.646, P < 0.001). Conclusion There was no correlation between 25(OH)D level and caries in children aged 6-48 months. The risk factors for ECC are age, breastfeeding before 6 months old, nighttime milk consumption or sleeping with a nipple and high cariogenic activity (Cariostat value of 1.5-3.0). It is necessary to establish good feeding habits and oral hygiene habits for children while promoting breastfeeding.

Key words: dental caries, early childhood caries, caries related factors, vitamin D, 25(OH)D, cariogenic activity of dental plaque, Cariostat

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