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母亲维生素 D 缺乏与幼儿龋病的关联。

Association of Maternal Vitamin D Deficiency with Early Childhood Caries.

机构信息

1 Alaska Native Tribal Health Consortium, Anchorage, AK, USA.

2 University of Manitoba, Dr. Gerald Niznick College of Dentistry, Rady Faculty of Health Sciences, Winnipeg, Canada.

出版信息

J Dent Res. 2019 May;98(5):549-555. doi: 10.1177/0022034519834518. Epub 2019 Mar 14.

Abstract

Alaska Native (AN) children experience one of the highest reported rates of severe early childhood caries (S-ECC). Serum vitamin D concentrations in AN childbearing women in the Yukon Kuskokwim Delta (YKD) region have decreased since the 1960s to currently low levels, related to a decrease in traditional marine diet. Recent studies suggest an association between prenatal vitamin D (25(OH)D) concentrations in mothers and S-ECC in their infants. We used independent t tests to analyze the influence of prenatal 25(OH)D levels in YKD AN mothers on S-ECC in their children using data collected in the Maternal Organics Monitoring Study (MOMS). Maternal 25(OH)D levels were assessed at prenatal visits and in cord blood. We queried electronic dental records to assess early childhood caries (ECC) status using highest decayed, missing, filled, primary teeth (dmft) scores at 12 to 59 mo of age. We examined prenatal and cord blood for 76 and 57 mother/infant pairs, respectively. Children 12 to 35 mo of age with "deficient" cord blood (25(OH)D <30 nmol/L) had a mean dmft score twice as high as children who were "nondeficient" at birth (9.3 vs. 4.7; P = 0.002). There was no significant difference in mean dmft scores for children aged 36 to 59 mo with deficient versus nondeficient cord blood 25(OH)D (10.9 vs. 8.7 P = 0.14). There was no significant difference in mean dmft scores for children aged 12 to 35 mo whose mothers had "sufficient" versus "insufficient" 25(OH)D during prenatal visits (9.0 vs. 7.4; P = 0.48). In this small sample, children with deficient vitamin D levels in cord blood had a dmft score at 12 to 35 mo 2-fold higher than children with nondeficient cord blood. Maternal 25(OH)D may influence the primary dentition, and improving vitamin D status in pregnant women might affect ECC rates in their infants.

摘要

阿拉斯加原住民(AN)儿童经历着最高报告的严重婴幼儿龋(S-ECC)率之一。育空 - 科尤库克三角洲(YKD)地区的 AN 生育妇女的血清维生素 D 浓度自 20 世纪 60 年代以来已降至目前的低水平,这与传统海洋饮食的减少有关。最近的研究表明,母亲产前维生素 D(25(OH)D)浓度与婴儿的 S-ECC 之间存在关联。我们使用独立的 t 检验分析了 YKD AN 母亲产前 25(OH)D 水平对其子女 S-ECC 的影响,该分析使用了在母体有机物监测研究(MOMS)中收集的数据。在产前就诊时和脐带血中评估了母体 25(OH)D 水平。我们通过查询电子牙科记录,使用 12 至 59 月龄时最高龋齿、缺失、填充、主要牙齿(dmft)评分来评估婴幼儿龋(ECC)状况。我们分别检查了 76 对和 57 对母婴对的产前和脐带血。脐带血中“不足”(25(OH)D <30 nmol/L)的 12 至 35 月龄儿童的平均 dmft 评分是“非不足”出生儿童的两倍(9.3 比 4.7;P = 0.002)。脐带血中 25(OH)D 不足与非不足的 36 至 59 月龄儿童的平均 dmft 评分无显著差异(10.9 比 8.7,P = 0.14)。在产前就诊时母亲的 25(OH)D 水平为“充足”与“不足”的 12 至 35 月龄儿童的平均 dmft 评分无显著差异(9.0 比 7.4;P = 0.48)。在这个小样本中,脐带血中维生素 D 水平不足的儿童在 12 至 35 月龄时的 dmft 评分是脐带血中维生素 D 水平非不足儿童的两倍。母体 25(OH)D 可能会影响乳牙,改善孕妇的维生素 D 状况可能会影响其婴儿的 ECC 发生率。

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