Vitamin D status and risk of tooth loss

描述（由申请人提供）：消除口腔健康差距和预防因牙周病和龋齿而导致的牙齿脱落是2010年健康人的中心目标。在美国，与白人相比，非裔美国人的牙齿脱落负担高得不成比例。非裔美国人维生素D不足的患病率也最高，这种情况在美国非常普遍。维生素D可能会影响牙周病和牙齿脱落的风险，因为它对骨骼的典型影响，以及它的免疫调节作用。此外，维生素D水平的巨大种族差异至少可以部分解释目前牙齿脱落的种族差异。我们的长期目标是确定维生素D在预防慢性牙周炎和牙齿脱落中的作用，目的是减少或消除口腔健康差距。本应用程序的主要目的是评估维生素D状态是否与牙齿脱落的发生率有关。拟议的流行病学研究将有效利用1986年至2004年期间卫生专业人员随访研究（HPFS）中获得的关于维生素D状况、其他健康相关变量和18年来发生的牙齿脱落的现有数据。25-羟基维生素D的血液浓度数据可用于1637名男性的子样本。此外，我们将使用已知的维生素D状态的决定因素（维生素D摄入量，种族，体力活动，体重指数和地区）来估计整个队列的长期维生素D状态，基于先前验证的预测规则。我们将测试这些维生素D水平是否与牙齿脱落的风险有关。这组卫生专业人员特别适合解决这个问题，因为牙齿脱落的自我报告非常准确，而且研究人群在牙齿脱落的社会经济决定因素方面相对均匀。由于维生素D不足和牙齿脱落的高患病率，这一建议具有重要的公共卫生意义。补充足够剂量的维生素D可能是一种简单、安全和廉价的方法，可以减少人口中牙齿脱落的总体负担，并减少牙齿脱落的种族差异。

DESCRIPTION (provided by applicant): The elimination of oral health disparities and the prevention of tooth loss due to periodontal disease and dental caries are central goals of Healthy People 2010. The burden of tooth loss in the U.S. is disproportionately high among African Americans when compared to whites. African Americans also have the highest prevalence of vitamin D insufficiency, a condition that is extremely common in the US. Vitamin D may affect the risk for periodontal disease and tooth loss through its canonical effect on bone, as well as its immuno-modulatory effects. Furthermore, the large racial disparities in vitamin D status may at least partially explain the existing racial disparities in tooth loss. Our long-term goal is to determine the role of vitamin D in the prevention of chronic periodontitis and tooth loss, with the aim of reducing or eliminating oral health disparities. The major objective of this application is to evaluate whether vitamin D status is associated with the incidence of tooth loss. The proposed epidemiologic study will make efficient use of existing data on vitamin D status, other health related variables and incident tooth loss over 18 years as previously obtained in the Health Professionals Follow-up Study (HPFS) between 1986 and 2004. Data on blood concentrations of 25-hydroxyvitamin D are available for a sub-sample 1,637 men. In addition, we will use known determinants of vitamin D status (vitamin D intake, race, physical activity, body mass index and region) to estimate long-term vitamin D status for the entire cohort, based on a previously validated prediction rule. We will test whether these measures of vitamin D status are associated with the risk of tooth loss. This cohort of health professionals is particularly suited to address this question, because self-report of tooth loss is extremely accurate and the study population is relatively homogeneous in regards to socio-economic determinants of tooth loss. This proposal has important public health implications because of the high prevalence of both vitamin D insufficiency and tooth loss. Supplementation with vitamin D at adequate doses may be a simple, safe and inexpensive means to reduce the overall burden of tooth loss in the population and to reduce racial disparities in tooth loss.