Center of Stomatology, The Second Xiangya Hospital of Central South University, 139 Renmin Middle Road, Changsha, Hunan, 410011, China.
National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
BMC Oral Health. 2023 Aug 29;23(1):607. doi: 10.1186/s12903-023-03322-2.
Temporomandibular joint disorders (TMD) is the most common non-dental pain complaint in the maxillofacial region, which presents a variety of symptoms and signs, including temporomandibular joints (TMJ) and masticatory muscle pain, joint noise, tinnitus, headaches, irregular or restricted mandibular function, masticatory difficulty, and restricted mouth opening. When comes to the relationship between obesity and TMD, it has remained controversial and inconsistent, therefore, we first conducted this meta-analysis to estimate the unclear relationship between obesity and TMD.
Searches were conducted in PubMed, Web of Science, Embase, and Cochrane Library. Subjects were divided into five groups according to BMI level in this study, including the normal weight group: 18.5 ≤ BMI < 25, overweight group: 25 ≤ BMI < 30, obesity group: BMI ≥ 30, control group: BMI < 25, and overweight and obesity group: BMI ≥ 25. Statistics analyses were conducted using Stata (15.0). The number of PROSPERO was CRD42022368315.
Eight studies were included in this study, and six articles with a total of 74,056 participants were synthesized for meta-analysis. Compared to normal weight individuals, overweight and obesity together decreased the risk of TMD (OR = 0.66, 95% CI = 0.46-0.95), and it was significantly decreased by obesity alone (OR = 0.58). Moreover, it was lower in obesity compared with control subjects (OR = 0.83, 95% CI = 0.73-0.94). Furthermore, in overweight and obese individuals, it was much lower in obesity than in overweight (OR = 0.82, 95% CI = 0.71-0.94).
Obesity is not a risk factor for TMD, and maybe a protective factor for TMD, of which patients with larger BMI are less likely to suffer from TMD pain. Therefore, the value of BMI should be taken into consideration in the assessment of TMD.
颞下颌关节紊乱（TMD）是颌面区域最常见的非牙科疼痛主诉，表现为多种症状和体征，包括颞下颌关节（TMJ）和咀嚼肌疼痛、关节弹响、耳鸣、头痛、下颌功能不规则或受限、咀嚼困难和张口受限。至于肥胖与 TMD 的关系，一直存在争议且不一致，因此，我们首先进行了这项荟萃分析，以评估肥胖与 TMD 之间不明确的关系。
在 PubMed、Web of Science、Embase 和 Cochrane Library 中进行了检索。根据本研究中的 BMI 水平，将受试者分为五组，包括正常体重组：18.5≤BMI＜25，超重组：25≤BMI＜30，肥胖组：BMI≥30，对照组：BMI＜25，超重和肥胖组：BMI≥25。使用 Stata（15.0）进行统计分析。PROSPERO 的注册号为 CRD42022368315。
本研究纳入了 8 项研究，其中有 6 项共 74056 名参与者的文章进行了荟萃分析。与正常体重者相比，超重和肥胖组共同降低了 TMD 的风险（OR=0.66，95%CI=0.46-0.95），且单纯肥胖组降低更显著（OR=0.58）。此外，肥胖组的 TMD 风险低于对照组（OR=0.83，95%CI=0.73-0.94）。此外，在超重和肥胖者中，肥胖组的 TMD 风险显著低于超重组（OR=0.82，95%CI=0.71-0.94）。
肥胖不是 TMD 的危险因素，而可能是 TMD 的保护因素，其中 BMI 较大的患者发生 TMD 疼痛的可能性较小。因此，在评估 TMD 时应考虑 BMI 的价值。
