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46 岁绝经期与颞下颌关节紊乱病的相关性:一项横断面研究。

Association of climacterium with temporomandibular disorders at the age of 46 years - a cross-sectional study.

机构信息

Faculty of Medicine, Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland.

Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.

出版信息

Acta Odontol Scand. 2023 May;81(4):319-324. doi: 10.1080/00016357.2022.2146746. Epub 2022 Nov 20.

Abstract

OBJECTIVE

Hormonal factors have been suggested to contribute to female dominance among subjects with temporomandibular disorders (TMD). Aim of the study was to examine the association of climacteric status with TMD amongst female participants in the Northern Finland Birth Cohort (NFBC) 1966 at 46 years of age.

MATERIAL AND METHODS

Among female subjects in NFBC1966, climacteric status was determined based on menstrual anamnesis and measurement of blood follicle-stimulating hormone (FSH) levels. Women with FSH > 25 IU/L and amenorrhoea > 4 months were defined as climacteric (case group,  71); women not diagnosed as climacteric were defined as preclimacteric (control group,  656). Differences between cases and controls were evaluated on self-reported TMD pain, clinical TMD signs and TMD diagnoses using modified Diagnostic Criteria for TMD (DC/TMD) protocol. Crosstabulation and logistic regression models were used to analyse differences between cases and controls.

RESULTS

Compared to preclimacteric women, climacteric women had significantly more often pain on palpation in temporomandibular joints (TMJs) (OR = 2.64, 95% CI 1.12-6.21,  .026) and more crepitus in TMJs (OR = 2.92, 95% CI 1.13-7.56,  .027). Degenerative joint disease diagnoses were more common in climacteric than preclimacteric women (OR = 2.27, 95% CI 1.05-4.91,  .037). Differences were statistically significant after adjusting for confounding factors (body mass index (BMI), smoking, parity). No statistically significant differences in self-reported TMD pain were noted between groups.

CONCLUSION

Among females at the age of 46 years, climacterium seems associated with TMD by increasing pain on palpation in TMJs, subjective symptoms, and clinical signs indicating degenerative changes in TMJs when using DC/TMD.

摘要

目的

有研究提示激素因素可能导致颞下颌关节紊乱病(TMD)患者中女性占主导地位。本研究旨在探讨绝经过渡期状态与芬兰北部出生队列(NFBC)1966 年女性参与者 TMD 的关系,这些女性在 46 岁时参与研究。

材料与方法

在 NFBC1966 的女性受试者中,根据月经病史和血液卵泡刺激素(FSH)水平测定来确定绝经过渡期状态。FSH>25IU/L 和闭经>4 个月的女性被定义为绝经期(病例组,71 例);未被诊断为绝经期的女性被定义为绝经过渡前期(对照组,656 例)。采用改良的 TMD 诊断标准(DC/TMD 方案),评估病例组和对照组之间在自我报告的 TMD 疼痛、临床 TMD 体征和 TMD 诊断方面的差异。交叉表和逻辑回归模型用于分析病例组和对照组之间的差异。

结果

与绝经过渡前期女性相比,绝经期女性的颞下颌关节(TMJ)触诊疼痛明显更常见(OR=2.64,95%CI 1.12-6.21,.026),TMJ 弹响也更常见(OR=2.92,95%CI 1.13-7.56,.027)。绝经期女性退行性关节病诊断明显多于绝经过渡前期女性(OR=2.27,95%CI 1.05-4.91,.037)。调整混杂因素(体重指数(BMI)、吸烟、产次)后,差异具有统计学意义。两组间自我报告的 TMD 疼痛无统计学显著差异。

结论

在 46 岁的女性中,使用 DC/TMD 时,绝经期似乎与 TMJ 触诊疼痛增加、TMJ 退行性变化的主观症状和临床体征有关,从而与 TMD 相关。

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