A LONGITUDINAL STUDY OF LEAD EXPOSURE AND DENTAL CARIES

铅暴露与龋齿的纵向研究

• 批准号: 6233005
• 负责人: GENE E WATSON
• 金额: $ 52.11万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-08-01 至 2004-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6233005
• 关键词: clinical research; dental caries; dental plaque; dentin; diet; disease /disorder prevention /control; disease /disorder proneness /risk; home health care; human subject; longitudinal human study; periodontium disorder; preventive dentistry; tooth; tooth enamel; tooth loss

The long-term goal of our research is to elucidate underlying mechanisms by which the physical and social environments result in health disparities. Our previous work has shown that the hypothesis that lead exposure is a risk factor for dental caries is plausible and could have significant public health impact, especially for individuals in impoverished circumstances (Watson et al., 1997; Moss et al., 1999). We will study dental caries risk due to environmental lead exposure in a birth cohort of 245 Cincinnati children that have been participants in the Cincinnati Lead Cohort Study since late 1979. The on-going study of 15-16 year-olds is currently in its third year of funding (R01 ES08158, Early Exposure to Lead and Adolescent Development, P.I.: K. Dietrich). This group of African-American and white Appalachian children is arguably the most well-described longitudinal cohort ever studied for prenatal and postnatal lead exposure (prenatal maternal blood lead concentration, neonatal blood lead concentration, quarterly assessments of the concentration of lead in blood from birth to 5 years and semi-annually thereafter). This cohort is unique among the major longitudinal studies of lead and child health in that a substantial number of subjects were exposed to clinically significant levels of lead during early development. Peak lead exposure in this cohort ranges from 5 to over 80 micrograms/dL. We will collect additional data specifically related to dental caries risk and perform laboratory microanalytic assessments of lead in plaque and enamel. This will allow us to test a series of hypotheses that relate environmental lead exposure to risk for dental caries development in adolescents. The work of this project will focus on four specific aims related to 1) Demonstrating the strength of the association between environmental lead exposure and risk for dental caries and ruling out alternative explanations; 2) Assessing the utility of permanent tooth enamel, deciduous tooth enamel, deciduous tooth dentin and supragingival plaque as biomarkers for lead exposure using microanalytic techniques; 3) Testing mechanistic hypotheses that show lead exposure a) reduces salivary gland function; b) acts as an effect modifer to reduce the protective effect of salivary fluoride; c) is most strongly linked to caries when measured during enamel formation; 4) Exploring more broadly the basis for oral disease disparities in disadvantaged groups by examining the interplay of lead, nutrition, and social factors.

我们研究的长期目标是阐明物理和社会环境导致健康差异的潜在机制。我们以前的工作表明，铅暴露是龋齿风险因素的假设是合理的，可能会对公众健康产生重大影响，特别是对贫困环境中的个人(Watson等人，1997年；Moss等人，1999年)。我们将研究245名辛辛那提儿童的出生队列中因环境铅暴露而导致的龋齿风险，这些儿童自1979年末以来一直参与辛辛那提铅队列研究。这项针对15-16岁青少年的正在进行的研究目前处于资助的第三年(R01 ES08158，早期铅暴露与青少年发育，P.I.：K.Dietrich)。这组非裔美国人和阿巴拉契亚白人儿童可以说是有史以来关于产前和出生后铅暴露研究最多的纵向队列(产前母亲血铅浓度、新生儿血铅浓度、从出生到5年的每季度血液铅浓度评估，以及此后每半年一次的评估)。这一队列在铅与儿童健康的主要纵向研究中是独一无二的，因为相当多的受试者在早期发育期间暴露于临床显著水平的铅。在这个队列中，铅暴露的峰值范围从5微克/分升到80微克/分升以上。我们将收集更多与龋齿风险相关的数据，并对牙菌斑和牙釉质中的铅进行实验室微量分析评估。这将使我们能够测试一系列假设，这些假设将环境铅暴露与青少年患龋齿的风险联系起来。这个项目的工作将集中在四个具体目标上：1)证明环境铅暴露与龋齿风险之间的联系强度，并排除其他解释；2)使用微量分析技术评估恒牙釉质、乳牙釉质、乳牙牙本质和牙龈上菌斑作为铅暴露的生物标志物的有效性；3)测试表明铅暴露a)降低唾液腺功能的机制假说；b)作为效应修饰剂减少唾液氟的保护作用；c)在釉质形成过程中测量与龋齿最密切的联系；4)通过检查铅、营养和社会因素的相互作用，更广泛地探索弱势群体口腔疾病差异的基础。