■这项研究的目的是探讨性与颌骨功能之间的关系,并测试焦虑是否介导颞下颌关节紊乱病(TMDs)患者性与颌骨功能之间的因果关系。
■共有488名TMD参与者被纳入分析。收集人口统计数据。最初使用GAD-7问卷评估广义焦虑症状和焦虑严重程度。使用JFLS-8量表测量颌骨功能限制。本研究使用有向无环图(DAG)来评估假设。进行中介分析以探索因果关系并计算总效应,自然直接效应(NDE)和自然间接效应(NIE)。
■在TMD患者中,女性与下颌功能之间存在显着关联(r=0.17,p<0.001),女性和焦虑(r=0.15,p=0.002),焦虑和颌骨功能(r=0.35,p<0.001)。此外,性别可直接导致下颌功能受损的差异(NDE:3.719,95%CI:1.619-5.828,p<0.001),并且也可以通过焦虑与颌骨功能因果关系(NIE:1.146,95%CI:0.267-2.024,p=0.011)。总疗效为4.865(95%CI,2.709-7.029,p<0.001)。
■发现了一种因果机制,即焦虑是性别影响下颌功能的媒介。因此,女性TMD患者的治疗需要考虑心理因素。需要进一步的临床试验来探讨心理治疗是否更有利于改善女性TMD患者的颌骨功能。
UNASSIGNED: The objective of this study is to explore the relationship between sex and jaw function and to test whether anxiety mediates the causal relationship between sex and jaw function in temporomandibular disorders (TMDs) patients.
UNASSIGNED: A total of 488 participants with TMD were included in the analysis. Demographic data were collected. Generalized anxiety symptoms and anxiety severity were initially assessed using the GAD-7 questionnaire. And jaw function limitation was measured using the JFLS-8 scale. A directed acyclic graph (DAG) was used in this study to evaluate the hypotheses. Mediation analysis was conducted to explore causality and to calculate the total effect, natural direct effect (NDE) and natural indirect effect (NIE).
UNASSIGNED: In TMD patients, there was a significant association between female and jaw function (r = 0.17, p < 0.001), female and anxiety (r = 0.15, p = 0.002), anxiety and jaw function (r = 0.35, p < 0.001). In addition, sex can directly lead to differences in impaired jaw function (NDE: 3.719, 95% CI: 1.619-5.828, p < 0.001), and can also be causally related to jaw function through anxiety (NIE: 1.146, 95% CI: 0.267-2.024, p = 0.011). And the total effect was 4.865 (95% CI, 2.709-7.029, p < 0.001).
UNASSIGNED: A causal mechanism was found that anxiety acts as a mediator of sex effects on jaw function. Therefore, psychological factors need to be taken into account in the treatment of female TMD patients. Further clinical trials are needed to explore whether psychotherapy is more beneficial to improve jaw function in female TMD patients.