Quintessence Int. 2024 Oct 24;55(9):714-721. doi: 10.3290/j.qi.b5586051.
The aim of this study was to identify the relationship between preventative dental practices and cardiometabolic health in adolescents.
Analysis included children aged 13 to 17 years enrolled in the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018 who completed an Oral Health Examination and Questionnaire. Deferred dental care was defined as not having a dental visit in the past year. Financial barriers to seeking dental care (vs no financial barriers) were assessed among those with deferred dental care in the past year. Primary cardiometabolic outcomes included obesity, elevated blood pressure, and hypertensive blood pressure. Secondary outcomes included dyslipidemia, glucose intolerance, uric acid, glomerular hyperfiltration, and albuminuria. Regression models adjusted for age, sex, race/ethnicity, household income, food insecurity, health insurance status, household education, and body mass index z-score examined associations using complex survey design procedures.
Of 2,861 adolescents, 17.6% (SE 0.9%) did not receive dental care in the past year and 20.2% (SE 1.9%) had a financial barrier to accessing dental care. In adjusted regression models, adolescents with deferred dental care had higher odds of dyslipidemia (odds ratio [OR]= 1.51, 95% CI 1.07 to 2.11, P = .020). Having a financial barrier was associated with lower odds of dyslipidemia (OR = 0.35, 95% CI 0.14 to 0.89, P = .03). Financial barriers were associated with lower non-high-density lipoprotein cholesterol (b = -7.95, 95% CI -14.87 to -1.05, P = .03) and higher high-density lipoprotein cholesterol (b = 3.06, 95% CI 0.37 to 5.75, P = .03) in adjusted models. Deferred dental care and financial barriers were not associated with any other cardiometabolic parameters.
In this nationally representative cohort of adolescents, there was an association between lack of preventative dental care and the cardiometabolic health marker of dyslipidemia. However, financial barriers to dental care were surprisingly associated with higher high-density lipoprotein cholesterol levels and lower odds of dyslipidemia.
本研究旨在确定青少年预防牙科实践与心脏代谢健康之间的关系。
分析纳入了 2011 年至 2018 年参加国家健康和营养检查调查（NHANES）的年龄在 13 至 17 岁的儿童，他们完成了口腔健康检查和问卷调查。延迟牙科护理被定义为过去一年没有进行牙科就诊。在过去一年中有延迟牙科护理的人中，评估了寻求牙科护理的财务障碍（与无财务障碍相比）。主要心脏代谢结局包括肥胖、血压升高和高血压性血压。次要结局包括血脂异常、葡萄糖耐量受损、尿酸、肾小球高滤过和白蛋白尿。使用复杂的调查设计程序，调整了年龄、性别、种族/民族、家庭收入、粮食不安全、医疗保险状况、家庭教育和体重指数 z 分数的回归模型，以检查关联。
在 2861 名青少年中，17.6%（SE 0.9%）过去一年未接受牙科护理，20.2%（SE 1.9%）在获得牙科护理方面存在财务障碍。在调整后的回归模型中，延迟牙科护理的青少年血脂异常的可能性更高（比值比[OR] = 1.51，95%置信区间 1.07 至 2.11，P =.020）。存在财务障碍与血脂异常的可能性降低相关（OR = 0.35，95%置信区间 0.14 至 0.89，P =.03）。在调整后的模型中，财务障碍与非高密度脂蛋白胆固醇降低（b = -7.95，95%置信区间-14.87 至-1.05，P =.03）和高密度脂蛋白胆固醇升高（b = 3.06，95%置信区间 0.37 至 5.75，P =.03）相关。延迟牙科护理和财务障碍与任何其他心脏代谢参数均无关联。
在这个具有全国代表性的青少年队列中，缺乏预防性牙科护理与血脂代谢健康标志物血脂异常之间存在关联。然而，牙科保健的财务障碍令人惊讶地与较高的高密度脂蛋白胆固醇水平和较低的血脂异常发生率相关。
