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Abstract：
BACKGROUND: Fluorosis is controlled by the duration of fluoride exposure and calcium and Vitamin D nutrition status.
OBJECTIVE: To examine (a) prevalence of dental and skeletal fluorosis in adolescents from upper, middle, and lower socioeconomic strata (SES) and (b) association of fluorosis with calcium intake and Vitamin D status.
METHODS: A cross-sectional study conducted in 10-13.9 years apparently healthy adolescents (n = 90), from different SES of Patan (Gujarat, India).
METHODS: Dental fluorosis was graded as mild, moderate, and severe. Radiographs of the right hand and wrist were examined and graded. Serum 25 hydroxyvitamin D3 (25OHD) and parathyroid hormone concentrations were measured. Diet was recorded (24 h recall) and calcium intake was computed (C-diet V-2.1, 2013, Xenios Technologies Pvt. Ltd).
METHODS: Generalized linear model was used to analyze relationships between fluorosis, SES, serum 25OHD concentration, and calcium intake.
RESULTS: Fluorosis was predominant in lower SES (17% had both dental and radiological features whereas 73% had dental fluorosis); no skeletal deformities were observed. Mean 25OHD concentrations and dietary calcium were 26.3 ± 4.9, 23.4 ± 4.7, and 18.6 ± 4 ng/ml and 441.2 ± 227.6, 484.3 ± 160.9, and 749.2 ± 245.4 mg/day, respectively, for lower, middle, and upper SES (P < 0.05). Fluorosis and SES showed a significant association (exponential β = 2.5, P = 0.01) as compared to upper SES, middle SES adolescents were at 1.3 times while lower SES adolescents were at 2.5 times higher risk. Serum 25OHD concentrations (P = 0.937) and dietary calcium intake (P = 0.825) did not show a significant association with fluorosis.
CONCLUSIONS: Fluorosis was more common in lower SES adolescents, probably due to the lack of access to bottled water. Relatively adequate calcium intake and serum 25OHD concentrations may have increased the efficiency of dietary calcium absorption, thus preventing severe fluorosis.
OBJECTIVE: To examine (a) prevalence of dental and skeletal fluorosis in adolescents from upper, middle, and lower socioeconomic strata (SES) and (b) association of fluorosis with calcium intake and Vitamin D status.
METHODS: A cross-sectional study conducted in 10-13.9 years apparently healthy adolescents (n = 90), from different SES of Patan (Gujarat, India).
METHODS: Dental fluorosis was graded as mild, moderate, and severe. Radiographs of the right hand and wrist were examined and graded. Serum 25 hydroxyvitamin D3 (25OHD) and parathyroid hormone concentrations were measured. Diet was recorded (24 h recall) and calcium intake was computed (C-diet V-2.1, 2013, Xenios Technologies Pvt. Ltd).
METHODS: Generalized linear model was used to analyze relationships between fluorosis, SES, serum 25OHD concentration, and calcium intake.
RESULTS: Fluorosis was predominant in lower SES (17% had both dental and radiological features whereas 73% had dental fluorosis); no skeletal deformities were observed. Mean 25OHD concentrations and dietary calcium were 26.3 ± 4.9, 23.4 ± 4.7, and 18.6 ± 4 ng/ml and 441.2 ± 227.6, 484.3 ± 160.9, and 749.2 ± 245.4 mg/day, respectively, for lower, middle, and upper SES (P < 0.05). Fluorosis and SES showed a significant association (exponential β = 2.5, P = 0.01) as compared to upper SES, middle SES adolescents were at 1.3 times while lower SES adolescents were at 2.5 times higher risk. Serum 25OHD concentrations (P = 0.937) and dietary calcium intake (P = 0.825) did not show a significant association with fluorosis.
CONCLUSIONS: Fluorosis was more common in lower SES adolescents, probably due to the lack of access to bottled water. Relatively adequate calcium intake and serum 25OHD concentrations may have increased the efficiency of dietary calcium absorption, thus preventing severe fluorosis.
摘要：
背景：氟中毒受氟暴露持续时间以及钙和维生素D营养状况控制。
目的：检查（a）青少年上消化道和骨骼氟中毒的患病率，中间,和较低的社会经济阶层（SES）和（b）氟中毒与钙摄入量和维生素D状态的关联。
方法：在10-13.9岁明显健康的青少年（n=90）中进行的一项横断面研究，来自不同的帕坦SES(古吉拉特邦，印度）。
方法：氟斑牙分级为轻度，中度,和严重。对右手和手腕的射线照片进行了检查和分级。测定血清25羟维生素D3(25OHD)和甲状旁腺激素浓度。记录饮食（24小时召回）并计算钙摄入量（C饮食V-2.1，2013，XeniosTechnologiesPvt。有限公司)。
方法：采用广义线性模型分析氟中毒、SES,血清25OHD浓度,和钙的摄入。
结果：氟中毒在较低的SES中占主导地位（17％具有牙齿和放射学特征，而73％患有氟中毒）；未观察到骨骼畸形。平均25OHD浓度和饮食钙分别为26.3±4.9、23.4±4.7和18.6±4ng/ml和441.2±227.6、484.3±160.9和749.2±245.4mg/天，分别,对于较低的，中间,和上SES（P<0.05）。与上SES相比，氟中毒和SES显示出显着关联（指数β=2.5，P=0.01）。SES中期青少年为1.3倍,而SES较低的青少年为2.5倍.血清25OHD浓度（P=0.937）和膳食钙摄入量（P=0.825）与氟中毒没有显着相关性。
结论：氟中毒在SES较低的青少年中更为常见，可能是由于缺乏瓶装水。相对充足的钙摄入量和血清25OHD浓度可能增加了膳食钙吸收的效率，从而预防严重的氟中毒。
目的：检查（a）青少年上消化道和骨骼氟中毒的患病率，中间,和较低的社会经济阶层（SES）和（b）氟中毒与钙摄入量和维生素D状态的关联。
方法：在10-13.9岁明显健康的青少年（n=90）中进行的一项横断面研究，来自不同的帕坦SES(古吉拉特邦，印度）。
方法：氟斑牙分级为轻度，中度,和严重。对右手和手腕的射线照片进行了检查和分级。测定血清25羟维生素D3(25OHD)和甲状旁腺激素浓度。记录饮食（24小时召回）并计算钙摄入量（C饮食V-2.1，2013，XeniosTechnologiesPvt。有限公司)。
方法：采用广义线性模型分析氟中毒、SES,血清25OHD浓度,和钙的摄入。
结果：氟中毒在较低的SES中占主导地位（17％具有牙齿和放射学特征，而73％患有氟中毒）；未观察到骨骼畸形。平均25OHD浓度和饮食钙分别为26.3±4.9、23.4±4.7和18.6±4ng/ml和441.2±227.6、484.3±160.9和749.2±245.4mg/天，分别,对于较低的，中间,和上SES（P<0.05）。与上SES相比，氟中毒和SES显示出显着关联（指数β=2.5，P=0.01）。SES中期青少年为1.3倍,而SES较低的青少年为2.5倍.血清25OHD浓度（P=0.937）和膳食钙摄入量（P=0.825）与氟中毒没有显着相关性。
结论：氟中毒在SES较低的青少年中更为常见，可能是由于缺乏瓶装水。相对充足的钙摄入量和血清25OHD浓度可能增加了膳食钙吸收的效率，从而预防严重的氟中毒。
