Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.
J Public Health Dent. 2022 Mar;82(2):239-246. doi: 10.1111/jphd.12470. Epub 2021 Jul 13.
Allostatic load (AL), defined as the overtime "wear and tear" on biological systems due to stress, disproportionately affects racial/ethnic minorities and has been shown to associate with racial inequality in oral health in the adult population. This study aims to assess racial/ethnic inequality in AL and untreated dental caries (UD) in children, and to assess the association between allostatic load and UD, and whether it varies by race/ethnicity.
Data from the National Health and Nutrition Examination Survey (NHANES) (2001-2010) for 8-17-year-old children (n = 11,378) was used. AL scores were generated using cardiovascular, metabolic and immune biomarkers. Multivariable log binomial regression models adjusted for age, sex, poverty: income ratio (PIR), health insurance status and the frequency of healthcare visits, were used to assess the relationships of interest.
Racial/ethnic inequality was evident in UD and AL, where Mexican American and black children exhibited more UD and a higher AL score than white. AL was associated with UD in fully adjusted models. This association was significant across all racial/ethnic groups, but was stronger in Mexican American and black children, compared to their white counterparts.
Similar racial inequality is evident in AL and UD that is not explained by poverty and/or behavioral factors. Racial/ethnic inequality is also evident in the association between AL and UD.
压力导致的生物系统“磨损”，即适应负荷（AL），对少数族裔的影响不成比例，且已证明与成年人口的口腔健康方面的种族不平等有关。本研究旨在评估儿童的 AL 和未经治疗的龋齿（UD）的种族/民族不平等，并评估 AL 与 UD 之间的关联，以及这种关联是否因种族/民族而异。
使用国家健康和营养检查调查（NHANES）（2001-2010 年）中 8-17 岁儿童的数据（n=11378）。使用心血管、代谢和免疫生物标志物生成 AL 评分。使用多变量对数二项式回归模型调整年龄、性别、贫困：收入比（PIR）、健康保险状况和医疗保健就诊频率，以评估相关关系。
UD 和 AL 中存在种族/民族不平等，其中墨西哥裔美国人和黑人儿童的 UD 比白人儿童多，AL 评分也比白人儿童高。在完全调整的模型中，AL 与 UD 相关。这种关联在所有种族/民族群体中都很明显，但在墨西哥裔美国人和黑人儿童中比在他们的白人同龄人中更强。
在 AL 和 UD 中存在类似的种族不平等，这不能用贫困和/或行为因素来解释。AL 与 UD 之间的关联也存在种族/民族不平等。
