J Am Dent Assoc. 2023 Nov;154(11):991-999.e2. doi: 10.1016/j.adaj.2023.07.013. Epub 2023 Sep 9.
Body mass index has been traditionally used to determine the nutritional status of children in studies on obesity and caries. Imaging methods provide a superior assessment of body fat. This study investigated the relationship between measures of adiposity and caries in permanent teeth in children and adolescents.
The analysis included 5,694 participants in the National Health and Nutrition Examination Survey from 2011 through 2018, aged 8 through 19 years. The body fat percentage (BF%) and fat mass index (FMI) were determined from whole-body dual-energy x-ray absorptiometry scans. Excess adiposity was defined as a sex- and age-specific value at or above the 75th percentile according to the US reference standards for BF% or FMI. Caries was measured with the decayed teeth and decayed, missing, and filled teeth indexes; prevalence of untreated dentin caries; and lifetime caries prevalence. The associations between adiposity and caries were tested in confounding variables-adjusted regression models.
The FMI score was associated with the decayed, missing, and filled teeth score (rate ratio, 1.03; 95% CI, 1.01 to 1.05) and lifetime caries prevalence (odds ratio, 1.06; 95% CI, 1.03 to 1.08), but the associations attenuated after adjustment for confounding variables. Neither the BF% score nor the presence of excess adiposity, defined according to the BF% or FMI reference standards, were associated with caries.
The authors found no association between measures of adiposity and caries among US children and adolescents.
Caries is a multifactorial disease, and any observed association between obesity and caries is most likely due to the shared determinants and risk factors of both conditions.
体质量指数(BMI)传统上用于评估肥胖与龋齿相关的儿童营养状况。影像学方法可更准确地评估体脂。本研究旨在探讨儿童和青少年体脂指标与龋齿的关系。
本分析纳入了 2011 至 2018 年全国健康和营养调查(NHANES)中 5694 名 8 至 19 岁的参与者。体脂肪百分比(BF%)和脂肪质量指数(FMI)由全身双能 X 射线吸收法测定。超重肥胖定义为根据美国 BF%或 FMI 参考标准,按照性别和年龄划分的第 75 百分位数及以上的值。龋齿采用龋齿、失牙和补牙指数(dmft)、未经治疗的牙本质龋患病率和终生龋齿患病率进行测量。在调整混杂变量的回归模型中检验了体脂与龋齿的关系。
FMI 得分与 dmft 得分(比率比,1.03;95%置信区间,1.01 至 1.05)和终生龋齿患病率(比值比,1.06;95%置信区间,1.03 至 1.08)相关,但在调整混杂变量后相关性减弱。BF%得分以及根据 BF%或 FMI 参考标准定义的超重肥胖与龋齿均无相关性。
作者发现美国儿童和青少年体脂指标与龋齿之间无关联。
龋齿是一种多因素疾病,肥胖与龋齿之间的任何观察到的关联很可能是由于这两种疾病的共同决定因素和危险因素所致。