神经发育障碍儿童青少年地中海膳食评分与龋患的关联

熊文娟; 苏媛媛; 刘钊; 黄晓庆; 曲之毅; 崔杉杉

doi:10.16835/j.cnki.1000-9817.2025037

神经发育障碍儿童青少年地中海膳食评分与龋患的关联

doi: 10.16835/j.cnki.1000-9817.2025037

1.
天津医科大学公共卫生学院，天津 300070
2.
首都医科大学公共卫生学院

基金项目:

国家自然基金项目 82273655

北京市教委科技课题 KM202410025026

详细信息

作者简介:
熊文娟(1994-)，女，江西南昌人，博士，讲师，主要研究方向为儿童少年卫生及妇幼保健

通讯作者:
崔杉杉，E-mail: cuishanshan@ccmu.edu.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R748 R153.2 R788^+.1
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- 被引次数: 0
出版历程
- 收稿日期: 2024-08-02
- 修回日期: 2024-09-23
- 网络出版日期: 2025-03-05
- 刊出日期: 2025-02-25

Association between Mediterranean diet scores and dental caries among children and adolescents with neurodevelopmental disorders

1.
School of Public Health, Tianjin Medical University, Tianjin (300070), China

摘要

摘要: 目的探究神经发育障碍(NDD)儿童青少年地中海膳食(MD)模式与龋患的关联，为制定科学的NDD儿童青少年饮食相关防龋策略提供依据。方法 2021年12月—2024年6月，从天津市9所特殊教育学校及康复机构招募147名2~22岁NDD儿童青少年进行问卷调查、3 d 24 h膳食回顾调查、口腔健康检查、体格发育测量及儿童青少年孤独症评定量表(CARS)评估。组间比较采用Mann-Whitney U检验、χ²检验或Fisher确切概率法；采用多元线性回归分析和限制性立方样条分析儿童青少年膳食质量与龋患的关联。结果 NDD儿童青少年中，未患龋组46名(31.3%), 患龋组101名(68.7%)，龋失补指数为2.0(4.0)，MD评分为4.0(2.0)分，MD低分组儿童青少年62名(42.2%)，高分组85名(57.8%)。未患龋组与患龋组NDD儿童青少年MD评分差异无统计学意义[未患龋组：4.0(2.0)，患龋组：4.0(2.0)，Z=-0.14，P>0.05]。儿童青少年MD评分与龋失补指数存在先上升后下降趋势(P_总体=0.02，P_非线性=0.04)，MD高分组NDD儿童青少年较MD低分组龋失补指数低(β=-2.00，95%CI=-3.39~-0.62，P < 0.05)；但在CARS得分≥30分的NDD儿童青少年中，MD模式与龋失补指数的关联无统计学意义(β=-0.63，95%CI=-0.29~0.15，P>0.05)。结论饮食模式接近地中海膳食模式的NDD儿童青少年龋患率更低，尤其是无孤独症谱系障碍症状或症状较轻的NDD儿童青少年。
- 神经发育障碍 /
- 膳食, 地中海 /
- 龋齿 /
- 回归分析 /
- 儿童 /
- 青少年
Abstract: Objective To explore the association between mediterranean diet (MD) patterns and dental caries among children and adolescents with neurodevelopmental disorders (NDD), so as to provide a basis for developing scientific anti-caries strategies related to diet. Methods From December 2021 to June 2024, a questionnaire survey, a three-day 24-hour dietary review survey, oral health examination, physical development measurement and Childhood Autism Rating Scale (CARS) evaluation were conducted involving 147 children and adolescents aged 2-22 years with NDD from nine special education schools and rehabilitation institutions in Tianjin. Group comparisons were carried out using the Mann-Whitney U test, Chi-square test, or Fisher's exact probability method. The correlation between dietary quality and dental caries was analyzed by adopting multiple linear regression analysis and restricted cubic spline. Results There were 46 children and adolescents (31.3%) in the non-dental caries group and 101 children and adolescents (68.7%) in the dental caries group. The number of decayed missing and filled teeth (dmft) was 2.0 (4.0), and the MD score was 4.0 (2.0) points. There were 62 children and adolescents (42.2%) in the low MD scores group and 85 children and adolescents (57.8%) in the high MD scores group. There was no significant difference in MD scores between NDD children in the non-dental caries group and those in the dental caries group [non-dental caries group: 4.0(2.0), dental caries group: 4.0(2.0), Z=-0.14, P>0.05]. The MD scores and dmft exhibited increasing and then decreasing trend (P_total=0.02, P_non-lineary=0.04). Children and adolescents with NDD in the MD high scores group had a lower number of dmft than those in the MD low scores group (β=-2.00, 95%CI=-3.39 to -0.62, P < 0.05). However, in children and adolescents with NDD and CARS scores ≥30, the above association was insignificant (β=-0.63, 95%CI=-0.29-0.15, P>0.05). Conclusions Children and adolescents with NDD who have dietary patterns similar to the Mediterranean diet, are found to have fewer dental caries, and this is observed among those with no or mild symptoms of autism spectrum disorder.
- Neurodevelopmental disorders /
- Diet, Mediterranean /
- Dental caries /
- Regression analysis /
- Child /
- Adolescent
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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图 1 神经发育障碍儿童青少年地中海膳食得分与龋失补指数的剂量反应关系

Figure 1. Dose-response relationship between mediterranean dietary scores and decayed missing and filled teeth in neurodevelopmental disorders children and adolescents

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表 1 NDD儿童青少年人口学特征构成在患龋组与未患龋组间比较

Table 1. Comparison of the composition for demographic characteristics among NDD children and adolescents between caries group and non-caries group

组别	选项	未患龋组(n=46)	患龋组(n=101)	χ²值	P值	组别	选项	未患龋组(n=46)	患龋组(n=101)	χ²值	P值
性别	男	37(80.4)	71(70.3)	1.67	0.20	家庭月收入/元	< 5 000	16(34.8)	60(59.4)	8.56	0.01
	女	9(19.6)	30(29.7)				5 000~10 000	19(41.3)	30(29.7)
民族	汉族	40(87.0)	93(92.1)	0.96	0.33		> 10 000	11(23.9)	11(10.9)
	少数民族	6(13.0)	8(7.9)			夜间睡前进食甜品频率	经常	0	5(5.0)	2.52	0.26^a
独生子女	是	22(47.8)	49(48.5)	0.01	0.94		偶尔	18(39.1)	44(43.6)
	否	24(52.2)	52(51.5)				从不	28(60.9)	52(51.5)
出生6个月内喂养方式	母乳喂养	24(52.2)	52(51.5)	1.60	0.46	刷牙起始年龄/岁	≤3	18(39.1)	40(39.6)	0.01	1.00
	混合喂养	13(28.3)	21(20.8)				4~6	19(41.3)	42(41.6)
	人工喂养	9(19.6)	28(27.7)				> 6	9(19.6)	19(18.8)
CARS得分	< 30	21(45.7)	53(52.5)	1.02	0.65	刷牙频率	每天	36(78.3)	81(80.2)	1.04	0.91
	30~36	16(34.8)	27(26.7)				经常	7(15.2)	15(14.9)
	> 36	9(19.6)	21(20.8)				偶尔	2(4.3)	2(2.0)
父亲文化程度	大专及以上	23(50.0)	35(34.7)	3.08	0.20^a		从不	1(2.2)	3(3.0)
	初中或高中	20(43.5)	58(57.4)			使用(含氟)牙膏	是	41(89.1)	93(92.1)	0.34	0.56
	小学及以下	3(6.5)	8(7.9)				否	5(10.9)	8(7.9)
母亲文化程度	大专及以上	22(47.8)	41(40.6)	0.81	0.67^a	定期口腔检查	是	42(91.3)	86(85.1)	1.06	0.43
	初中或高中	21(45.7)	50(49.5)				否	4(8.7)	15(14.9)
	小学及以下	3(6.5)	10(9.9)
注：()内数字为构成比/%；^a表示Fisher确切概率法。

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表 2 患龋与未患龋NDD儿童青少年每日膳食摄入情况比较[M(IQR)]

Table 2. Comparison of dietary intake every ady among NDD children and adolescents between caries group and non-caries group[M(IQR)]

组别	人数	能量/kcal	谷薯类/g	蔬菜类/g	水果类/g	畜禽肉/g	水产类/g	蛋类/g	奶及奶制品/g	大豆及坚果/g	MD评分
未患龋组	46	1 236.0(592.0)	283.3(198.1)	121.7(100.3)	68.3(161.3)	92.9(93.0)	0.0(14.4)	37.1(44.2)	5.9(173.3)	0.0(11.3)	4.0(2.0)
患龋组	101	1 162.0(695.0)	279.7(213.3)	103.3(96.3)	50.0(116.7)	78.3(90.2)	0.0(16.7)	33.3(50.7)	13.3(133.3)	3.5(20.0)	4.0(2.0)
合计	147	1 196.0(647.0)	279.7(206.6)	113.3(97.5)	53.3(133.3)	83.3(90.0)	0.0(16.7)	33.8(43.8)	11.7(133.3)	0.0(18.3)	4.0(2.0)
Z值		-0.92	-0.82	-0.56	-1.24	-0.60	0.16	-1.21	-0.27	0.15	-0.14
P值		0.36	0.42	0.58	0.22	0.55	0.88	0.23	0.79	0.88	0.89
注：1 kcal=4.18 kJ。

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