Abnormal Micronutrient Intake Is Associated with the Risk of Periodontitis: A Dose-response Association Study Based on NHANES 2009-2014.
Abnormal Micronutrient Intake Is Associated with the Risk of Periodontitis: A Dose-response Association Study Based on NHANES 2009-2014.
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近年来，微量营养素摄入量与牙周炎风险之间的关系受到广泛关注。然而，大多数研究集中在它们之间的线性关系。本研究旨在探讨微量营养素摄入与牙周炎之间的剂量反应关系。共有 8959 名接受牙周检查并报告微量营养素摄入水平的参与者来自美国国家健康和营养检查调查（NHANES，2009-2014）数据库。在倾向评分匹配（PSM）后进行逻辑回归以评估微量营养素摄入与牙周炎之间的关联，并进行限制三次样条（RCS）分析以探索剂量反应关联。 PSM 之后，5530 名参与者被纳入 RCS 分析。充分摄入以下微量营养素可降低牙周炎的风险：维生素 A、维生素 B1、维生素 B2 和维生素 E。此外，过量摄入以下微量营养素会增加牙周炎的风险：维生素 B1（男性 1.8 毫克/天；女性 1.3 毫克/天）、维生素 C（男性 90 毫克/天）和铜（1.1 毫克/天，合计）。总之，维生素A、维生素B2、维生素C和铜与牙周炎之间存在线性相关性，即摄入足够的维生素A和维生素B2可能有助于降低牙周炎的患病率；相比之下，大量摄入维生素 C 和铜会增加风险。此外，还发现维生素 B1 和维生素 E 与牙周炎的发生率存在非线性剂量反应关系。在合理限度内，补充摄入有助于降低牙周炎的患病率，而过量摄入则无显着帮助，甚至可能增加风险。然而，仍应考虑健康意识等混杂因素。
The association between micronutrient intake and the risk of periodontitis has received much attention in recent years. However, most studies focused on the linear relationship between them. This study aimed to explore the dose–response association between micronutrient intake and periodontitis. A total of 8959 participants who underwent a periodontal examination, and reported their micronutrient intake levels were derived from the US National Health and Nutrition Examination Survey (NHANES, 2009–2014) database. Logistic regression was performed to evaluate associations between micronutrient intake and periodontitis after propensity score matching (PSM), and restricted cubic splines (RCS) analysis was conducted to explore the dose–response associations. Following PSM, 5530 participants were included in the RCS analysis. The risk of periodontitis was reduced with sufficient intake of the following micronutrients: vitamin A, vitamin B1, vitamin B2, and vitamin E. In addition, the risk of periodontitis was increased with excessive intake of the following micronutrients: vitamin B1 (1.8 mg/day, males; 1.3 mg/day, females), vitamin C (90 mg/day, males), and copper (1.1 mg/day, combined). In conclusion, a linear association was found between vitamin A, vitamin B2, vitamin C, and copper and periodontitis—namely, a sufficient intake of vitamin A and vitamin B2 might help reduce the prevalence of periodontitis; by contrast, a high intake of vitamin C and copper increased the risk. In addition, a nonlinear dose–response association was found for the incidence of periodontitis with vitamin B1 and vitamin E. When within reasonable limits, supplemental intake helped reduce the prevalence of periodontitis, while excessive intake did not help significantly and might even increase the risk. However, confounding factors, such as health awareness, should still be considered.