Department of Preventive & Community Dentistry, University of Iowa College of Dentistry, Iowa City, IA, USA.
J Dent Res. 2014 Apr;93(4):353-9. doi: 10.1177/0022034514520708. Epub 2014 Jan 27.
Controversy persists concerning the impact of community water fluoridation on bone health in adults, and few studies have assessed relationships with bone at younger ages. Ecological studies of fluoride's effects showed some increase in bone mineral density of adolescents and young adults in areas with fluoridated water compared with non-fluoridated areas. However, none had individual fluoride exposure measures. To avoid ecological fallacy and reduce bias, we assessed associations of average daily fluoride intake from birth to age 15 yr for Iowa Bone Development Study cohort members with age 15 yr dual-energy x-ray absorptiometry (DXA) bone outcomes (whole body, lumbar spine, and hip), controlling for known determinants (including daily calcium intake, average daily time spent in moderate-to-vigorous intensity physical activity, and physical maturity). Mean (SD) daily fluoride intake was 0.66 mg (0.24) for females and 0.78 mg (0.30) for males. We found no significant relationships between daily fluoride intake and adolescents' bone measures in adjusted models (for 183 females, all p values ≥ .10 and all partial R(2) ≤ 0.02; for 175 males, all p values ≥ .34 and all partial R(2) ≤ 0.01). The findings suggest that fluoride exposures at the typical levels for most US adolescents in fluoridated areas do not have significant effects on bone mineral measures.
关于社区饮水氟化对成年人骨骼健康的影响一直存在争议，很少有研究评估其与年轻时骨骼的关系。氟化物影响的生态学研究表明，与非氟化地区相比，氟化水中的青少年和年轻成年人的骨矿物质密度有所增加。然而，这些研究都没有个体氟化物暴露测量。为了避免生态学谬误和减少偏差，我们评估了爱荷华骨骼发育研究队列成员从出生到 15 岁时的平均每日氟化物摄入量与 15 岁时双能 X 射线吸收法（DXA）骨骼结果（全身、腰椎和髋部）之间的关联，同时控制了已知的决定因素（包括每日钙摄入量、每天中等到剧烈强度体力活动的平均时间以及身体成熟度）。女性的平均（SD）每日氟化物摄入量为 0.66 毫克（0.24），男性为 0.78 毫克（0.30）。在调整后的模型中，我们没有发现每日氟化物摄入量与青少年骨骼指标之间存在显著关系（对于 183 名女性，所有 p 值均≥.10，所有部分 R²≤0.02；对于 175 名男性，所有 p 值均≥.34，所有部分 R²≤0.01）。这些发现表明，在氟化地区，大多数美国青少年的典型氟化物暴露水平对骨矿物质指标没有显著影响。
