Nygaard Nikoline, Eriksen Anne Kirstine, Ängquist Lars, Belstrøm Daniel, Stankevic Evelina, Hansen Torben, Olsen Anja, Markvart Merete
Section for Clinical Oral Microbiology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Nørre Allé 20, 2200, Copenhagen, Denmark.
Danish Cancer Institute, Diet, Cancer and Health, Strandboulevarden 49, 2100, Copenhagen, Denmark.
Acta Diabetol. 2025 Jan 13. doi: 10.1007/s00592-024-02437-4.
Evidence suggests a bidirectional relationship between oral health status and type 2 diabetes (T2D) in adults. Studies on associations between childhood oral health and T2D in adulthood are lacking.
This is a nationwide Danish registry-based cohort study of individuals born between 1963 and 1972, having at least one registration in the National Child Odontology Registry between 1972 and 1987 (n = 627,758). Follow-up lasted from 1995 to 2018. Main exposure variables were the highest achieved levels of dental caries and gingivitis between 1972 and 1987. The outcome was T2D diagnosis during follow-up. Data was analyzed using Cox-regression, stratified on sex, with age as the underlying timescale and highest achieved level of education between age 25-30 years as Cox-strata. Main analyses were conducted with and without age-restrictions (T2D diagnosis before/after age 40).
Compared to lowest-level references, high levels of gingivitis associated with increased hazard ratios (HRs) of T2D in both males (HR [95% confidence interval]: 1.59 [1.47; 1.72]) and females (1.87 [1.68; 2.08]), as did severe dental caries (males: (1.15 [1.04; 1.27], in females: 1.19 [1.06; 1.35]). Below age 40, gingivitis associated with increased HRs in males (1.84 ([1.58; 2.15]) and females (1.94 [1.63; 2.30]). Above age 40, both exposures displayed higher HRs in males (high gingivitis: 1.52 [1.39; 1.66] vs. severe caries: 1.23 [1.09; 1.38]) and females (1.83 [1.59; 2.10] vs. 1.37 [1.17; 1.59]).
Data suggest an association between childhood dental caries and gingivitis with risk of receiving a T2D diagnosis in adulthood. However, results are affected by residual confounding warranting further studies.
有证据表明，成年人的口腔健康状况与2型糖尿病（T2D）之间存在双向关系。关于儿童口腔健康与成年后T2D之间关联的研究尚缺。
这是一项基于丹麦全国登记处的队列研究，研究对象为1963年至1972年出生、在1972年至1987年期间至少在国家儿童牙科学登记处有一次登记记录的个体（n = 627,758）。随访时间从1995年持续至2018年。主要暴露变量为1972年至1987年期间龋齿和牙龈炎的最高患病水平。研究结果为随访期间的T2D诊断。数据采用Cox回归分析，按性别分层，以年龄为基本时间尺度，以25至30岁之间达到的最高教育水平作为Cox分层。主要分析在有和没有年龄限制的情况下进行（40岁之前/之后的T2D诊断）。
与最低水平参考组相比，高水平的牙龈炎与男性（风险比[95%置信区间]：1.59[1.47；1.72]）和女性（1.87[1.68；2.08]）患T2D的风险比（HRs）增加相关，严重龋齿也是如此（男性：1.15[1.04；1.27]，女性：1.19[1.06；1.35]）。在40岁以下，牙龈炎与男性（1.84[1.58；2.15]）和女性（1.94[1.63；2.30]）的风险比增加相关。在40岁以上，两种暴露因素在男性（高水平牙龈炎：1.52[1.39；1.66]与严重龋齿：1.23[1.09；1.38]）和女性（1.83[1.59；2.10]与1.37[1.17；1.59]）中均显示出较高的风险比。
数据表明儿童龋齿和牙龈炎与成年后被诊断为T2D的风险之间存在关联。然而，结果受到残余混杂因素的影响，需要进一步研究。
