妊娠期糖尿病史与女性自评口腔健康之间的 关系——基于2009至2014 NHAENS数据

Relationship between History of Gestational Diabetes Mellitus and Women’s Self-Rated Oral Health—Based on NHAENS Data from 2009 to 2014

摘要: 目的：使用国家健康和营养检查调查(NHANES)的数据来评估和比较妊娠期糖尿病(GDM)史与自评口腔健康(SROH)的关系。方法：合并2009~2014年NHANES数据，纳入4767名女性。“你是否患过妊娠期糖尿病”，用来评估曾患妊娠期糖尿病的情况。自评口腔健康由自我报告确定。以年龄、性别、种族、贫困收入比、教育程度、BMI、高血压、吸烟、牙周状况、口腔自我保健、牙周治疗史作为协变量，控制潜在的混杂因素，单因素和多因素logistic回归模型用于评估妊娠期糖尿病与自评口腔健康之间的联系。结果：在4767名资料完整的女性中，自评口腔健康与是否曾经患过妊娠期糖尿病之间存在关系。调整协变量后自评口腔健康与GDM史之间分别为1.441 (95% CI 1.151~1.803, P = 0.001)、1.477 (95% CI 1.158~1.883, P = 0.002)和1.480 (95% CI 1.156~1.895, P = 0.002)。结论：在控制已知的混杂因素后，曾患妊娠期糖尿病者自评口腔健康较对照组差。有无GDM史的女性在牙周状况和口腔健康方面存在差异。结果表明了在这一群体中改善口腔保健服务的必要性。

Abstract: Aim: To evaluate and to compare the relationship between a history of gestational diabetes mellitus (GDM) and self-rated oral health (SROH) by using data from the National Health and Nutrition Examination Survey (NHANES). Methods: Based on NHANES data from 2009 to 2014, 4767 women were included in this study. “Have you ever had gestational diabetes mellitus” was a question that was used to assess whether the participants have gestational diabetes mellitus. SROH was determined by self-report. Univariate and multivariate logistic regression models were used to assess the relationship between gestational diabetes mellitus and SROH, adjusting for potential confounders, with age, sex, race, poverty income ratio, education, body mass index, hypertension, smoking, periodontal status, oral self-care, and periodontal treatment history as covariates. Results: Among the 4767 women with complete data, SROH was correlated with GDM status. After adjusting for the covariates, the correlation between SROH and history of GDM was significant (odds ratio 1.441, 95% confidence interval [CI] 1.151~1.803, P = 0.001; odds ratio 1.477, 95% CI 1.158~1.883, P = 0.002; and odds ratio 1.480, 95% CI 1.156~1.895, P = 0.002, respectively). Conclusions: After controlling for known confounders, SROH was worse in patients with previous GDM than in controls. Women with or without a history of GDM showed differences in periodontal status and oral health. The results indicate the necessity to improve oral health services in women.