与男性青少年触诊颞下颌疼痛相关的性激素——流行病学 LIFE 儿童研究的结果。

Sex hormones associated with temporomandibular pain on palpation in male adolescents-Results of the epidemiologic LIFE child study.

机构信息

Clinic of Pediatric and Preventive Dentistry, University of Leipzig, Leipzig, Germany.

Department of Prosthetic Dentistry and Materials Science, University of Leipzig, Leipzig, Germany.

出版信息

J Oral Rehabil. 2023 Oct;50(10):972-979. doi: 10.1111/joor.13530. Epub 2023 Jun 21.

DOI:10.1111/joor.13530

PMID:37277983

Abstract

OBJECTIVE

This study aimed to investigate whether the sex steroid precursor hormone dehydroepiandrosterone sulphate (DHEA-S), sex hormone-binding globulin (SHBG) and testosterone (TT) are associated with temporomandibular (TM) pain on palpation in male adolescents.

METHODS

Out of the LIFE Child study dataset containing 1022 children and adolescents aged 10-18 years (496 males, 48.5%), we used a subsample of 273 male adolescents (mean age: 13.8 ± 2.3 years) in advanced pubertal development (PD) to analyse the association between hormones and TM pain. The Tanner scale was applied to describe the stage of PD. Pain on palpation of the temporalis and masseter muscles and the TM joints (palpation pain) was assessed using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Serum levels of sex hormones (DHEA-S, SHBG and TT) were determined using standardised laboratory analyses. Free TT was estimated from the ratio between TT and SHBG (free androgen index[FAI]). We calculated the risk of perceived positive palpation pain for male participants as a function of hormone levels (DHEA-S, FAI) taking into account age and body mass index (BMI).

RESULTS

Among more developed (Tanner stage 4-5) male adolescents, 22.7% (n = 62) reported palpation pain in the TM region. In these participants, FAI levels were approximately half that of individuals without such pain (p < .01). DHEA-S levels were about 30% lower in the pain group (p < .01). In multivariable regression analyses, the odds ratio (OR) for pain on palpation decreased to 0.75 (95% confidence interval [CI]: 0.57-0.98) per 10 units of FAI level compared to those without pain, after controlling for the effects of age and adjusted BMI. We observed the same effect for this subgroup per unit of DHEA-S serum level (OR = 0.71; 95% CI: 0.53-0.94).

CONCLUSION

At subclinical lower levels of serum free TT and DHEA-S, male adolescents are more likely to report pain on standardised palpation of the masticatory muscles and/or TM joints. This finding supports the hypothesis that sex hormones may influence pain reporting.

摘要

目的

本研究旨在探讨甾体激素前体硫酸脱氢表雄酮（DHEA-S）、性激素结合球蛋白（SHBG）和睾酮（TT）是否与男性青少年颞下颌（TM）触诊疼痛有关。

方法

在 LIFE Child 研究数据集（包含 1022 名 10-18 岁儿童和青少年，其中 496 名为男性，占 48.5%）中，我们使用其中 273 名处于青春期后期（PD）的男性青少年（平均年龄：13.8±2.3 岁）亚组来分析激素与 TM 疼痛之间的关系。采用 Tanner 量表来描述 PD 阶段。通过使用颞下颌关节紊乱诊断标准（DC/TMD）来评估咀嚼肌（颞肌和咬肌）和 TM 关节的触诊疼痛（触诊疼痛）。采用标准化实验室分析方法测定血清性激素（DHEA-S、SHBG 和 TT）水平。通过 TT 与 SHBG 的比值（游离雄激素指数[FAI]）估算 TT 的游离水平。我们计算了男性参与者感知 TM 区触诊疼痛的阳性率（考虑年龄和体重指数（BMI）的情况下，作为激素水平（DHEA-S、FAI）的函数）。

结果

在发育程度较高（Tanner 分期 4-5 期）的男性青少年中，22.7%（n=62）报告 TM 区有触诊疼痛。在这些参与者中，FAI 水平约为无疼痛者的一半（p<.01）。疼痛组的 DHEA-S 水平低约 30%（p<.01）。在多变量回归分析中，与无疼痛者相比，FAI 水平每增加 10 个单位，触诊疼痛的比值比（OR）降低至 0.75（95%置信区间[CI]：0.57-0.98），调整年龄和调整 BMI 后。我们观察到，在该亚组中，血清 DHEA-S 水平每增加一个单位，其 OR 为 0.71（95%CI：0.53-0.94），也有同样的效果。