饮水氟含量与龋齿率的剂量-效应关系的Meta回归分析  

Meta-regression on dose-response relationship of fluoride content in drinking water and dental caries rate

作　　者：潘申龄 安伟[1] 李红岩[1] 杨敏[1] 

机构地区：[1]中国科学院生态环境研究中心环境水质学国家重点实验室,北京100085

出　　处：《环境与健康杂志》2013年第8期703-706,共4页Journal of Environment and Health

基　　金：国家自然科学基金项目(51290283;21277169);国家高技术研究发展计划(863)项目(2012AA062802)

摘　　要：目的研究饮水氟含量与龋齿率的剂量一效应关系，以确定预防龋齿的适宜水氟范围。方法对检索国内外数据库得到的19篇关于我国饮水氟含量与龋齿率关系的文献进行Meta回归分析。采用分式多项式（fractionalpolynomial，FP）结合Logistic回归建立模型，同时考虑到数据质量差异，采取加权回归。结果最优模型为最佳二阶FP模型，其拟合效果显著优于一般Logistic回归和最佳一阶FP模型。饮水氟含量与龋齿率呈u型剂量一效应关系，最低点的龋齿率为13．9％。饮水氟〉1．1mg／L时，随着饮水氟含量的升高，龋齿率下降的速率减慢，因此，将此值定为氟的防龋上限值。结合饮水氟含量在0．6—1．1mg／L区间内的龋齿率计算值，确定控制龋齿率为35％、30％时的适宜饮水氟含量范围分别为0．7～1．1mg／L和0．9～1．1mz．／L。结论氟表现为低浓度防龋齿、中浓度无明显作用、高浓度加重龋齿，且其防龋齿作用有限。Objective To study the dose-response relationship of fluoride content in drinking water and dental caries rate, and to determine the appropriate fluoride range in drinking water for prevention of caries. Methods Meta-regression analysis was applied to the 19 studies about the relationship of fluoride content in drinking water and dental caries rate in China,searched from national and international databases. Fractional polynomial（FP） was combined with logistic regression to establish model, and weighted regression was adopted, the differences of data quality was taken into account. Results The optimal model was the best second-order FP model,fitting significantly better than the general Logistic regression and best first-order FP model. The U-shaped dose-response relationship of fluoride in drinking water and dental caries rate was presented,and the lowest caries rate was 13.9%. When fluoride in drinking water increased more than 1.1 mg/L,the decline of caries rate slowed, so this value was set as the upper limit of fluoride range to prevent dental caries. Combined with the calculation value of caries rate under the fluoride range of 0.6-1.1 mg/L,the appropriate water fluoride ranges,to control 35% and 30% caries rate,were determined as 0.7-1.1 mg/L and 0.9-1.1 mg/L,respectively. Conclusion low concentration of fluoride may prevent dental caries,moderate concentration has no significant effect,while high concentration may aggravate dental caries, and its caries preventive effect is limited.

关 键 词：饮水氟 龋齿 Meta回归 分式多项式 

分 类 号：R181.3[医药卫生—流行病学]