PDF(Pubmed)
Abstract：
BACKGROUND: Dental caries is the most common non-communicable human disease, yet little is known about the role of environmental metals, despite teeth consisting of a hard matrix of trace elements. We conducted a cross-sectional study of associations between environmental metals and objective assessment of dental caries and subjective assessments of oral health among a representative sample of U.S. children and adolescents.
METHODS: Data were from the 2017-March 2020 pre-pandemic data file of the National Health and Nutrition Examination Survey (NHANES). To account for metal mixtures, we used weighted quantile sum (WQS) regression to estimate the joint impact of multiple trace elements assessed in blood and urine with oral disease outcomes.
RESULTS: The blood metal mixture index was associated with a 32% (95% CI: 1.11, 1.56) increased risk of decayed surfaces while the urine metal mixture index was associated with a 106%, RR (95% CI = 2.06 (1.58, 2.70) increased caries risk. For both blood and urine, Mercury (Hg) had the largest contribution to the mixture index followed by Lead (Pb). The WQS blood metal mixture index was also significantly associated with poorer self-rated oral health, although the magnitude of the association was not as strong as for the objective oral disease measures, RR (95% CI) = 1.04 (1.02, 1.07).
CONCLUSIONS: Increased exposure to a metal mixture was significantly related to poorer objective and subjective oral health outcomes among U.S. children and adolescents. These are among the first findings showing that metal mixtures are a significant contributor to poor oral health.
METHODS: Data were from the 2017-March 2020 pre-pandemic data file of the National Health and Nutrition Examination Survey (NHANES). To account for metal mixtures, we used weighted quantile sum (WQS) regression to estimate the joint impact of multiple trace elements assessed in blood and urine with oral disease outcomes.
RESULTS: The blood metal mixture index was associated with a 32% (95% CI: 1.11, 1.56) increased risk of decayed surfaces while the urine metal mixture index was associated with a 106%, RR (95% CI = 2.06 (1.58, 2.70) increased caries risk. For both blood and urine, Mercury (Hg) had the largest contribution to the mixture index followed by Lead (Pb). The WQS blood metal mixture index was also significantly associated with poorer self-rated oral health, although the magnitude of the association was not as strong as for the objective oral disease measures, RR (95% CI) = 1.04 (1.02, 1.07).
CONCLUSIONS: Increased exposure to a metal mixture was significantly related to poorer objective and subjective oral health outcomes among U.S. children and adolescents. These are among the first findings showing that metal mixtures are a significant contributor to poor oral health.
摘要：
背景：龋齿是人类最常见的非传染性疾病，然而对环境金属的作用知之甚少，尽管牙齿由微量元素的坚硬基质组成。我们对美国代表性儿童和青少年样本中环境金属与龋齿客观评估和口腔健康主观评估之间的关联进行了横断面研究。
方法：数据来自国家健康和营养检查调查（NHANES）的2017-2020年3月大流行前数据文件。为了说明金属混合物，我们使用加权分位数和(WQS)回归评估血液和尿液中多种微量元素对口腔疾病结局的联合影响.
结果：血液金属混合物指数与32％（95％CI：1.11，1.56）的表面腐烂风险增加相关，而尿液金属混合物指数与106％相关，RR(95%CI=2.06(1.58,2.70)增加患龋风险。血液和尿液，汞（Hg）对混合物指数的贡献最大，其次是铅（Pb）。WQS血液金属混合指数也与较差的自我评估口腔健康显着相关，尽管关联的程度不如客观的口腔疾病指标那么强，RR（95%CI）=1.04（1.02，1.07）。
结论：在美国儿童和青少年中，金属混合物暴露的增加与较差的客观和主观口腔健康结果显著相关。这些是第一个发现，表明金属混合物是口腔健康不良的重要原因。
方法：数据来自国家健康和营养检查调查（NHANES）的2017-2020年3月大流行前数据文件。为了说明金属混合物，我们使用加权分位数和(WQS)回归评估血液和尿液中多种微量元素对口腔疾病结局的联合影响.
结果：血液金属混合物指数与32％（95％CI：1.11，1.56）的表面腐烂风险增加相关，而尿液金属混合物指数与106％相关，RR(95%CI=2.06(1.58,2.70)增加患龋风险。血液和尿液，汞（Hg）对混合物指数的贡献最大，其次是铅（Pb）。WQS血液金属混合指数也与较差的自我评估口腔健康显着相关，尽管关联的程度不如客观的口腔疾病指标那么强，RR（95%CI）=1.04（1.02，1.07）。
结论：在美国儿童和青少年中，金属混合物暴露的增加与较差的客观和主观口腔健康结果显著相关。这些是第一个发现，表明金属混合物是口腔健康不良的重要原因。
