切换至 "中华医学电子期刊资源库"

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
引用本文:

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/OL]. 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/OL]. 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。

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.

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
表2 三组受试者Hb及MCV对比对比(
xˉ
±s
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[rP)]
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
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
1
Bargrizan M, Fekrazad R, Goudarzi N, et al. Effects of antibacterial photodynamic therapy on salivary mutans streptococci in 5- to 6-year-olds with severe early childhood caries[J]. Lasers Med Sci, 2019, 34(3):433-440. DOI: 10.1007/s10103-018-2650-2.
2
Silva MJ, Kilpatrick NM, Craig JM, et al. Genetic and early-life environmental influences on dental caries risk: a twin study[J]. Pediatrics, 2019, 143(5): e20183499. DOI: 10.1542/peds.2018-3499.
3
Bulut H, Bulut G. The relationship between obesity and dental caries according to life style factors in schoolchildren: a case-control study[J]. Acta Odontol Scand, 2020, 78(5):345-351. DOI: 10.1080/00016357.2020.1720799.
4
Coxon JD, Hosey MT, Newton JT. The impact of dental anxiety on the oral health of children aged 5 and 8 years: a regression analysis of the Child Dental Health Survey 2013[J]. Br Dent J, 2019, 227(9):818-822. DOI: 10.1038/s41415-019-0853-y.
5
Liu AQ, Zhang LS, Guo H, et al. Long-term dental intervention and laboratory examination in a patient with Vitamin D-dependent rickets type I: A case report[J]. Medicine (Baltimore), 2020, 99(41):e22508. DOI: 10.1097/MD.0000000000022508.
6
Liu AQ, Zhang LS, Guo H, et al. Long-term dental intervention and laboratory examination in a patient with Vitamin D-dependent rickets type I: A case report[J]. Medicine (Baltimore), 2020, 99(41):e22508. DOI: 10.1097/MD.0000000000022508.
7
王沪宁, 王艳, 张皓, 等. 上海市1296名3~5岁儿童龋病及其相关危险因素分析[J]. 上海口腔医学, 2020, 29(2):174-178.
8
游弋, 黄培城, 彭程纬, 等. 长沙市雨花区3~5岁儿童龋齿流行病学调查及龋活性检测[J]. 中国医师杂志, 2021, 23(8):1169-1171,1175.
9
Mitrakul K, Chanvitan S, Jeamset A, et al. Quantitative analysis of S. mutans, Lactobacillus and Bifidobacterium found in initial and mature plaques in Thai children with early childhood caries[J]. Eur Arch Paediatr Dent, 2017, 18(4):251-261. DOI: 10.1007/s40368-017-0295-7.
10
Colombo A, Tanner A. The role of bacterial biofilms in dental caries and periodontal and peri-implant diseases: a historical perspective[J]. J Dent Res, 2019, 98(4):373-385. DOI: 10.1177/0022034519830686.
11
孙琦, 彭源, 李路平. 重症龋儿童体内血红蛋白及维生素D水平变化特点及临床意义[J]. 儿科药学杂志, 2020, 26(2):4-6. DOI: 10.13407/j.cnki.jpp.1672-108X.2020.02.002.
12
Shen A, Bernabé E, Sabbah W. Severe dental caries is associated with incidence of thinness and overweight among preschool Chinese children[J]. Acta Odontol Scand, 2020, 78(3):203-209. DOI: 10.1080/00016357.2019.1679390.
13
de Jesus VC, Shikder R, Oryniak D, et al. Sex-based diverse plaque microbiota in children with severe caries[J]. J Dent Res, 2020, 99(6):703-712. DOI: 10.1177/0022034520908595.
14
郑佳雯, 郑苔菁, 刘洪宏, 等. 儿童维生素D水平与龋齿发生风险相关性的Meta分析[J]. 解放军医学杂志, 2020, 45(2):192-199. DOI: 10.11855/j.issn.0577-7402.2020.02.14.
15
杨琴秋, 付冬梅. 早期龋齿及重度龋齿儿童双歧杆菌水平对比研究[J]. 西南国防医药, 2020, 30(4):342-345. DOI: 10.3969/j.issn.1004-0188.2020.04.019.
16
Nimitphong H, Guo W, Holick MF, et al. Vitamin D inhibits adipokine production and inflammatory signaling through the vitamin D receptor in human adipocytes[J]. Obesity (Silver Spring), 2021, 29(3):562-568. DOI: 10.1002/oby.23109.
17
Onishi T, Shintani S, Wakisaka S, et al. Relationship of vitamin D with calbindin D9k and D28k expression in ameloblasts[J]. Arch Oral Biol, 2008, 53(2):117-123. DOI: 10.1016/j.archoralbio.2007.09.009.
18
Navarro C, Grgic O, Trajanoska K, et al. Associations between prenatal, perinatal, and early childhood vitamin d status and risk of dental caries at 6 years[J]. J Nutr, 2021, 151(7):1993-2000. DOI: 10.1093/jn/nxab075.
19
Wójcik D, Krzewska A, Szalewski L, et al. Dental caries and vitamin D3 in children with growth hormone deficiency: A STROBE compliant study[J]. Medicine (Baltimore), 2018, 97(8):e9811. DOI: 10.1097/MD.0000000000009811.
20
管玉蓉, 卫雅蓉, 刘茵子. 缺铁性贫血、维生素D缺乏症和儿童重症龋之间的相关性分析[J]. 中国妇幼保健, 2015, 30(29):4986-4988. DOI: 10.7620/zgfybj.j.issn.1001-4411.2015.29.24.
[1] 李午丽, 赵春晖, 孙成, 郑桂婷, 孟丹婕, 李颂. 选择性与完全去龋技术治疗恒牙深龋近髓的临床疗效比较[J/OL]. 中华口腔医学研究杂志(电子版), 2024, 18(04): 243-249.
[2] 钟佩芝, 杜宇. 龋病诊断方法的研究进展[J/OL]. 中华口腔医学研究杂志(电子版), 2024, 18(02): 73-79.
[3] 罗远杰, 杨靖梅, 孟姝, 敖逸博, 申道南. 槲皮素防治口腔疾病的研究进展[J/OL]. 中华口腔医学研究杂志(电子版), 2024, 18(02): 117-122.
[4] 张秋子, 胡利梅, 陈雅茹, 左丽, 任卫东. 维生素D水平与亚急性甲状腺炎预后的相关性研究[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(02): 217-219.
[5] 李婷, 张琳. 血清脂肪酸代谢物及维生素D水平与结直肠癌发生的关系研究[J/OL]. 中华普外科手术学杂志(电子版), 2023, 17(06): 661-665.
[6] 方道成, 胡媛媛. 钙和维生素D与肾结石形成关系的研究进展[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(06): 653-656.
[7] 白若靖, 郭军. 维生素D对肺部疾病临床意义的研究进展[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(04): 659-662.
[8] 暴静, 吴霞, 田雅萍, 尹钢. 维生素D3联合孟鲁司特钠治疗支气管哮喘对血清VEGF、TGF-β1及肺功能的影响[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(01): 63-67.
[9] 刘思含, 张静. 老年人血清铁与C 反应蛋白的比值及25-羟基维生素D3 与肾功能受损的关系研究[J/OL]. 中华肾病研究电子杂志, 2024, 13(05): 268-272.
[10] 李新星, 方晏红, 陈会振, 张蓝月, 刘涵. 维生素D与眼病关系的研究进展[J/OL]. 中华眼科医学杂志(电子版), 2023, 13(06): 366-370.
[11] 房桂彬, 肖进, 傅光涛, 郑秋坚. 老年髋部骨折患者术后1年行走能力的影响因素分析[J/OL]. 中华老年骨科与康复电子杂志, 2024, 10(05): 273-280.
[12] 韩俊岭, 王刚, 马厉英, 连颖, 徐慧. 维生素D 联合匹维溴铵治疗腹泻型肠易激综合征患者疗效及对肠道屏障功能指标的影响研究[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(06): 560-564.
[13] 周敏, 张仁清, 卢贤红. 秋泻灵联合双歧杆菌三联活菌散对轮状病毒腹泻患儿免疫功能、心肌酶和C反应蛋白的影响[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(04): 365-368.
[14] 窦丽辉, 李鹏, 窦静敏, 王贵玲. 辨证针灸联合双歧杆菌三联活菌胶囊治疗脑梗死恢复期脾胃虚弱证功能性消化不良的疗效[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(03): 218-221.
[15] 王秀, 王义国. 益生菌联合恩替卡韦治疗乙型肝炎肝硬化临床疗效的meta分析[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(02): 164-171.
阅读次数
全文


摘要