Phipps K R, Orwoll E S, Bevan L
Oregon Health Sciences University, School of Dentistry, Portland 97201, USA.
J Dent Res. 1998 Sep;77(9):1739-48. doi: 10.1177/00220345980770091001.
While the benefit of fluoridation in the prevention of dental caries has been overwhelmingly substantiated, the effect of fluoride on bone mineral density is less clear. This cross-sectional study was designed to compare the bone mineral densities of older adults exposed to various levels of fluoride from community water systems. Participants were recruited from 3 rural communities with naturally occurring fluoride in their water systems at 0.03, 0.7, and 2.5 mg/L. All adults, age 60 and over, were eligible if they were ambulatory and had a long-term history (> or = 20 yrs) of ingesting city water. Bone mineral density (BMD) was measured by means of dual-energy x-ray absorptiometry at 3 anatomical sites: lumbar spine, proximal femur, and forearm. A total of 353 white non-Hispanic women and 317 white non-Hispanic men took part in the study. When the data were stratified by city of residence and gender, men and women living in the community with high levels of fluoride in their community water system had significantly higher lumbar spine BMD than their counterparts from the communities with low and moderate fluoride levels. The women in the high-fluoride community had significantly higher proximal femur BMD, but there were no statistically significant differences among men in either proximal femur or forearm BMD. Long-term exposure (> or = 20 yrs) to higher levels of fluoride appears to have a positive impact on lumbar spine and proximal femur BMD. Based on the results of this study, exposure to fluoride at levels considered "optimal" for the prevention of dental caries (from 0.7 to 1.2 mg/L) appears to have no significant impact on bone mineral density. The relationship between higher levels of fluoride exposure and bone mineral density requires further investigation.
虽然氟化物在预防龋齿方面的益处已得到大量证实，但氟化物对骨密度的影响尚不清楚。本横断面研究旨在比较社区供水系统中接触不同氟化物水平的老年人的骨密度。研究对象从3个农村社区招募，这些社区的供水系统中天然氟化物含量分别为0.03、0.7和2.5毫克/升。所有60岁及以上的成年人，只要能独立行走且有长期（≥20年）饮用城市供水的历史，均符合入选标准。通过双能X线吸收法在3个解剖部位测量骨密度：腰椎、股骨近端和前臂。共有353名非西班牙裔白人女性和317名非西班牙裔白人男性参与了这项研究。当数据按居住城市和性别分层时，生活在社区供水系统氟化物含量高的社区的男性和女性，其腰椎骨密度显著高于生活在氟化物含量低和中等的社区的同龄人。高氟社区的女性股骨近端骨密度显著更高，但男性在股骨近端或前臂骨密度方面均无统计学显著差异。长期（≥20年）接触较高水平的氟化物似乎对腰椎和股骨近端骨密度有积极影响。基于本研究结果，接触被认为对预防龋齿“最佳”水平（0.7至1.2毫克/升）的氟化物似乎对骨密度没有显著影响。更高水平的氟化物暴露与骨密度之间的关系需要进一步研究。
