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| 重症龋患儿血清VDBP VDR表达及临床意义 |
| Expression and clinical significance of serum VDBP and VDR in children with severe caries |
| 投稿时间：2022-11-18 |
| DOI：10.3969/j.issn.1000-0399.2023.06.006 |
| 中文关键词: 重症龋 维生素 D 结合蛋白 维生素 D 受体 龋失补指数 |
| 英文关键词: Severe caries Vitamin D-binding protein Vitamin D receptor Caries depletion index |
| 基金项目:南京市科学技术局（编号：BE2021609） |
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| 中文摘要: |
| 目的 探讨重症龋患儿血清维生素D结合蛋白(VDBP)、维生素D受体(VDR)表达及临床意义。方法 选取2020年6月至2022年6月在南京大学医学院附属口腔医院接受治疗的113例龋齿患儿作为研究对象,根据龋齿严重程度,分为非重症组(n=72)和重症组(n=41)。采用酶联免疫吸附法检测血清VDBP、VDR水平。采用Pearson相关分析探讨龋齿患儿血清VDBP、VDR水平与龋失补指数(DMFT)的关系,采用受试者工作特性曲线评估血清VDBP、VDR对重症龋的诊断价值,多因素logistic回归分析探讨影响重症龋发生的危险因素。结果 非重症组患儿血清VDBP、VDR水平高于重症组,DMFT低于重症组(P<0.05)。Pearson相关分析显示,龋齿患儿血清VDBP、VDR水平与DMFT呈负相关(r=-0.713、-0.604,均P<0.05)。血清VDBP、VDR诊断重症龋的曲线下面积(AUC)分别为0.871、0.829,截断值分别为11.01 ng/mL、16.76 ng/mL,特异度分别为67.52%、53.20%,敏感度分别为93.12%、93.12%,二者联合诊断的AUC为0.908,特异度为85.21%,敏感度为86.25%。两组患儿每天刷牙次数、定期去口腔科检查、吃甜食频率、家长口腔健康意识比较,差异有统计学意义(P<0.05)。多因素logistic回归分析显示,没有定期去口腔科检查、吃甜食频率≥ 2次/天、VDBP ≤ 11.01 ng/mL、VDR ≤ 16.76 ng/mL均是发生重症龋的危险因素(P<0.05)。结论 血清VDBP、VDR水平在重症龋患儿中明显降低,VDBP联合VDR检测对临床诊断重症龋发生具有重要意义。 |
| 英文摘要: |
| Objective To explorethe expression and clinical significance of serum vitamin D binding protein(VDBP) and vitamin D receptor(VDR) in children with severe caries. Methods A total of 113 children with dental caries who received treatment in Dental Hospital of Affiliated Hospital of Nanjing University School of Medicine from June 2020 to June 2022 were selected as the research objects, and were divided into non-severe group (n=72) and severe group(n=41) according to the severity of dental caries.Enzyme-linked immunosorbent assay was employed todetect the serum VDBP and VDR levels.Pearson correlation analysis was used to investigate the relationship between serum VDBP and VDR levels and caries loss and complement index(DMFT) in children withdentalcaries.ROC was used to evaluate the diagnostic value of serum VDBP and VDR for severe caries.Multivariate logistic regression was applied to explore the risk factors affecting the occurrence of severe caries. Results The serum VDBP and VDR levels in the non-severe group were higher than those in the severe group,and DMFT was lower than that in the severe group(P<0.05).Pearson correlation analysis showed that serum VDBP and VDR levels were negatively correlated with DMFT in children with dental caries(r=-0.713, -0.604, both P<0.05). The AUC(95%CI) of serum VDBP and VDR for the diagnosis of severe caries was 0.871(0.821～0.921) and 0.829(0.779～0.879), respectively, the cut-off valueswere 11.01ng/mL, 16.76ng/mL, the specificity was 67.52%, 53.20%, respectively, and the sensitivity was 93.12%, 93.12%. The AUC of the combined diagnosis was 0.908, the specificity was 85.21%,and the sensitivity was 86.25%.There were significant differences in the number of times of daily brushing,regular visits to the dental department,frequency of eating sweets,and parents' oral health awareness in the non-severe group and the severe group(P<0.05).No regular dental checkups(OR=2.375,95%CI:1.586～3.556),frequency of eating sweets≥2 times/d(OR=2.568,95%CI:1.685～3.913),VDBP≤11.01ng/mL (OR=3.343, 95%CI: 2.044～5.468) and VDR≤16.76 ng/mL(OR=2.762, 95%CI: 1.781～4.285) were risk factors for severe caries(P<0.05). Conclusions Serum VDBP and VDR levels are significantly lower in children with severe caries.The detection of VDBP combined with VDR is of great significance for the clinical diagnosis of severe caries. |
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