四川省11~13岁儿童龋齿与体重指数、腰围的相关性研究

孙桃兰; 严鑫淼; 卢雨航; 谭馨; 王卓; 李淼晶

doi:10.16766/j.cnki.issn.1674-4152.003306

四川省11~13岁儿童龋齿与体重指数、腰围的相关性研究

doi: 10.16766/j.cnki.issn.1674-4152.003306

1.
成都医学院公共卫生学院，四川成都 610500
2.
四川省疾病预防控制中心，四川成都 610041
3.
成都医学院大健康与智能工程学院

基金项目:

四川省卫生健康委员会科研课题 20PJ122

详细信息

通讯作者:
李淼晶，E-mail: limiaojing@aliyun.com

中图分类号: R781.1 R725.8
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- 文章访问数: 77
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- PDF下载量: 10
- 被引次数: 0
出版历程
- 收稿日期: 2023-07-11
- 网络出版日期: 2024-01-29

Correlation between caries and body mass index and waist circumference in children aged 11 to 13 in Sichuan Province

1.
School of Public Health, Chengdu Medical College, Chengdu, Sichuan 610500, China

摘要

摘要: 目的了解四川省11~13岁儿童的龋齿患病情况和肥胖现状，并探讨龋齿与体重指数、腰围的相关性，为制定儿童肥胖和龋齿的干预策略提供参考依据。方法 2021年5月—2022年3月对四川省8个城市的5 992名11~13岁常住儿童进行问卷调查、体格检查和龋齿检查，测量身高、体重，计算体重指数，根据2014年儿童青少年发育水平的综合评价标准，将研究对象分为消瘦、正常、超重或肥胖。测量并记录腰围，根据2018年国家卫生健康委员会推荐的高腰围筛查界值判断是否为中心性肥胖。采用Spearman相关分析研究体重指数、腰围与龋失补指数的相关性，非条件logistic回归分析模型分析超重肥胖、中心性肥胖与龋齿患病的关系。结果龋齿患病率为36.75%(2 202名)、超重或肥胖率为20.64%(1 237名)、中心性肥胖率为14.85%(890名)。Spearman相关分析显示体重指数和腰围均与龋失补指数呈负相关关系(均P < 0.001)。调整混杂因素后，多因素logistic回归分析显示，与超重或肥胖的儿童相比，体重指数正常(OR=1.363，95% CI：1.187~1.565)和消瘦(OR=1.652，95% CI：1.309~2.085)儿童的龋齿患病风险更高；与中心性肥胖的儿童相比，腰围正常的儿童龋齿患病风险更高(OR=1.385，95% CI：1.186~1.618)。与既不超重肥胖又无中心性肥胖的儿童相比，单纯超重肥胖儿童的龋齿患病风险降低，超重肥胖且中心性肥胖儿童的龋齿患病风险降低。结论四川省11~13岁儿童龋齿患病率较高，应进一步加强口腔干预措施；同时发现体重指数、腰围与儿童龋病呈负相关关系，超重或肥胖、中心性肥胖降低了儿童龋齿患病的风险。
- 儿童 /
- 龋齿 /
- 体重指数 /
- 腰围
Abstract: Objective To investigate the prevalence of dental caries and obesity in children aged 11-13 years in Sichuan Province, and to explore the relationship between dental caries and body mass index and waist circumference, in order to provide a reference for formulating intervention strategies for childhood obesity and dental caries. Methods From May 2021 to March 2022, a total of 5 992 permanent resident children aged 11-13 years in 8 cities in Sichuan Province were examined by questionnaire, physical examination and dental caries examination, and their height and weight were measured to calculate their body mass index. Study participants were classified as emaciated, normal, overweight or obese according to the 2014 comprehensive assessment criteria for the developmental status of children and adolescents. Waist circumference was measured and recorded to determine whether central obesity was diagnosed according to the high waist circumference screening threshold recommended by the National Health Commission in 2018. Spearman correlation analysis was used to examine the relationship between body mass index, waist circumference and caries loss and the supplementation index. Unconditional logistic regression analysis was used to analyze the relationship between overweight, central obesity and dental caries. Results The prevalence of caries was 36.75% (2 202), overweight 20.64% (1 237) and central obesity 14.85% (890). Spearman correlation analysis showed that both body mass index and waist circumference were negatively correlated with the caries loss index (all P < 0.001). After adjustment for confounders, multivariate logistic regression analysis showed that compared with overweight OR obese children, children with normal body mass index (OR=1.363, 95% CI: 1.187-1.565) and those with wasting (OR=1.652, 95% CI: 1.309-2.085) had a higher risk of dental caries. Compared to children with central obesity, children with normal waist circumference had a higher risk of dental caries (OR=1.385, 95% CI: 1.186-1.618). Compared to children who were neither overweight nor centrally obese, the risk of dental caries was reduced in overweight obese children alone and in overweight obese children with central obesity. Conclusion The prevalence of dental caries in children aged 11-13 years in Sichuan Province is high, and oral intervention measures should be further strengthened. Body mass index and waist circumference were negatively correlated with dental caries in children. Overweight or obesity and central obesity reduced the risk of caries in children.
- Children /
- Dental caries /
- Body mass index /
- Waist circumference

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表 1 四川省11~13岁儿童龋齿患病情况比较[人(%)]

Table 1. Comparison of caries prevalence among 11-13-year-old children in Sichuan Province [people(%)]

项目	人数	龋齿患病	χ²值	P值
性别
女	2 951(49.25)	1 183(40.09)	27.609	<0.001
男	3 041(50.75)	1 019(33.51)
年龄
11岁	1 410(23.54)	470(33.33)	10.650	0.005
12岁	3 949(65.90)	1 506(38.14)
13岁	633(10.56)	226(35.70)
父母最高文化程度
初中及以下	3 312(55.27)	1 214(36.65)	1.428	0.490
高中	1 983(33.09)	744(37.52)
大专及以上	697(11.63)	244(35.01)
甜品
很少/从不	1 315(21.95)	426(32.40)	18.540	<0.001
每周≤1次	1 961(32.73)	709(36.16)
每周≥2次	2 716(45.33)	1 067(39.29)
刷牙频率
并非每天都刷	711(11.87)	288(40.51)	5.540	0.063
每天刷1次	2 049(34.20)	729(35.58)
每天刷2次及以上	3 232(53.93)	1 185(36.66)
BMI
消瘦	405(6.76)	171(42.22)	31.855	<0.001
正常	4 350(72.60)	1 658(38.11)
超重或肥胖	1 237(20.64)	373(30.15)
中心性肥胖
正常	5 102(85.15)	1 933(37.89)	18.813	<0.001
肥胖	890(14.85)	269(30.22)

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表 2 四川省11~13岁儿童BMI、腰围与龋失补指数的相关性分析

Table 2. Correlation analysis of BMI, waist circumference, and caries loss index in children aged 11 to 13 in Sichuan Province

项目	龋失补指数(dmf)
项目	r值	P值
BMI	-0.050	<0.001
腰围(cm)	-0.080	<0.001

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表 3 变量赋值情况

Table 3. Status of variable assignment

变量	赋值方法
是否龋齿患病	否=0，是=1
性别	男=1，女=2
年龄	以实际值赋值
父母最高文化程度	初中及以下=1，高中=2，大专及以上=3
甜品	很少/从不=1，每周≤1次=2，每周≥2次=3
刷牙频率	并非每天都刷=1，每天刷1次=2，每天刷2次及以上=3
BMI	消瘦=1，正常=2，超重或肥胖=3
中心性肥胖	正常=1，肥胖=2
肥胖情况	无超重/肥胖和中心性肥胖=(0, 0, 0), 单纯超重/肥胖=(0, 0, 1), 单纯中心性肥胖=(0, 1, 0), 超重/肥胖且中心性肥胖=(1, 0, 0)

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表 4 四川省11~13岁儿童龋齿患病与BMI、腰围的多因素logistic回归分析模型

Table 4. Multivariate logistic regression model analyzing the relationship between caries prevalence, BMI, and waist circumference in 11-13-year-old children from Sichuan Province

项目	模型1					模型2
项目	B	SE	Wald χ²	P值	OR(95% CI)	B	SE	Wald χ²	P值	OR(95% CI)
BMI分级
消瘦	0.514	0.119	18.817	<0.001	1.672(1.326~2.110)	0.502	0.119	17.838	<0.001	1.652(1.309~2.085)
正常	0.318	0.070	20.531	<0.001	1.374(1.198~1.577)	0.310	0.070	19.352	<0.001	1.363(1.187~1.565)
是否中心性肥胖
正常	0.337	0.079	18.270	<0.001	1.401(1.200~1.634)	0.326	0.079	16.982	<0.001	1.385(1.186~1.618)
注：BMI分级以超重或肥胖参照；是否中心性肥胖以肥胖为参照。

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表 5 四川省11~13岁儿童龋齿患病与BMI、腰围协同的多因素logistic回归分析

Table 5. Multivariate logistic regression analyzing the relationship between caries prevalence, BMI, and waist circumference in 11-13-year-old children from Sichuan Province

肥胖情况	B	SE	Wald χ²	P值	OR(95% CI)
单纯超重/肥胖	-0.249	0.094	7.019	0.008	0.780(0.648~0.937)
单纯中心性肥胖	-0.196	0.137	2.044	0.153	0.822(0.628~1.076)
超重/肥胖且中心性肥胖	-0.421	0.094	20.169	<0.001	0.656(0.546~0.789)
注：以无超重/肥胖和中心性肥胖为参照。

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