背景:牙周炎的发病机制可能与宿主介导的口腔微生物菌斑积聚引起的炎症和免疫反应有关。营养素具有抗炎和促炎能力。抗氧化剂和微量营养素的饮食摄入与饮食的炎症负担有关。复合饮食抗氧化指数(CDAI)是评估饮食抗氧化特性的综合指数,与牙周炎的关系尚不清楚。本研究的目的是探讨牙周炎与CDAI之间的关系。
方法:该研究是一项横断面设计,包括来自2009-2014年国家健康与营养调查(NHANES)数据库的7471名参与者。根据相关标准将参与者分为实验组和对照组,其中对照组包括无/轻度牙周炎的参与者(包括3,646名参与者),实验组包括中度/重度牙周炎的参与者(包括3,825名参与者).首先,比较两组参与者的基线特征22.采用加权logistic回归分析探讨牙周炎与CDAI的关系。并采用约束三次样条对二者之间的线性关系进行评价。最后,亚组分析用于评估模型稳定性.
结果:两组参与者之间的年龄差异具有统计学意义,性别,种族,教育,家庭收入与贫困的比率(PIR),体重指数(BMI),吸烟状况,饮酒状况,和糖尿病的患病率。CDAI,作为连续变量,未发现与牙周炎显著相关。根据四分位数将CDAI转换为分类变量。在模型1中,与最低四分位数组的参与者相比,第二和第三四分位数组的参与者患牙周炎的风险较低(OR(95CI):0.81(0.681,0.963),P=0.021;OR(95CI):0.811(0.691,0。951),分别为P=0.014;)。在模型2中,第二个的参与者,第三,与最低四分位数组相比,第四四分位数组发生牙周炎的风险较低(OR(95CI):0.803(0.66,0.978),P=0.0349;或(95CI):0.753(0.632,0.897),P=0.0028;OR(95CI):0.753(0.617,0.92),分别为P=0.0083;)。CDAI与牙周炎之间存在非线性关系(p非线性=0.0055),拐点出现在CDAI等于0.6342处。
结论:在美国成年人中,CDAI与牙周炎之间存在非线性关系。然而,我们仍需要进一步的前瞻性研究来验证我们的结果.
BACKGROUND: The pathogenesis of periodontitis may be related to host-mediated inflammatory and immune responses caused by accumulation of oral microbial plaque. Nutrients have anti-inflammatory and pro-inflammatory capabilities. Dietary intake of antioxidants and micronutrients is associated with the inflammatory burden of the diet. The Composite Dietary Antioxidant Index (CDAI) is a composite index for assessing the antioxidant properties of a diet and the relationship with periodontitis is unclear. The aim of this study was to investigate the relationship between periodontitis and CDAI.
METHODS: The study was a cross-sectional design and included 7471 participants from the National Health and Nutrition Examination Survey (NHANES) 2009-2014 database. Participants were divided into experimental and control groups according to the relevant criteria, where the control group consisted of participants with no/mild periodontitis (including 3646 participants) and the experimental group consisted of participants with moderate/severe periodontitis (including 3825 participants). First, baseline characteristics 22 of the two groups of participants were compared. Weighted logistic regression analyses was used to explore the relationship between periodontitis and CDAI. And the linear relationship between the two was assessed using restricted cubic spline. Finally, subgroup analyses was used to assess model stability.
RESULTS: Differences between the two groups of participants were statistically significant in age, gender, race, education, ratio of household income to poverty(PIR), body mass index(BMI), smoking status, drinking status, and prevalence of diabetes. CDAI, as a continuous variable, was not found to be significantly associated with periodontitis. The CDAI was converted to categorical variables according to quartile. In model1, participants in the second and third quartile groups had a lower risk of developing periodontitis compared with participants in the lowest quartile group(OR(95%CI):0.81(0.681,0.963),P=0.021;OR(95%CI):0.811(0.691,0. 951),P=0.014;respectively). In model2, participants in the second, third, and fourth quartile groups had a lower risk of developing periodontitis compared to the lowest quartile group(OR(95%CI):0.803(0.66,0.978),P=0.0349;OR(95%CI):0.753( 0.632, 0.897),P=0.0028;OR(95%CI):0.753(0.617,0.92),P=0.0083;respectively). There was a non-linear relationship between CDAI and periodontitis (p non-linearity = 0.0055), with the inflection point occurring at a CDAI equal to 0.6342.
CONCLUSIONS: There is a nonlinear relationship 44 between CDAI and periodontitis in US adults. However, further prospective studies are still needed to validate our results.