Lavalle-Carrasco Jesús, Vergara-Onofre Marcela, González-González Rogelio, Bologna-Molina Ronell, Isiordia-Espinoza Mario Alberto, Gaona Enrique, Molina-Frechero Nelly
Dental Sciences, Autonomous Metropolitan University Xochimilco (UAM), 04960, Mexico City, Mexico.
Division of Biological and Health Sciences, Autonomous Metropolitan University Xochimilco (UAM), 04960, Mexico City, Mexico.
Biol Trace Elem Res. 2023 Mar;201(3):1051-1062. doi: 10.1007/s12011-022-03227-1. Epub 2022 Apr 9.
The intake of high concentrations of fluoride, mainly through drinking water, diet and fluoridated dentifrices, produces fluorosis, which in its early stages is manifested as dental fluorosis (DF). To recognize exposure to fluoride in endemic areas and to evaluate the risk of developing health impairment, the WHO has established several biomarkers that are used to determine systemic fluorine (F) exposure. Thus, the aim of this study was to conduct a systematic review and meta-analysis of the relationship between the severity of DF and fluoride biomarkers in endemic areas. The protocol of this study was previously registered as CRD42021244974. A digital search was carried out in PubMed/Medline, SpringerLink, Scopus, Cochrane and Google Scholar by employing the keywords "urine", "nails", "hair", "plasma", "saliva" and "dental fluorosis" for the original studies with content associated with F for the biomarkers and DF. The mean difference was established as the effect measure for the meta-analysis. Seven studies fulfilled the eligibility criteria, among which five assessed urine and two employed nails as fluoride biomarkers. A positive significant difference was found between the biomarkers and the severity of DF (0.27, p < 0.001) and individually for each biomarker (urine: 0.14, p = 0.001; nails: 0.88, p < 0.05). The F concentration in urine and nails is correlated with the severity of DF, with the most evident differences between healthy individuals and those with mild severity. Both biomarkers are adequate to assess this relationship in endemic areas of fluoride and DF.
摄入高浓度氟化物，主要通过饮用水、饮食和含氟牙膏，会导致氟中毒，其早期表现为氟斑牙（DF）。为了识别地方性氟中毒地区的氟暴露情况并评估健康受损风险，世界卫生组织建立了几种生物标志物，用于确定全身性氟（F）暴露。因此，本研究的目的是对地方性氟中毒地区DF严重程度与氟生物标志物之间的关系进行系统评价和荟萃分析。本研究方案先前已注册为CRD42021244974。通过在PubMed/Medline、SpringerLink、Scopus、Cochrane和谷歌学术中进行数字检索，使用关键词“尿液”“指甲”“头发”“血浆”“唾液”和“氟斑牙”，检索与生物标志物和DF的F相关内容的原始研究。将平均差异确定为荟萃分析的效应量。七项研究符合纳入标准，其中五项评估尿液，两项使用指甲作为氟生物标志物。在生物标志物与DF严重程度之间发现了显著正差异（0.27，p<0.001），且每种生物标志物单独分析时也存在显著差异（尿液：0.14，p=0.001；指甲：0.88，p<0.05）。尿液和指甲中的F浓度与DF严重程度相关，健康个体与轻度严重程度个体之间的差异最为明显。两种生物标志物都足以评估氟化物和DF地方性流行地区的这种关系。
