5歳児の齲蝕レベルとBMI測定値との関連。子ども個人レベルでの分析と横断的多変量解析

Associations between caries levels and BMI measures among five-year-old children. Analysis and cross-sectional multi-variable analysis at individual child level.

• G M Davies
• V Copley
• J S Neville

抄録

目的:

イングランドの全国調査から得られたBMI（body mass index）と齲蝕レベルとの間の関連性の有無と方向性を、それぞれの個別の指標を用いて確立すること。

OBJECTIVES: To establish the existence and directions of any associations between measures of body mass index (BMI) with caries levels using individual measures of each as derived from national surveys in England.

方法:

2017年全国小児測定プログラムから算出された5歳児のBMIと、2016-17年PHE（Public Health England）全国歯科疫学調査から算出された齲蝕測定値を小児レベルで確実に関連付けた。う蝕レベルとBMI zスコアの個人レベルでの比較は、多変量回帰を用いて行った。

METHODS: The BMIs of five-year-old children calculated from the 2017 National Child Measurement Programme and caries measures from the 2016-17 Public Health England (PHE) National dental epidemiology survey were securely linked at a child level. Comparison at individual level of caries levels and BMI z scores was done using multivariable regression.

結果:

67,033人の子供の記録をリンクさせ、貧困層の五分位を割り当てた。BMI Zスコアのカテゴリーと齲蝕レベルとの関連が確立された。平均的なBMI（22.5％）の子どもと比較して、太りすぎ（24.4％）および非常に太りすぎ（27.6％）の子どもの齲蝕有病率は高かった。オッズ比は、太りすぎと超太りすぎの子供の有病率で1.08と1.14で統計的に有意であった。低BMIの子供は健康なBMIの子供（0.7 d₃mft、3.3 d₃mft）に比べてう蝕の重症度（1.2 d₃mft）と程度（う蝕のある子供では4.4 d₃mft）が高く、統計学的に有意な罹患率比は1.24であった。低体重児は健常児に比べてう蝕経験が多く、重症化する可能性が高かった。剥奪と民族性は交絡因子であった。

RESULTS: Records for 67,033 children were linked and allocated a deprivation quintile. An association between BMI Z score categories and caries levels was established. Caries prevalence was higher among overweight (24.4%) and very overweight (27.6%) children compared with those of average BMI (22.5%). Odds ratios were statistically significant at 1.08 and 1.14 for prevalence among overweight and very overweight children. Children of low BMI were found to have higher caries severity (1.2 d₃mft) and extent (4.4 d₃mft among those with any caries) compared to children of healthy BMI (0.7 d₃mft, 3.3 d₃mft) with statistically significant Incidence Rate Ratio of 1.24. Underweight children were more likely to have caries experience and more severe attack compared with children of healthy weight. Deprivation and ethnicity were confounding factors.

結論:

子供のBMIと齲蝕レベルの間にはいくつかの関連性があり、BMIが高い子供の齲蝕有病率が増加する。この関連性は、貧困、民族性、水のフロリデーションの関連性以上であるが、これらの要因はBMIと齲蝕の関連性の強さに影響を与えている。

CONCLUSIONS: There is some association between child BMI status and caries levels whereby caries prevalence among children of higher BMI is increased. The associations are over and above those of deprivation, ethnicity and water fluoridation individually, but these factors impact on the strength of the link between BMI and caries.

Copyright© 2020 Dennis Barber Ltd.