Kim Young-Suk, Ha Mina, Kwon Ho-Jang, Kim Hae-Young, Choi Youn-Hee
Department of Dental Hygiene, U1 University, Yeongdong, Korea.
Department of Preventive Medicine, Dankook University College of Medicine, 119 Dandae-ro, Dongnam-gu, Cheonan, Chungnam, 31116, Republic of Korea.
BMC Oral Health. 2017 Jan 13;17(1):42. doi: 10.1186/s12903-017-0335-z.
The objective of this study was to examine the association between low blood lead levels of <5 μg/dL and the development of dental caries among children.
The Children's Health and Environment Research (CHEER) group recruited a cohort of 7,059 school-aged children from six Korean cities. The final study populations in the permanent and deciduous teeth groups were 1,564 and 1,241 children, respectively, after excluding 4 children with blood lead levels of >5 μg/dL. Compared with the children who did not have dental caries, the risk of having dental caries according to blood lead level was estimated by using the zero-inflated negative binomial model.
The geometric mean (geometric standard deviation, maximum) blood lead level was 1.53 μg/dL (1.57, 4.89 μg/dL), and 74.4% of children had a level of <2 μg/dL. Blood lead level was significantly higher in the children with than in those without deciduous dental caries (1.59 vs. 1.51 μg/dL), similarly with permanent dental caries (1.65 vs. 1.51 μg/dL). After adjustment for covariates, deciduous teeth surfaces that were decayed and filled increased significantly with increasing blood lead levels in a dose-dependent manner (prevalence ratio, 1.14; 95% confidence interval: 1.02-1.27). However, the risk of having dental caries in permanent teeth was not linearly associated with the increase in blood lead level.
In the sum of decayed and filled surfaces, we found a significant increase in risk of dental caries of the deciduous teeth with an increase in blood lead levels (<5 μg/dL) but found no statistical significance in the association with decayed and filled surfaces of caries separately.
本研究的目的是检验血铅水平低于5μg/dL与儿童龋齿发生之间的关联。
儿童健康与环境研究（CHEER）小组从韩国六个城市招募了7059名学龄儿童队列。排除4名血铅水平>5μg/dL的儿童后，恒牙组和乳牙组的最终研究人群分别为1564名和1241名儿童。通过零膨胀负二项式模型，比较无龋齿儿童，根据血铅水平评估患龋齿的风险。
血铅水平的几何均值（几何标准差，最大值）为1.53μg/dL（1.57，4.89μg/dL），74.4%的儿童血铅水平<2μg/dL。患乳牙龋齿儿童的血铅水平显著高于未患乳牙龋齿的儿童（1.59 vs. 1.51μg/dL），恒牙龋齿情况类似（1.65 vs. 1.51μg/dL）。调整协变量后，乳牙龋坏和充填面随着血铅水平升高呈剂量依赖性显著增加（患病率比，1.14；95%置信区间：1.02 - 1.27）。然而，恒牙患龋齿的风险与血铅水平升高无线性关联。
在龋坏和充填面总和方面，我们发现血铅水平（<5μg/dL）升高会使乳牙龋齿风险显著增加，但分别与龋坏面和充填面的关联无统计学意义。
