维生素D水平与低龄儿童龋风险的相关性分析  

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

作　　者：秦秀荣[1] 韩靖[2] 张瑜[2] 刘思雨 邵林琴[1] QIN Xiurong;HAN Jing;ZHANG Yu;LIU Siyu;SHAO Linqin(Department of Pediatric Dentistry,Jinan Stomatological Hospital,Jinan 250001,China;Department of Paediatrics and Child Health,Jinan Maternity and Child Care Hospital,Jinan 250000,China;Jinan Stomatological Hospital Affiliated to Binzhou Medical University,Jinan 250001,China)

机构地区：[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

出　　处：《口腔疾病防治》2022年第2期111-116,共6页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：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)。

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(c2=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。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 collect⁃ed,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(c2=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,breast⁃feeding before 6 months old,nighttime milk consumption or sleeping with a nipple and high cariogenic activity(Cario⁃stat value of 1.5⁃3.0).It is necessary to establish good feeding habits and oral hygiene habits for children while promot⁃ing breastfeeding.

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 

分 类 号：R78[医药卫生—口腔医学]