1 Postgraduate Program of Dentistry, Federal University of Maranhão, São Luís, Brazil.
2 Department of Medicine III, Federal University of Maranhão, São Luís, Brazil.
J Dent Res. 2018 May;97(5):508-514. doi: 10.1177/0022034517745326. Epub 2018 Jan 17.
Chronic oral diseases are rarely studied together, especially with an emphasis on their common risk factors. This study examined the association of added sugar consumption on "chronic oral disease burden" among adolescents, with consideration of obesity and systemic inflammation pathways through structural equation modeling. A cross-sectional study was conducted of a complex random sample of adolescent students enrolled at public schools in São Luís, Brazil ( n = 405). The outcome was chronic oral disease burden, a latent variable based on the presence of probing depth ≥4 mm, bleeding on probing, caries, and clinical consequences of untreated caries. The following hypotheses were tested: 1) caries and periodontal diseases among adolescents are correlated with each other; 2) added sugar consumption and obesity are associated with chronic oral disease burden; and 3) chronic oral disease burden is linked to systemic inflammation. Models were adjusted for socioeconomic status, added sugar consumption, oral hygiene behaviors, obesity, and serum levels of interleukin 6 (IL-6). All estimators of the latent variable chronic oral disease burden involved factor loadings ≥0.5 and P values <0.001, indicating good fit. Added sugar consumption (standardized coefficient [SC] = 0.212, P = 0.005), high IL-6 levels (SC = 0.130, P = 0.036), and low socioeconomic status (SC = -0.279, P = 0.001) were associated with increased chronic oral disease burden values. Obesity was associated with high IL-6 levels (SC = 0.232, P = 0.001). Visible plaque index was correlated with chronic oral disease burden (SC = 0.381, P < 0.001). Our finding that caries and periodontal diseases are associated with each other and with added sugar consumption, obesity, and systemic inflammation reinforces the guidance of the World Health Organization that any approach intended to prevent noncommunicable diseases should be directed toward common risk factors.
慢性口腔疾病很少被一起研究，尤其是在强调其共同危险因素方面。本研究通过结构方程模型，考察了添加糖的消耗与青少年“慢性口腔疾病负担”之间的关联，同时考虑了肥胖和全身炎症途径。这是一项在巴西圣路易斯公立学校入学的青少年学生中进行的复杂随机抽样的横断面研究（n=405）。结果是慢性口腔疾病负担，这是一个基于探诊深度≥4mm、探诊出血、龋齿和未经治疗的龋齿临床后果的潜在变量。检验了以下假设：1）青少年的龋齿和牙周病相互关联；2）添加糖的消耗和肥胖与慢性口腔疾病负担相关；3）慢性口腔疾病负担与全身炎症有关。模型调整了社会经济地位、添加糖的消耗、口腔卫生行为、肥胖和血清白细胞介素 6（IL-6）水平。慢性口腔疾病负担的所有潜在变量估计都涉及因子负荷≥0.5 和 P 值<0.001，表明拟合良好。添加糖的消耗（标准化系数[SC]=0.212，P=0.005）、高 IL-6 水平（SC=0.130，P=0.036）和低社会经济地位（SC=-0.279，P=0.001）与慢性口腔疾病负担值的增加相关。肥胖与高 IL-6 水平相关（SC=0.232，P=0.001）。可见菌斑指数与慢性口腔疾病负担呈正相关（SC=0.381，P<0.001）。我们发现龋齿和牙周病相互关联，与添加糖的消耗、肥胖和全身炎症有关，这加强了世界卫生组织的指导，即任何预防非传染性疾病的方法都应该针对共同的危险因素。
