Vu Giang T, Little Bert B, Esterhay Robert J, Jennings J' Aime, Creel Liza, Gettleman Lawrence
Department of Health Management and Systems Sciences, School of Public Health and Information Sciences, Louisville, Kentucky, USA.
Professor Emeritus, School of Dentistry University of Louisville, Louisville, Kentucky, USA.
J Public Health Dent. 2022 Jan;82(1):79-87. doi: 10.1111/jphd.12489. Epub 2021 Dec 3.
The objective of this study was to analyze factors associated with oral health-related quality of life (OHRQoL) between type 2 diabetes mellitus (T2DM) and nondiabetic US adults.
The study sample included 2945 participants (aged ≥20) selected from National Health and Nutrition Examination Survey (NHANES) 2003-2004 that represented 130,689,262 million persons in a probability weighted sample. Oral health outcomes were measured by the NHANES version of Oral Health Impact Profile (OHIP) for OHRQoL and summarized as additive scores (OHIP-ADD) and as prevalence of negative impacts (OHIP-SC). Multiple logistic regression models used dichotomous outcome variables OHIP-ADD and OHIP-SC. The cut-off values for poor OHRQoL were heuristically defined as OHIP-ADD ≥6 and as OHIP-SC > 0.
Poor OHRQoL was significantly (p < 0.0001) predicted by T2DM (OR = 1.43, OR = 1.73), obesity (OR = 1.24), untreated dental caries (OR = 1.79), periodontal disease (OR = 1.07), evaluated unmet denture need (OR = 1.72), low income (OR = 1.22), smoking (OR = 1.04, OR = 1.99), African-American (OR = 1.19), and female (OR = 1.66) in both logistic regression models. In contrast, protective factors significantly (p < 0.0001) associated with poor OHRQoL were private dental insurance (OR = 0.81), college education (OR = 0.85), and annual dental prophylaxis (OR = 0.83), after adjustment for covariates.
This study showed that private insurance coverage and annual prophylaxis are associated with better average OHRQoL among individuals with T2DM. Improved OHRQoL may be associated with glycaemia control, decreased BMI, and smoking cessation. The highest odds for poor OHRQoL were found among US adults with T2DM with uncontrolled HbA1c, untreated dental caries, and current smoking.
本研究的目的是分析美国2型糖尿病（T2DM）成人与非糖尿病成人之间与口腔健康相关生活质量（OHRQoL）相关的因素。
研究样本包括从2003 - 2004年国家健康和营养检查调查（NHANES）中选取的2945名参与者（年龄≥20岁），该样本在概率加权样本中代表130689262万人。口腔健康结果通过NHANES版口腔健康影响概况（OHIP）来衡量OHRQoL，并总结为累加得分（OHIP - ADD）和负面影响患病率（OHIP - SC）。多个逻辑回归模型使用二分结果变量OHIP - ADD和OHIP - SC。OHRQoL差的临界值通过启发式定义为OHIP - ADD≥6和OHIP - SC>0。
在两个逻辑回归模型中，T2DM（OR = 1.43，OR = 1.73）、肥胖（OR = 1.24）、未治疗的龋齿（OR = 1.79）、牙周病（OR = 1.07）、评估的义齿需求未满足（OR = 1.72）、低收入（OR = 1.22）、吸烟（OR = 1.04，OR = 1.99）、非裔美国人（OR = 1.19）和女性（OR = 1.66）均显著（p < 0.0001）预测OHRQoL差。相比之下，在调整协变量后，与OHRQoL差显著（p < 0.0001）相关的保护因素是私人牙科保险（OR = 0.81）、大学教育（OR = 0.85）和年度牙齿预防（OR = 0.83）。
本研究表明，私人保险覆盖和年度预防与T2DM患者中更好的平均OHRQoL相关。OHRQoL的改善可能与血糖控制、BMI降低和戒烟有关。OHRQoL差的最高几率在HbA1c未得到控制、有未治疗的龋齿且当前吸烟的美国TIDM成人中发现。
