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中华临床医师杂志(电子版)

中华临床医师杂志(电子版) ›› 2022, Vol. 16 ›› Issue (05) : 442 -446. doi: 10.3877/cma.j.issn.1674-0785.2022.05.013

临床研究

血清维生素D及双歧杆菌水平与儿童重症龋齿的关系分析
董霞1, 杨卫国1,†(), 王明华1   
  1. 1. 266000　青岛，青岛市中医医院（市海慈医院）口腔科
  • 收稿日期:2022-02-18 出版日期:2022-05-15
  • 通信作者: 杨卫国
  • 基金资助:
    国家自然科学基金(81670979)

Relationship of serum vitamin D and Bifidobacterium levels with severe dental caries in children

Xia Dong1, Weiguo Yang1,†(), Minghua Wang1   

  1. 1. Dental Department, Qingdao Haici Hospital, Qingdao 266000, China
  • Received:2022-02-18 Published:2022-05-15
  • Corresponding author: Weiguo Yang
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董霞, 杨卫国, 王明华. 血清维生素D及双歧杆菌水平与儿童重症龋齿的关系分析[J]. 中华临床医师杂志(电子版), 2022, 16(05): 442-446.

Xia Dong, Weiguo Yang, Minghua Wang. Relationship of serum vitamin D and Bifidobacterium levels with severe dental caries in children[J]. Chinese Journal of Clinicians(Electronic Edition), 2022, 16(05): 442-446.

目的

分析维生素D及双歧杆菌水平与儿童重症龋齿的关系。

方法

回顾性分析2020年2月至2021年2月于青岛海慈医院就诊的86例龋齿患儿临床资料，按照病情严重程度分为轻症组（n=54）与重症组（n=32），另选择50健康儿童作为健康对照组。检测三组血清1，25二羟维生素D3［1，25（OH）2D3］、双歧杆菌水平、牙菌斑指数、血红蛋白（Hb）水平及平均红细胞体积（MCV）。采用Pearson相关分析考察1，25（OH）2D3、双歧杆菌水平与牙菌斑指数、Hb及MCV的相关性。绘制受试者工作特征（ROC）曲线，分析1，25（OH）2D3、双歧杆菌水平及其联合预测儿童重症龋齿发生的价值。

结果

重症组1，25（OH）2D3水平＜轻症组＜健康组，重症组双歧杆菌水平及牙菌斑指数评分＞轻症组＞健康组，差异均有统计学意义（均P＜0.05）；重症组Hb水平及MCV＜轻症组＜健康组，差异均有统计学意义（均P＜0.05）；重症龋齿患儿的维生素D与牙菌斑指数呈负相关（r=-3.762，P＜0.05），与Hb、MCV呈正相关（r=4.148、3.984，均P＜0.05），双歧杆菌水平与Hb、MCV呈负相关（r=-4.685、-3.713，均P＜0.05），与牙菌斑指数呈正相关（r=5.558，P＜0.05）。ROC曲线显示，1，25（OH）2D3、双歧杆菌水平及二者联合预测重症龋齿发生的曲线下面积（AUC）分别为0.802（95%CI：0.705~0.900）、0.724（95%CI：0.608~0.841）、0.819（95%CI：0.721~0.917）。

结论

重症龋齿患儿的维生素D水平降低，双歧杆菌水平升高，二者水平与牙菌斑指数、Hb等密切相关，且联合可有效预测重症龋齿的发生。

关键词: 龋齿, 儿童重症龋齿, 维生素D, 双歧杆菌
Objective

To analyze the relationship of vitamin D and Bifidobacterium levels with severe dental caries in children.

Methods

The clinical data of 86 children with dental caries treated at Qingdao Haici Hospital from February 2020 to February 2021 were analyzed retrospectively. According to the severity of dental caries, these children were divided into either a mild group (n=54) or a severe group (n=32). Fifty healthy children were selected as normal controls. Serum 1,25(OH)2D3, bifidobacteria level, plaque index, hemoglobin (Hb), and average erythrocyte volume (MCV) were detected. Pearson correlation analysis was performed to explore the correlation of 1,25(OH)2D3 and bifidobacteria level with plaque index, Hb, and MCV. ROC curve analysis was performed to assess the value of 1,25(OH)2D3 and bifidobacteria level, alone or in combination, in predicting severe caries in children.

Results

The 1,25(OH)2D3 level was lowest in the severe group, and it was lower in the mild group than in healthy controls (P＜0.05); Bifidobacterium level was highest in the severe group, and it was higher in the mild group than in healthy controls ( P＜0.05). Hb and MCV were lowest in the severe group, and they were higher in healthy controls than those in the mild group (P＜0.05). There was a negative correlation between vitamin D and plaque index in children with severe dental caries (r=-3.762, P＜0.05), and vitamin D was positively correlated with Hb and MCV (r=4.148 and 3.984, respectively, P＜0.05). The level of Bifidobacterium was negatively correlated with Hb and MCV (r=-4.685 and -3.713, respectively, P＜0.05), but was positively correlated with dental plaque index (r=5.558, P＜0.05). The area under the ROC curve (AUC) of 1,25(OH)2D3 and Bifidobacterium level alone in predicting severe caries was 0.802 (95%CI:0.705-0.900) and 0.724 (95%CI: 0.608-0.841), respectively; and the AUC of their combination was 0.819 (95%CI: 0.721-0.917).

Conclusion

Children with severe dental caries have reduced vitamin D levels and increased Bifidobacterium levels, and the levels of both indices are closely related to dental plaque index and Hb. The combination of vitamin D and Bifidobacterium levels can effectively predict the occurrence of severe dental caries.

Key words: Dental caries, Severe dental caries in children, Vitamin D, Bifidobacterium
表1 三组受试者维生素D、双歧杆菌水平及牙菌斑指数评分对比（
xˉ
±s）
组别 例数 1，25（OH）2D3（mmol/L） 双歧杆菌（CFU/ml） 牙菌斑指数（分）
健康组 50 86.71±10.26 6.15±1.76 1.30±0.28
轻症组 54 73.65±9.38a 18.43±4.68a 2.67±0.66a
重症组 32 61.28±6.62ab 24.14±6.92ab 3.75±1.20ab
F值 79.961 171.549 114.01
P值 ＜0.001 ＜0.001 ＜0.001
表2 三组受试者Hb及MCV对比对比（
xˉ
±s）
组别 例数 Hb（g/L） MCV（Fl）
健康组 50 124.32±7.14 92.45±6.64
轻症组 54 113.22±6.86a 78.42±7.07a
重症组 32 104.72±6.71ab 71.45±6.28ab
F值 82.071 107.082
P值 ＜0.001 ＜0.001
表3 重症龋齿患儿维生素D、双歧杆菌水平与牙菌斑指数、Hb及MCV相关性分析［r（P）］
指标 牙菌斑指数 Hb MCV
1，25（OH）2D3 -3.762（＜0.001） 4.148（＜0.001） 3.984（＜0.001）
双歧杆菌水平 5.558（＜0.001） -4.685（0.003） -3.713（＜0.001）
表4 维生素D与双歧杆菌水平预测儿童重症龋齿的预测价值分析
指标 切点值 灵敏度 特异度 约登指数 AUC 标准误 P值 95%CI
下限 上限
1，25（OH）2D3 66.645 0.796 0.758 0.554 0.802 0.050 0.000 0.705 0.900
双歧杆菌水平 20.785 0.685 0.655 0.340 0.724 0.059 0.001 0.608 0.841
联合 - 0.911 0.805 0.716 0.819 0.050 0.000 0.721 0.917
图1 维生素D、双歧杆菌水平及其联合预测儿童重症龋齿的受试者工作特征曲线
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