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全口牙缺失与生命后期的应激负荷变化:英国老龄化纵向研究的 12 年随访分析。

Complete Tooth Loss and Allostatic Load Changes Later in Life: A 12-Year Follow-Up Analysis of the English Longitudinal Study of Ageing.

机构信息

From the English Longitudinal Study of Ageing (ELSA), Department of Epidemiology and Public Health (Oliveira), University College London; Division of Population and Patient Health, Dental Institute (Sabbah, Bernabé), King's College London, London, United Kingdom; and Health Science Department and Rehabilitation Post-graduate Program (Schneider), Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil.

出版信息

Psychosom Med. 2021 Apr 1;83(3):247-255. doi: 10.1097/PSY.0000000000000925.

Abstract

OBJECTIVE

There is little evidence of the association between complete tooth loss and allostatic load (AL). We investigated, firstly, the association between complete tooth loss and changes in AL for 12 years among older English adults. A second aim was to explore the role of fruit and vegetable consumption in explaining the aforementioned association.

METHODS

AL was calculated for 2430 English Longitudinal Study of Ageing cohort (2004/5-2016/17) participants 50 years and older based on nine biomarkers: systolic and diastolic blood pressures, glycated hemoglobin, high- and low-density lipoprotein cholesterol, triglycerides, fibrinogen, C-reactive protein, and waist circumference. The exposure was complete tooth loss. Participants were classified as dentate or edentulous. A linear mixed-effects model was fitted to model the 12-year change in AL score and its association with complete tooth loss after adjustments for confounders (demographic factors, socioeconomic position, and health behaviors).

RESULTS

Around 11% of the participants were edentulous. Complete tooth loss was positively associated with baseline AL scores but not with its rate of change over time. The predicted mean AL scores were 3.60 (95% confidence interval [CI] = 3.53-3.68) and 3.98 (95% CI = 3.76-4.21) as well as 4·28 (95% CI = 4·18, 4·39) and 4·66 (95% CI = 4·42, 4·90) for dentate and edentulous participants, at baseline and end of follow-up, respectively. Fruit and vegetable consumption was not associated with baseline AL or its rate of change.

CONCLUSIONS

Complete tooth loss was associated with baseline AL score but not with its development over time, whereas the consumption of fruit and vegetables did not help to explain this association. Both conditions may share common determinants earlier in life.

摘要

目的

关于全口缺牙与身体压力负荷(allostatic load,AL)之间的关联,目前证据有限。我们首先调查了在英国老年人群中,全口缺牙与 12 年期间 AL 变化之间的关系。第二个目的是探讨水果和蔬菜摄入在解释上述关联中的作用。

方法

基于 9 项生物标志物(收缩压和舒张压、糖化血红蛋白、高低密度脂蛋白胆固醇、甘油三酯、纤维蛋白原、C 反应蛋白和腰围),对 2430 名参加英国老龄化纵向研究(2004/5-2016/17 年)的年龄在 50 岁及以上的人群进行了 AL 计算。暴露因素为全口缺牙。参与者被分为有牙或无牙。采用线性混合效应模型,在调整混杂因素(人口统计学因素、社会经济地位和健康行为)后,对 AL 评分的 12 年变化及其与全口缺牙的关系进行建模。

结果

约 11%的参与者无牙。全口缺牙与基线 AL 评分呈正相关,但与随时间的变化率无关。预测的平均 AL 评分分别为 3.60(95%置信区间 [CI] = 3.53-3.68)和 3.98(95% CI = 3.76-4.21)以及 4.28(95% CI = 4.18, 4.39)和 4.66(95% CI = 4.42, 4.90),分别为有牙和无牙参与者的基线和随访结束时的评分。水果和蔬菜的摄入与基线 AL 或其变化率均无关。

结论

全口缺牙与基线 AL 评分相关,但与随时间的发展无关,而水果和蔬菜的摄入并不能解释这种关联。这两种情况可能在生命早期有共同的决定因素。

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