江苏省成年人群龋齿患病情况与空腹、服糖后血糖水平的零膨胀泊松回归分析

A zero-inflated Poisson regression analysis of the prevalence of dental caries,fasting plasma glucose,plasma glucose after taking sugar in Jiangsu adults

目的了解江苏地区成年人群中龋齿与糖尿病、空腹血糖(FPG)和口服75 g葡萄糖耐量试验(OGTT)2 h后血糖(2 h PG)之间的关系,为龋齿和糖尿病的防治提供理论依据。方法于2017年6月至2018年6月采用多阶段分层整群随机抽样法在江苏省3个监测点共抽取1 800名18岁及以上常住居民进行问卷调查、体格检查和实验室检测。采用Stata15软件进行秩和检验和零膨胀泊松回归分析。结果本研究共纳入1 671名符合标准的研究对象,平均年龄为(50.2±14.4)岁。其中,男性774名,女性897名。调查对象的糖尿病新检出率和龋齿患病率分别为6.22%和77.86%。新检出糖尿病组的因龋失牙数(MT)和龋失补指数(DMFT)均高于非糖尿病组,差异均有统计学意义(P<0.05)。零膨胀泊松回归分析结果显示,高FPG水平(与FPG<6.1 mmol/L者相比,6.1 mmol/L≤FPG<7.0 mmol/L人群MCR=1.124,95%CI:1.049-1.204;FPG≥7.0 mmol/L人群MCR=1.221,95%CI:1.104-1.350)、高2 h PG水平(与2 h PG<7.8 mmol/L者相比,7.8mmol/L≤2 h PG<11.1 mmol/L人群MCR=1.120,95%CI:1.059-1.184;2 h PG≥11.1 mmol/L人群MCR=1.164,95%CI:1.044-1.298)均会引起DMFT的增加,有统计学意义(P<0.01)。结论在江苏成年人群中,龋齿患病情况与糖尿病及血糖水平有关,为降低龋患率,应在糖尿病患者和血糖水平较高人群中开展口腔疾病预防保健知识宣教,养成良好的口腔卫生习惯。

Objective To understand the relationship between dental caries and diabetes,fasting plasma glucose(FPG) or plasma glucose after oral 75 g glucose tolerance test(OGTT) for 2 hours(2 h PG) in Jiangsu adults,and to provide the theory evidence for the prevention and treatment of dental caries and diabetes. Methods From June 2017 to June 2018,the multistage stratified random cluster sampling method was used to select 1 800 permanent residents (≥18 year old) from 3 monitoring points in Jiangsu Province as the subjects,the investigation was performed by questionnaire,physical examination and laboratory test. The rank sum test and zero-inflated Poisson regression analysis were used to analyze the data. The used software was Stata 15. Results A total of1 671(male:774 cases;female:897 cases) eligible subjects were included in this study. The average age of the subjects was(50.2±14.4) years old. The new detection rate of diabetes and the morbidity of dental caries in subjects were 6.22% and 77.86%,respectively. The numbers of missing tooth(MT) and decayed-missing-filled tooth(DMFT) in the newly detected diabetes group were significantly higher than those in the non-diabetic group(P<0.05).The results of zero-inflated Poisson regression analysis showed that high FPG level(compared with FPG<6.1 mmol/L,6.1 mmol/L≤FPG<7.0 mmol/L population,MCR=1.124,95%CI:1.049-1.204,FPG≥7.0 mmol/L population,MCR=1.221,95%CI:1.104-1.350),high 2 h PG level(compared with 2 h PG<7.8 mmol/L,7.8 mmol/L ≤2 h PG <11.1 mmol/L population,MCR =1.120,95% CI:1.059-1.184,2 h PG ≥11.1 mmol/L population,MCR=1.164,95%CI:1.044-1.298) will cause the significant increase in DMFT(P<0.01). Conclusion Among Jiangsu adults,the morbidity of dental caries was related to diabetes and plasma glucose level. In order to reduce the morbidity of dental caries,education on oral disease prevention and health care should be carried out among diabetic patients and residents with high plasma glucose,developing good oral hygiene habits.