饮酒与牙周炎发生风险的Meta分析

发布时间：2019-05-22 17:31

【摘要】：目的:目前有多项流行病学研究探讨了饮酒与牙周炎发生风险之间的关系,但是结论并不一致。本研究拟通过Meta分析的方法,定量综合分析多项观察性研究的结果,以探究饮酒和牙周炎发生风险之间的关系,并进一步评价饮酒量大小与牙周炎发生之间的剂量-反应关系。方法:制定检索策略及文献纳入标准,检索Pub Med、Web of Science及Embase三个数据库,获取饮酒与牙周炎发生风险关系研究的全部相关英文文献,对检索到的文献进行严格的筛选,以期获得最全面的文献。对符合标准的文献提取数据,进行Meta分析。本研究运用随机效应模型计算合并的相对危险度(Relative Risk,RR)及其95%置信区间(95%CI),使用限制性立方样条法探究剂量-反应关系。采用Q检验探讨研究间的异质性,利用I2值定量评估异质性的大小,采用敏感性分析来探讨单个研究对总的合并效应值的影响,运用漏斗图法和Egger线性回归检验法来判断是否存在发表偏倚。结果:共有17篇文献,包含18个研究,符合纳入标准。所有研究总的调查对象为90147人,包括了来自欧洲、亚洲和美洲的不同人群。在这18个研究中,横断面研究14个,队列研究4个。其中,有6个研究提供了饮酒量和牙周炎发生风险关系的数据,可以被纳入进行剂量-反应关系分析。Meta分析总的合并效应显示:饮酒与牙周炎发生风险相关,并且饮酒能够显著增加牙周炎的发生风险。相对于饮酒摄入的最低剂量,饮酒摄入的最高剂量与牙周炎发生风险的合并RR值为1.59(95%CI:1.37-1.85)。将研究对象按性别进行分析,结果显示在男性和女性人群中饮酒都是牙周炎的一个危险因素,RR值分别为1.25(95%CI:1.11-1.41)和2.15(95%CI:1.36-3.41)。亚组分析结果显示:(1)按研究设计类型分析,队列研究和横断面研究结果均表明饮酒是牙周炎发生的危险因素,其RR值分别为1.28(95%CI:1.04-1.57)和1.66(95%CI:1.39-1.99);(2)按研究对象所在大洲进行分析,亚洲、欧洲以及美洲合并分析结果也都表明饮酒能够增加牙周炎的发生风险,其RR值分别为1.45(95%CI:1.15-1.82)、1.76(95%CI:1.13-2.74)和1.76(95%CI:1.34-2.32);(3)按混杂因素中是否调整体质指数进行分析,在调整了体质指数和未调整体质指数两组中,饮酒都能够增加牙周炎的发生风险,其RR值分别为1.57(95%CI:1.29-1.90)和1.62(95%CI:1.37-1.92)。剂量-反应关系分析发现,饮酒与牙周炎发生风险之间存在线性的剂量-反应关系(P for nonlinearity=0.88),饮酒量每天每增加1克,牙周炎的发生风险将会增加0.4%。漏斗图法和Egger线性回归检验法(P=0.076)分析结果均显示饮酒与牙周炎发生风险之间不存在发表偏倚。结论:饮酒与牙周炎发生风险有关,并且饮酒是牙周炎发生的一个的危险因素。随着饮酒量的增加,牙周炎发生风险也随着增加,并存在线性的剂量-反应关系。
[Abstract]:Objective: at present, there are many epidemiological studies to explore the relationship between drinking and the risk of periodontitis, but the conclusions are not consistent. The purpose of this study was to quantitatively and comprehensively analyze the results of many observational studies by Meta analysis in order to explore the relationship between alcohol consumption and the risk of periodontitis, and to further evaluate the dose-response relationship between alcohol consumption and periodontitis. Methods: the retrieval strategy and literature inclusion standard were established, Pub Med,Web of Science and Embase databases were searched, all the relevant English literature on the relationship between drinking and periodontitis risk were obtained, and the searched literature was strictly screened. With a view to obtaining the most comprehensive literature. The data were extracted from the literature in accordance with the standard and analyzed by Meta. In this study, the combined relative risk (Relative Risk,RR) and its 95% confidence interval (95%CI) were calculated by random effect model, and the dose-response relationship was investigated by restricted cubic splicing method. Q test was used to explore the heterogeneity between the studies, I2 value was used to quantitatively evaluate the heterogeneity, and sensitivity analysis was used to explore the influence of a single study on the total combined effect value. Funnel diagram method and Egger linear regression test are used to judge whether there is publication bias. Results: there were 17 literatures, including 18 studies, which met the inclusion criteria. A total of 90147 people were surveyed, including different populations from Europe, Asia and the United States. Of these 18 studies, 14 were cross-section studies and 4 were cohort studies. Among them, six studies provided data on the relationship between alcohol consumption and the risk of periodontitis, which could be included in the dose-response relationship analysis. Meta-analysis showed that drinking was associated with the risk of periodontitis. And drinking can significantly increase the risk of periodontitis. Compared with the minimum dose of drinking, the combined RR value of the maximum dose of drinking and the risk of periodontitis was 1.59 (95%CI:1.37-1.85). The subjects were analyzed by sex, and the results showed that drinking alcohol was a risk factor for periodontitis in both men and women. The RR values were 1.25 (95%CI:1.11-1.41) and 2.15 (95%CI:1.36-3.41), respectively. The results of subgroup analysis showed that: (1) according to the design type of the study, the results of cohort study and cross-section study showed that drinking was a risk factor for periodontitis. The RR values were 1.28 (95%CI:1.04-1.57) and 1.66 (95%CI:1.39-1.99), respectively. (2) by continent, the results of combined analysis in Asia, Europe and America also showed that drinking increased the risk of periodontitis, with RR values of 1.45 (95%CI:1.15-1.82), respectively. 1.76 (95%CI:1.13-2.74) and 1.76 (95%CI:1.34-2.32); (3) according to whether the body mass index was adjusted or not, drinking could increase the risk of periodontitis in both the adjusted body mass index group and the unadjusted body mass index group. The RR values are 1.57 (95%CI:1.29-1.90) and 1.62 (95%CI:1.37-1.92), respectively. Dose-response relationship analysis showed that there was a linear dose-response relationship between alcohol consumption and the risk of periodontitis (P for nonlinearity=0.88). The risk of periodontitis increased by 0.4% for every 1 g of alcohol consumption per day. The results of funnel diagram and Egger linear regression test (P 鈮，

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