Lina Stangvaltaite-Mouhat, Rasa Skudutyte-Rysstad, Ólöf Anna Steingrimsdóttir, Abhijit Sen
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引用次数: 0
Abstract
Introduction: Dental caries is considered the most prevalent noncommunicable disease worldwide, while metabolic syndrome (MetS) is another noncommunicable condition with an increasing global burden. These conditions are caused by common risk factors, such as lifestyle and diet, which are shaped by overarching socioeconomic determinants. The aim of this study was to assess socioeconomic disparities in caries/MetS comorbidity.
Methods: This cross-sectional study included data from adults participating in the population-based Trøndelag Health Study (HUNT4, 2017-2019). Inclusion criteria were dentate 35 years or older participants in Oral Health Examination having records of socioeconomic determinants. Socioeconomic determinants included self-reported educational level (3 categories) and household income (3 categories). The outcome was a comorbidity of untreated caries (number of teeth with clinically and radiographically detected cavitation in dentine, D3T) and MetS (defined by the Joint Interim Statement). A modified Poisson regression analysis with robust error variances was used to estimate the prevalence ratio (PR) and the corresponding 95% confidence interval (CI). Sensitivity analyses were performed.
Results: Out of 7,347, 3,840 (52%) participants were included (55% women, the mean age of the participants 57.4 years; standard deviation 12.3). Neither dental caries nor MetS were recorded in 1,052 (27%) participants, while 887 (23%) experienced caries/MetS comorbidity. Caries/MetS comorbidity was associated with the educational level in a gradient: basic and middle educational level (vs. higher), PR 1.47 (95% CI: 1.22-1.79) and PR 1.29 (95% CI: 1.15-1.47), respectively. Income gradient was also observed: lower and medium income level (vs. higher) PR 1.46 (95% CI: 1.19-1.80) and PR 1.23 (95% CI: 1.03-1.48), respectively. The sensitivity analyses yielded results of similar strength.
Conclusion: A socioeconomic gradient was observed in caries/MetS comorbidity in adult Norwegian population. This finding supports integrated public health interventions targeting both health conditions simultaneously, particularly among populations with lower educational levels aiming to decrease overall burden of these conditions and reduce socioeconomic disparities. Oral health services should be a part of the Universal Health Coverage to reduce financial barriers to access. Further research in other contexts and longitudinal studies as well as public health intervention studies are warranted.
简介：龋齿被认为是世界上最普遍的非传染性疾病，而代谢综合征（MetS）是另一种非传染性疾病，其全球负担日益加重。这些疾病是由生活方式和饮食等共同的风险因素引起的，而这些因素又受到社会经济因素的影响。本研究的目的是评估龋齿/ met合并症的社会经济差异。方法：本横断面研究纳入了参与基于人群的Trøndelag健康研究（HUNT4, 2017-2019）的成年人数据。纳入标准为参加口腔健康检查且有社会经济决定因素记录的35岁或以上有牙齿的参与者。社会经济因素包括自我报告的教育水平（3个类别）和家庭收入（3个类别）。结果是未治疗的龋齿（临床和放射学检测到牙本质空化的牙齿数量，D3T）和MetS（由联合临时声明定义）的合并症。采用修正的泊松回归分析和稳健误差方差来估计患病率（PR）和相应的95%置信区间（CI）。进行敏感性分析。结果：7347名参与者中有3840名（52%）被纳入，其中55%为女性，参与者的平均年龄为57.4岁（标准差（SD） 12.3）。1052名（27%）参与者既没有龋齿也没有MetS，而887名（23%）参与者有龋齿/MetS合并症。龋齿/ met共病与受教育程度呈梯度相关：基础和中等受教育程度（相对较高），PR分别为1.47 （95% CI 1.22-1.79）和1.29 （95% CI 1.15-1.47）。还观察到收入梯度：低收入和中等收入水平（相对于高收入水平）的PR分别为1.46 （95% CI 1.19-1.80）和1.23 （95% CI 1.03-1.48）。敏感性分析得出了类似强度的结果。结论：挪威成年人龋齿/MetS合并症存在社会经济梯度。这一发现支持同时针对这两种健康状况的综合公共卫生干预措施，特别是在教育水平较低的人群中，旨在减少这些疾病的总体负担并缩小社会经济差距。口腔卫生服务应成为全民健康覆盖的一部分，以减少获得口腔卫生服务的财务障碍。其他背景下的进一步研究和纵向研究以及公共卫生干预研究是必要的。
期刊介绍：
''Caries Research'' publishes epidemiological, clinical and laboratory studies in dental caries, erosion and related dental diseases. Some studies build on the considerable advances already made in caries prevention, e.g. through fluoride application. Some aim to improve understanding of the increasingly important problem of dental erosion and the associated tooth wear process. Others monitor the changing pattern of caries in different populations, explore improved methods of diagnosis or evaluate methods of prevention or treatment. The broad coverage of current research has given the journal an international reputation as an indispensable source for both basic scientists and clinicians engaged in understanding, investigating and preventing dental disease.
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