目的:新的证据表明牙周炎与饮食选择之间存在双向关系,因此,营养。本研究旨在评估牙周炎分期之间的潜在因果关系,功能齿单元(FTU)的损失,咀嚼功能,和不同食物组的摄入量使用路径分析。
方法:一名单一校准的检查者确定了241名报告牙齿更换的中国受试者的连续样本的牙周炎阶段。通过双色口香糖的混合能力来量化它们的咀嚼功能。经过验证的食物频率问卷用于由经验丰富的校准评估者计算33种食物的摄入量。在验证假设后,使用Amos23进行视觉结构方程建模。在NHANES数据库的9043名受试者中评估了结果的一致性和年龄的潜在改变效应。
结果:以牙周炎分期和年龄为外源性因素,建立了非常显著的模型。牙周炎分期诊断显着影响后部FTU的数量和口腔健康相关的生活质量(OHRQoL,路径系数[PC]分别=-0.55和-0.20,p<.05)。在模型中,FTUs对OHRQoL也有独立影响(PC=0.23,p<0.05)。FTU确定咀嚼功能水平(PC=-0.38,p<0.05),这反过来又影响蔬菜的摄入量,而不是水果或肉类的摄入量(PC=-0.18,p<.0.5,PC=0.06,NS和PC=0.11,NS,分别)。年龄对蔬菜和肉类摄入量的影响显着,并且与牙周炎分期诊断相关。对NHANES数据库的分析证实了牙周炎对18-44、45-60和>60岁年龄组的咬合对数量和蔬菜消费的负面影响。
结论:牙周炎显示出影响跨文化和年龄组蔬菜摄入的潜在因果途径。影响的大小可能具有临床和公共卫生意义。其他研究,包括干预试验,需要测试这种将口腔健康与营养联系起来的潜在机制。
OBJECTIVE: Emerging evidence points to a two-way relationship between periodontitis and dietary choices and, thus, nutrition. This study aimed to assess the potential cause-effect relationship between the periodontitis stage, loss of functional tooth units (FTUs), masticatory function, and intake of different food groups using path analysis.
METHODS: A single calibrated examiner determined the periodontitis stage of a consecutive sample of 241 Chinese subjects reporting for tooth replacement. Their masticatory function was quantified by the mixing ability of a two-colour chewing gum. Validated food frequency questionnaires were used to calculate the intake of 33 food group items by an experienced calibrated rater. After verification of assumptions, visual structural equation modeling was performed with Amos 23. The consistency of results and the potential modifying effect of age were assessed in 9043 subjects from the NHANES database.
RESULTS: Highly significant models were constructed using periodontitis stage and age as exogenous factors. Periodontitis stage diagnosis significantly affected the number of posterior FTUs and oral health-related quality of life (OHRQoL, path coefficient [PC] = -0.55 and -0.20, p < .05, respectively). In the model, FTUs also had an independent effect on OHRQoL (PC = 0.23, p < .05). FTUs determined the level of masticatory function (PC = -0.38, p < .05), which in turn affected vegetable intake but not fruit or meat intake (PC = -0.18, p < .0.5, PC = 0.06, NS and PC = 0.11, NS, respectively). The effect of age was significant for vegetable and meat intake and was also correlated with periodontitis stage diagnosis. Analysis of the NHANES database confirmed the negative impact of periodontitis on the number of occluding pairs and vegetable consumption for the 18-44, 45-60 and >60 age groups.
CONCLUSIONS: Periodontitis showed a potential cause-effect pathway affecting vegetable intake across cultures and age groups. The size of the effect is potentially of clinical and public health significance. Additional studies, including intervention trials, are required to test this potential mechanism linking oral health to nutrition.