单核细胞/高密度脂蛋白胆固醇比值与牙周炎的关系:基于NHANES数据库的横断面研究  

Association of monocyte/high⁃density lipoprotein cholesterol ratio with periodontitis:a cross⁃sectional study based on the NHANES database

作　　者：胡志强 张琦[1] 李欣鹏 崔宇琛 袁佳敏 朱宪春[1] HU Zhiqiang;ZHANG Qi;LI Xinpeng;CUI Yuchen;YUAN Jiamin;ZHU Xian-chun(Department of Orthodontic,Hospital of Stomatology,Jilin University,Changchun 130021,China)

机构地区：[1]吉林大学口腔医院正畸科,吉林长春130021

出　　处：《口腔疾病防治》2025年第3期212-220,共9页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：吉林省自然科学基金项目(YDZJ202201ZYTS057)。

摘　　要：目的探究单核细胞/高密度脂蛋白胆固醇比值(monocyte/high-density lipoprotein choleterol ratio,MHR)与牙周炎的关联,为牙周炎的影响因素提供依据。方法选取美国国家健康和营养调查(National Health and Nutrition Examination,NHANES)数据库中2009—2010年、2011—2012年、2013—2014年3个周期受试者的MHR、牙周炎情况及其他协变量数据,共纳入8456名研究对象。根据牙周炎患病情况(有、无)对研究对象进行分组,采用加权logistic回归方法逐步调整混杂因素,构建3个回归模型(不调整协变量,部分调整协变量及完全调整协变量)分析MHR与牙周炎之间的关系。将MHR按照四分位法从小到大分为Q1~Q4四组进行加权趋势分析,使用限制性立方样条分析MHR(连续)与牙周炎之间的非线性关系,并进行了亚组分析及敏感性分析。结果3个加权logistic回归模型均显示MHR与牙周炎间存在正相关关系[OR=2.92,95%CI:2.14~3.99,P<0.001(不调整);OR=1.97,95%CI:1.39~2.78,P<0.001(部分调整);OR=1.62,95%CI:1.10~2.39,P=0.017(完全调整)]。趋势分析显示,与Q1组相比,Q4组的单因素分析(OR=1.92,95%CI:1.58~2.33,P<0.001)、多因素分析(OR=1.30,95%CI:1.03~1.64,P=0.029)均显示MHR升高会引起牙周炎患病风险显著升高。限制性立方样条结果显示,不支持MHR与牙周炎之间的非线性关系(P for nonlinear>0.05),亚组分析显示各协变量与MHR无明显交互作用(P>0.05),敏感性分析也表明了MHR与牙周炎之间存在正相关关系(OR=1.67,95%CI:1.31~2.14,P<0.001)。结论MHR与牙周炎患病风险具有正相关关系。Objective To investigate the association between monocyte to high-density lipoprotein cholesterol ratio(MHR)and periodontitis and to provide new epidemiologic evidence on the factors affecting periodontitis.Methods Data on MHR,periodontitis,and other covariates were selected from the NHANES(National Health and Nutrition Exami-nation)database for 3 cycles of subjects in 2009-2010,2011-2012,and 2013-2014,and a total of 8456 study subjects were included.The study participants were grouped according to the prevalence of periodontitis(presence or absence),and three regression models(unadjusted covariates,partially adjusted covariates,and fully adjusted covariates)were constructed to analyze the relationship between MHR and periodontitis by using a weighted logistic regression method with stepwise adjustment for confounders.MHR was divided into four groups from Q1 to Q4 according to quartiles from small to large for weighted trend analysis,and the nonlinear relationship between MHR(continuous)and periodontitis was analyzed using a restricted cubic spline with subgroup analysis and sensitivity analysis.Results All three logistic regression models showed a positive association between MHR and periodontitis(OR=2.92,95%CI:2.14-3.99,P<0.001(not adjusted);OR=1.97,95%CI:1.39-2.78,P<0.001(partially adjusted);OR=1.62,95%CI:1.10-2.39,P=0.017(fully adjusted)).Trend analysis showed a significantly higher risk of developing periodontitis in the Q4 group compared with the Q1 group in both single(OR=1.92,95%CI:1.58-2.33,P<0.001)and multifactorial analyses(OR=1.30,95%CI:1.03-1.64,P=0.029).Restricted cubic spline results did not support a nonlinear relationship be-tween MHR and periodontitis(P for nonlinear>0.05),subgroup analysis showed no significant interaction between the covariates and MHR(P>0.05),and sensitivity analysis also showed a positive correlation between MHR and periodonti-tis(OR=1.67,95%CI:1.31-2.14,P<0.001).Conclusion MHR is positively associated with the risk of developing periodontitis.

关 键 词：牙周炎 单核细胞 高密度脂蛋白 单核细胞/高密度脂蛋白胆固醇比值 美国国家健康和营养调查 横断面研究 敏感性分析 限制性立方样条 

分 类 号：R78[医药卫生—口腔医学]