Cariological studies of individuals with long-term sorbitol consumption.
Cariological studies of individuals with long-term sorbitol consumption.
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对长期食用山梨醇的个体进行的龋齿学研究。
DOI：
10.1159/000261269
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发表时间：
1990
期刊：
影响因子：
4.2
通讯作者：
S. Edwardsson
中科院分区：
文献类型：
--
作者：
D. Birkhed;G. Svensäter;S. Edwardsson
山梨糖醇在许多产品中用作低致龋蔗糖替代物，例如口香糖和冰淇淋[Birkhed等人，1984]，研究表明，过量使用山梨糖醇甜味产品会导致牙菌斑中山梨糖醇产生的酸增加[Frostell，1965; Gülzow，1971; Mäkinen，1976; Birkhed等人，1978，1979]，菌斑和唾液中变形链球菌数量增加[Loesche et al，1984]，菌斑中发酵山梨醇的微生物总数增加[Rateitschak-Plüss和Guggenheim，1982]，其他研究表明摄入山梨醇（每日2-3次）不会促进龋齿[Bänöczy et al，1981; Glass，1983; Möller and Poulsen，1973]。有些人经常使用香草味的产品，可能会有龋齿的风险。因此，研究经常食用含山梨醇的糖果和其他食品的个体的龋齿增量和与龋齿相关的变量被认为是有意义的。参加本研究的标准如下：（1）山梨醇摄入至少2年;（2）每天至少4次定期摄入含山梨醇的产品;（3）蔗糖摄入仅限于主餐，每天两餐之间最多1-2次;（4）无疾病或药物史。从1977年到1979年，有17个人符合这四个标准。此外，还纳入了3名每天食用山梨醇产品2-3次的受试者。20例受试者中有6例在观察期内被排除，因为他们停止了含胆固醇产品的消费。因此，最终人群包括14例受试者（2例男性和12例女性）。进行基线检查，包括一般健康、药物治疗、饮食习惯（包括2天记录和访谈）的病史，由两位作者（DB和SE）同时进行的龋齿登记[Gustafsson et al.，1954年; Gröndahl等人，1977]，唾液分泌率的测定[Heintze等，1983]、体内菌斑pH [Frostell，1970]和体外菌斑悬浮液中的产酸活性[Birkhed，1978]。在大约2年后的随访检查中，重复了龋齿登记、病史和饮食访谈。此外，在这种情况下还收集唾液样品用于测定变形链球菌和乳酸杆菌计数[Gold等人，1973; Birkhed等人，1979]和在琼脂上的乙醇发酵微生物[Cornick和Bowen，1972]。其中一名受试者在13个月后接受了第三次检查。参考数据来自非选择人群的研究[Birkhed et al.，1978年; Köhler等人，1982; Hugoson等人，1986; Köhler，personal commun. j.通过皮尔逊相关系数研究变量之间的相关性。四字段表进行了测试，Fisher的精确概率检验。在检测实际值与参比物质值之间的差异时，采用配对样品的Student检验。表1中给出了每个个体的山梨醇消耗量。它持续了2到12年。计算表明，虽然与其他碳水化合物饮食（如蔗糖和淀粉）相比，参与者中山梨醇的每日摄入量较低，但产品的质地使山梨醇的暴露时间相对较长。主餐和两餐之间的次数
Sorbitol is used as a low-cariogenic sucrose substi tute in many products, such as chewing gums and lo zenges [Birkhed et al., 1984], Studies suggest that an excessive use of sorbitol-sweetened products results in an increased production of acid from sorbitol in plaque [Frostell, 1965; Gülzow, 1971; Mäkinen, 1976; Birkhed et al., 1978, 1979], an increased number of mutans streptococci in plaque and saliva [Loesche et al, 1984], and an increased total number of sorbitolfermenting microorganisms in plaque [Rateitschak-Plüss and Guggenheim, 1982], Other studies indicate that an intake of sorbitol (2-3 times daily) does not promote caries [Bänöczy et al., 1981; Glass, 1983; Möller and Poulsen, 1973]. Some people use sorbitolflavoured products often and might run a caries risk. It was, therefore, thought to be of interset to study the caries increment and variables related to dental caries in individuals with a frequent consumption of sorbi tol-containing sweets and other food products. The following criteria were set up for participation in the study:(1) sorbitol consumption for at least 2 years;(2) regular intake of sorbitol-containing prod ucts at least four times a day;(3) sucrose consumption limited to the principa'meals and to maximum 1-2 between meals per day and (4) no history of diseases or medication. From 1977 to 1979, 17 individuals were identified who fulfilled these four criteria. Fur ther, 3 persons were included who consumed sorbitol products 2-3 times a day. Six of the 20 subjects were excluded during the observation period because they stopped their consumption of sorbitol-containing products. Thus, the final population consisted of 14 subjects (2 men and 12 women). A baseline examina tion was carried out, including a case history of gen eral health, medication, dietary habits (including a 2-day record and interview), caries registration per formed simultaneously by two of the authors (DB and SE)[Gustafsson et al., 1954; Gröndahl et al., 1977], determination of salivary secretion rate [Heintze et al., 1983], plaque pH in vivo [Frostell, 1970], and acid production activity in plaque suspen sions in vitro [Birkhed, 1978]. At a follow-up exami nation, approximately 2 years later, the caries regis tration, case history, and dietary interview were re peated. Further, a saliva sample was also collected on this occasion for determination of mutans strepto cocci and lactobacilli counts [Gold et al., 1973; Birkhed et al., 1979] and of sorbitol-fermenting mi croorganisms on a sorbitol-agar [Cornick and Bowen, 1972]. One of the subjects was examined a third time after another 13 months. Reference data were re ceived from studies with nonselected populations [Birkhed et al., 1978; Köhler et al., 1982; Hugoson et al., 1986; Köhler, personal commun. j. Correlations between variables were studied by means of Pearsonian correlation coefficient. Four-field tables were tested by Fisher’s exact probability test. In testing dif ferences between actual values and values from the reference material, Student’st test for paired samples was applied.The sorbitol consumption for each individual is given in table 1. It lasted between 2 and 12 years. Cal culations showed that although the daily intake of sorbitol among the participants was low on a weight basis compared to the consumption of other carbohy drate diets, eg, sucrose and starch, the texture of the products gives a relatively long exposure time to sor bitol. The number of main meals and between meals