Nishida M, Grossi S G, Dunford R G, Ho A W, Trevisan M, Genco R J
Sunstar, Inc., Osaka, Japan.
J Periodontol. 2000 Jul;71(7):1057-66. doi: 10.1902/jop.2000.71.7.1057.
Dietary calcium has long been a candidate to modulate periodontal disease. Animal as well as human studies of calcium intake, bone mineral density, and tooth loss provide a rationale for hypothesizing that low dietary intake of calcium is a risk factor for periodontal disease.
We evaluated the role of dietary calcium intake as a contributing risk factor for periodontal disease utilizing the Third National Health and Nutrition Examination Survey (NHANES III), which is representative of the U.S. civilian non-institutionalized population. Dietary calcium intake was determined from a 24-hour dietary recall. The U.S. Department of Agriculture Nutrient Database was used as a source of nutrient composition data. Periodontal disease was measured by attachment loss. In addition, serum calcium was assessed using venous blood samples. Logistic regression analysis was used to examine the association between periodontal disease and dietary calcium intake or serum calcium levels after adjusting for covariants including age, gender, tobacco consumption, and gingival bleeding.
The association of lower dietary calcium intake with periodontal disease was found for young males and females (20 to 39 years of age), and for older males (40 to 59 years of age). The relationship between low dietary calcium intake and increased levels of periodontal disease showed an estimated odds ratio (OR) of 1.84 (95% CI: 1.36 to 2.48) for young males, 1.99 (95% CI: 1.34 to 2.97) for young females, and 1.90 (95% CI: 1.41 to 2.55) for the older group of males. These odds ratios were adjusted for gingival bleeding and tobacco consumption. The dose response was also seen in females, where there was 54% greater risk of periodontal disease for the lowest level of dietary calcium intake (2 to 499 mg) and 27% greater risk in females who took moderate levels of dietary calcium (500 to 799 mg) as compared to those who took 800 mg or more dietary calcium per day. A statistically significant association between low total serum calcium and periodontal disease was found in younger females aged 20 to 39 with OR = 6.11 (95% CI: 2.36 to 15.84) but not for males or older females, after adjusting for tobacco use, gingival bleeding, and dietary calcium intake.
These results suggest that low dietary intake of calcium results in more severe periodontal disease. Further studies will be needed to better define the role of calcium in periodontal disease and to determine the extent to which calcium supplementation will modulate periodontal disease and tooth loss.
长期以来，膳食钙一直被认为是调节牙周疾病的一个因素。关于钙摄入量、骨矿物质密度和牙齿脱落的动物及人体研究为以下假设提供了理论依据：即膳食钙摄入量低是牙周疾病的一个风险因素。
我们利用第三次全国健康与营养检查调查（NHANES III）评估膳食钙摄入量作为牙周疾病促成风险因素的作用，该调查代表了美国非机构化平民人口。通过24小时膳食回顾确定膳食钙摄入量。美国农业部营养数据库被用作营养成分数据的来源。用附着丧失来衡量牙周疾病。此外，使用静脉血样评估血清钙。在对年龄、性别、烟草消费和牙龈出血等协变量进行调整后，采用逻辑回归分析来检验牙周疾病与膳食钙摄入量或血清钙水平之间的关联。
在年轻男性和女性（20至39岁）以及老年男性（40至59岁）中发现膳食钙摄入量较低与牙周疾病有关。膳食钙摄入量低与牙周疾病水平升高之间的关系显示，年轻男性的估计比值比（OR）为1.84（95%置信区间：1.36至2.48），年轻女性为1.99（95%置信区间：1.34至2.97），老年男性组为1.90（95%置信区间：1.41至2.55）。这些比值比针对牙龈出血和烟草消费进行了调整。在女性中也观察到了剂量反应，膳食钙摄入量最低水平（2至499毫克）的女性患牙周疾病的风险比每天摄入800毫克或更多膳食钙的女性高54%，摄入中等水平膳食钙（500至799毫克）的女性患牙周疾病的风险高27%。在20至39岁的年轻女性中，总血清钙水平低与牙周疾病之间存在统计学上的显著关联，OR = 6.11（95%置信区间：2.36至15.84），但在男性或老年女性中未发现这种关联，这是在对烟草使用、牙龈出血和膳食钙摄入量进行调整之后。
这些结果表明，膳食钙摄入量低会导致更严重的牙周疾病。需要进一步研究以更好地确定钙在牙周疾病中的作用，并确定补钙在调节牙周疾病和牙齿脱落方面的程度。
