Salivary stress biomarkers and anxiety symptoms in children with and without temporomandibular disorders.
Salivary stress biomarkers and anxiety symptoms in children with and without temporomandibular disorders.
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DOI：
10.1590/1807-3107bor-2017.vol31.0078
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发表时间：
2017-09-28
影响因子：
2.5
通讯作者：
Castelo, Paula Midori
中科院分区：
文献类型：
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作者：
Kobayashi, Fernanda Yukie;Gaviao, Maria Beatriz Duarte;Castelo, Paula Midori
颞下颌紊乱（TMD）的病因被认为是一种异质性的心理生理障碍，在临床牙科中一直是一个有争议的问题。本研究旨在评估患有和非TMD儿童的唾液α -淀粉酶（sAA）、皮质醇水平和焦虑症状是否存在差异。最初，在公立学校筛选了316名年轻受试者（非参考样本）；选取年龄在7-14岁之间的76名受试者，分为TMD组和对照组，每组38名受试者按性别、年龄和有无睡眠磨牙症进行匹配。采集4份唾液样本：醒来时、醒来后30分钟和1小时（禁食）以及夜间（晚上8点），每隔2天采集一次，以检测皮质醇和sAA的昼夜变化。使用儿童多维焦虑量表（masc -巴西版）筛选焦虑症状。采用Shapiro-Wilk检验、Student’st检验/Mann-Whitney U检验和相关检验进行数据分析。TMD组唾液皮质醇曲线下面积（AUCG均值±SD = 90.22±63.36 * 94.21±63.13 g/dL/min）、sAA AUCG均值±SD = 2544.52±2142.00 * 2054.03±1046.89 U/mL/min)与对照组比较差异均无统计学意义（p < 0.05）；然而，临床组在社交焦虑领域（t = 3.759, CI = 2.609, 8.496）、分离/恐慌（t = 2.243, CI = 0.309, 5.217）、躯体症状（U = 433.500）、MASC总分（t = -3.527, CI = -23.062, -6.412）存在差异，检验幂为bbb80 %，效应量大（d = 0.80）， MASC总分、皮质醇、sAA水平之间无显著相关性。虽然患有TMD的儿童在焦虑症状上得分较高，但在有TMD和没有TMD的儿童之间的唾液应激生物标志物上没有观察到差异。
The etiology of temporomandibular disorders (TMD), which are considered as a heterogeneous group of psychophysiological disturbances, remains a controversial issue in clinical dentistry. This study aimed to evaluate whether the salivary alpha-amylase (sAA), cortisol levels, and anxiety symptoms differ between children with and without TMD. Initially, 316 young subjects were screened in public schools (nonreferred sample); 76 subjects aged 7-14 years were selected and comprised the TMD and control groups with 38 subjects each matched by sex, age, and the presence/absence of sleep bruxism. Four saliva samples were collected: upon waking, 30 min and 1 h after awakening (fasting), and at night (at 8 PM) on 2 alternate days to examine the diurnal profiles of cortisol and sAA. Anxiety symptoms were screened using the Multidimensional Anxiety Scale for Children (MASC-Brazilian version). Shapiro-Wilk test, Student's t-test/Mann-Whitney U test, and correlation tests were used for data analysis. No significant differences were observed in the salivary cortisol area under the curve (AUCG mean ± SD = 90.22 ± 63.36 * 94.21 ± 63.13 g/dL/min) and sAA AUCG (mean ± SD = 2544.52 ± 2142.00 * 2054.03 ± 1046.89 U/mL/min) between the TMD and control groups, respectively (p > 0.05); however, the clinical groups differed in social anxiety domain (t = 3.759; CI = 2.609, 8.496), separation/panic (t = 2.243; CI = 0.309, 5.217), physical symptoms (U = 433.500), and MASC total score (t = -3.527; CI = -23.062, -6.412), with a power of the test >80% and large effect size (d = 0.80), with no significant correlation between the MASC total score, cortisol, and sAA levels. Although children with TMD scored higher in anxiety symptoms, no difference was observed in the salivary stress biomarkers between children with and without TMD.