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钙-维生素 D 强化牛奶和牙周治疗对产妇口腔健康及代谢和炎症特征的探索性疗效。

Exploratory Efficacy of Calcium-Vitamin D Milk Fortification and Periodontal Therapy on Maternal Oral Health and Metabolic and Inflammatory Profile.

机构信息

Faculty of Health and Life Sciences, School of Nursing, Midwifery and Health, Coventry University, Priory Street, Coventry CV1 5FB, UK.

Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro 21941-902, Brazil.

出版信息

Nutrients. 2021 Feb 27;13(3):783. doi: 10.3390/nu13030783.

Abstract

In this 2 × 2 factorial, outcome-assessor blinded, feasibility randomised trial we explored the effect of a non-pharmaceutical multi-component intervention on periodontal health and metabolic and inflammatory profiles among pregnant women with periodontitis receiving prenatal care in a Brazilian public health centre. 69 pregnant women (gestational age ≤20 weeks, T0) were randomly allocated into four groups: (1) fortified sachet (vitamin D and calcium) and powdered milk plus periodontal therapy during pregnancy (early PT) ( = 17); (2) placebo sachet and powdered milk plus early PT ( = 15); (3) fortified sachet and powdered milk plus late PT (after delivery) ( = 19); (4) placebo sachet and powdered milk plus late PT ( = 18). Third trimester (T1) and 6-8 weeks postpartum (T2) exploratory outcomes included periodontal health (% sites with bleeding on probing (BOP)), glucose, insulin, C-Reactive Protein, serum calcium and vitamin D. The mean BOP was significantly reduced in the early PT groups, while BOP worsened in the late PT groups. No significant effect of fortification on BOP was observed. Changes in glucose levels and variation on birthweight did not differ among groups This feasibility trial provides preliminary evidence for estimating the minimum clinically important differences for selected maternal outcomes. A large-scale trial to evaluate the interventions' clinical benefits and cost-effectiveness is warranted.

摘要

在这项 2×2 析因、结局评估者设盲、可行性随机试验中,我们探讨了一种非药物多组分干预措施对在巴西公共卫生中心接受产前护理的牙周炎孕妇牙周健康以及代谢和炎症特征的影响。69 名孕妇(妊娠周数≤20 周,T0)被随机分为四组:(1)强化袋(维生素 D 和钙)和奶粉加孕期牙周治疗(早期 PT)(=17);(2)安慰剂袋和奶粉加早期 PT(=15);(3)强化袋和奶粉加晚期 PT(产后)(=19);(4)安慰剂袋和奶粉加晚期 PT(=18)。第三孕期(T1)和产后 6-8 周(T2)的探索性结局包括牙周健康(探诊出血位点百分比(BOP))、血糖、胰岛素、C 反应蛋白、血清钙和维生素 D。早期 PT 组的 BOP 显著降低,而晚期 PT 组的 BOP 恶化。强化治疗对 BOP 无显著影响。血糖水平的变化和出生体重的差异在各组之间没有差异。这项可行性试验为估计选定产妇结局的最小临床重要差异提供了初步证据。需要进行大规模试验来评估干预措施的临床获益和成本效益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe73/7997467/45c4cb9c5cea/nutrients-13-00783-g001.jpg

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