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基于人群的研究:代谢综合征对牙齿缺失影响的反事实方法。

Counterfactual approach on the effect of metabolic syndrome on tooth loss: A population-based study.

机构信息

Postgraduate Program in Dentistry, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.

Section of Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.

出版信息

J Periodontol. 2022 Apr;93(4):591-602. doi: 10.1002/JPER.21-0175. Epub 2021 Sep 14.

Abstract

BACKGROUND

This study aimed to investigate the effect of metabolic syndrome (MetS) on tooth loss in adults from a population-based sample.

METHODS

Cross-sectional analysis based on data from a cohort study (2009 to 2014) with adults from Southern Brazil. MetS (exposure), lack of functional dentition and number of lost teeth (outcomes) were assessed using self-reported, laboratory and clinical data. Possible confounders included sex, age, family income, education level, smoking status, and sugar consumption. The effect of MetS on the outcomes was estimated using conventional logistic or negative binomial regression models. Marginal structural modeling (MSM) with stabilized weights (a counterfactual analytical method) was also used to enhance group comparability and estimate causal effects.

RESULTS

A total of 1,283 participants had available information for the outcomes. Individuals with MetS were more likely to experience a lack of functional dentition than those without MetS (odds ratio [OR] from logistic regression, 1.7; 95% CI, 1.0 to 2.9; OR from MSM, 3.2; 95% CI, 2.3 to 4.6). Moreover, the number of teeth lost was 20% higher in participants with MetS compared with those without MetS in conventional analysis (mean ratio [MR], 1.2; 95% CI, 1.1 to 1.3). The MR increased to 1.7 (95% CI, 1.5 to 2.0) when using MSM.

CONCLUSION

Our findings provide evidence on the effect of MetS on tooth loss.

摘要

背景

本研究旨在从基于人群的样本中调查代谢综合征(MetS)对成年人牙齿缺失的影响。

方法

横断面分析基于来自巴西南部成年人队列研究(2009 年至 2014 年)的数据。使用自我报告、实验室和临床数据评估代谢综合征(暴露)、无功能牙列和缺失牙齿数量(结局)。可能的混杂因素包括性别、年龄、家庭收入、教育水平、吸烟状况和糖消费。使用传统的逻辑或负二项回归模型估计代谢综合征对结局的影响。边缘结构建模(MSM)也使用稳定权重(一种反事实分析方法)来增强组可比性并估计因果效应。

结果

共有 1283 名参与者有结局的可用信息。患有代谢综合征的个体比没有代谢综合征的个体更有可能出现无功能牙列(逻辑回归的比值比 [OR],1.7;95%置信区间,1.0 至 2.9;MSM 的 OR,3.2;95%置信区间,2.3 至 4.6)。此外,与无代谢综合征者相比,常规分析中患有代谢综合征者的牙齿缺失数高出 20%(均值比 [MR],1.2;95%置信区间,1.1 至 1.3)。当使用 MSM 时,MR 增加到 1.7(95%置信区间,1.5 至 2.0)。

结论

我们的研究结果提供了代谢综合征对牙齿缺失影响的证据。

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