Association of periodontitis with intakes of vitamins, minerals and dietary fiber in non-smoking Japanese adults: a cross-sectional study
概要
Ꮫ ㄽ ᩥ
Association of periodontitis with intakes of vitamins,
minerals and dietary fiber in non-smoking Japanese
adults: a cross-sectional study
㸦᪥ᮏேࡢ㠀ႚ↮⪅࠾ࡅࡿࣅࢱ࣑ࣥࠊ࣑ࢿࣛࣝࠊ
㣗≀⧄⥔ࡢᦤྲྀṑ࿘⅖ࡢ㛵㐃㸸ᶓ᩿◊✲㸧
ᕷᕝ ▱⨾
ᗈᓥᏛᏛ㝔 ་ṑ⸆ಖᏛ◊✲⛉
ദ࢞՟ఖ⭍ཱྀ غޛᗣ⛉Ꮫᑓᨷ
2021 ೧ౕ
ᣦᑟᩍဨ㸸ᕝ ᾈᶞ ᩍᤵ
㸦་⣔⛉Ꮫ◊✲⛉ ཱྀ⭍⏕≀ᕤᏛ◊✲ᐊ㸧
┠ ḟ
Ϩ㸬⥴ゝ ࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭
ϩ㸬◊✲᪉ἲ ࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭
㸯㸬 ⌮ᑂᰝ࠾ࡼࡧ⌮ⓗ㓄៖
㸰㸬 ◊✲ཧຍ⪅ࡢເ㞟
㸱㸬 ཱྀ⭍ෆࡢ᳨ᰝ
㸲㸬 㣗ㄪᰝ
㸳㸬 ࡑࡢࡢㄪᰝ㡯┠
㸴㸬 ゎᯒᑐ㇟⪅ࡢᢳฟ
㸵㸬 ⤫ィゎᯒ
Ϫ㸬⤖ᯝ ࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭
㸯㸬 ᑐ㇟⪅ࡢ≉ᛶ
㸰㸬 %23 ᰤ㣴⣲ᦤྲྀ㔞ࡢ┦㛵
㸱㸬 3,6$ ᰤ㣴⣲ᦤྲྀ㔞ࡢ┦㛵
㸲㸬 3,6$ 㣗ရ⩌ูᦤྲྀ㔞ࡢ┦㛵
㸳㸬 3(6$ ᰤ㣴⣲ᦤྲྀ㔞ࡢ┦㛵
㸴㸬 3(6$ 㣗ရ⩌ูᦤྲྀ㔞ࡢ┦㛵
ϫ㸬⪃ᐹ ࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭
Ϭ㸬⤖ㄽ ࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭
ϭ㸬ཧ⪃ᩥ⊩ ࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭
Ϯ㸬ㅰ㎡ ࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭࣭
Ϩɿॻݶ
ṑ࿘ࡣࠊ⬻༞୰ 1)-3)ࡸ⢾ᒀ 4)ࠊᚰ⾑⟶ᝈ 4), 5) ࠸ࡗࡓ⅖ᛶᝈࡢࣜࢫࢡቑຍ
┦㛵ࡍࡿࡇࡀ▱ࡽࢀ࡚࠸ࡿࠋࡲࡓࠊࡇࢀࡽࡢ༴㝤ᅉᏊ࡞ࡿ⫧‶ࡶṑ࿘㛵㐃
ࡍࡿࡇࡀሗ࿌ࡉࢀ࡚࠸ࡿ
6)-10)ࠋ㏆ᖺࡢṑ࿘ᰤ㣴⣲㛵ࡍࡿ◊✲࡛ࡣࠊࣅࢱ࣑ࣥ
Cࠊβ-࢝ࣟࢸࣥࠊࣅࢱ࣑ࣥ Dࠊࣅࢱ࣑ࣥ Eࠊⴥ㓟ࠊω-3 ⬡⫫㓟࡞ࡢᦤྲྀࡀṑ࿘⅖ࢆ㍍
ῶࡉࡏࡿྍ⬟ᛶࡀ♧၀ࡉࢀ࡚࠸ࡿ 11)-17)ࠋࡉࡽࠊ㣗ࡽᦤྲྀࡉࢀࡿ࣑ࢿࣛࣝࡢ୰࡛
ࡶ≉࢝ࣝࢩ࣒࢘ࡣ㦵ࡸṑࡢᵓᡂᡂศ࡛࠶ࡾࠊṑᵴ㦵ࡢ⥔ᣢ㔜せ࡞ᙺࢆᯝࡓࡍࡇ
ࡀศࡗ࡚࠸ࡿ
17), 18)ࠋ30
ṓ๓ᚋࡢⱝ࠸ዪᛶࢆᑐ㇟ࡋࡓᶓ᩿◊✲࡛ࡣࠊ࢝ࣝࢩ࢘
࣒ᦤྲྀ㔞ࡀከ࠸ࠊṑ࿘⨯ᝈ⋡ࡢపࡉ᭷ព㛵㐃ࡋ࡚࠸ࡓࡇࡀሗ࿌ࡉࢀ࡚࠸
ࡿ 19)ࠋࡋࡋࠊ㣗ࡽᦤྲྀࡉࢀࡿᰤ㣴⣲㔞ࡣࠊ㣗ࡿᶵ⬟ࡸ⏕ά⎔ቃ࡞ᵝࠎ࡞せ
ᅉᕥྑࡉࢀࡸࡍࡃࠊࡉࡽ࡞ࡿ᳨ウࡀᚲせࡉࢀ࡚࠸ࡿࠋ࠼ࡤࠊႚ↮ࡣṑ࿘ࡢࣜ
ࢫࢡࢆቑຍࡉࡏࡿ 20)ࡔࡅ࡛࡞ࡃࠊ㣗ࡽᦤྲྀࡉࢀࡓࣅࢱ࣑ࣥ C ࡢ⏝ࢆ᪩ࡵࠊ㠀ႚ
↮⪅ࡼࡾࡶከࡃࡢࣅࢱ࣑ࣥ C ࢆᚲせࡍࡿ 21)ࠋࡲࡓࠊ⢾ᒀ࠾ࡅࡿ㧗⾑⢾≧ែࡶ㓟
ࢫࢺࣞࢫࢆ㧗ࡵࡿࡓࡵࠊࣅࢱ࣑ࣥ C ࡢᚲせ㔞ࡀ㧗ࡲࡿࡇࡀ♧၀ࡉࢀ࡚࠸ࡿ 22)ࠋࡉ
ࡽࠊṑࡀ 20 ᮏᮍ‶ࡢ⪅ࡢቑຍࡣࠊࡼࡃჶࢇ࡛㣗ࡽࢀࡿ⪅ࡢῶᑡ㛵㐃ࡋ 23)ࠊᦤྲྀ
ྍ⬟࡞㣗ᮦࡀ㝈ᐃࡉࢀࡸࡍࡃ࡞ࡿࡇ࡛ࠊṑ࿘⅖ᰤ㣴⣲ᦤྲྀ㔞ࡢ┦㛵ಀࢆṇ☜
ุ᩿ࡍࡿࡇࡀ㞴ࡋ࠸ሙྜࡀ࠶ࡿࠋࡑࡢࡓࡵࠊṑ࿘⅖ᑐࡍࡿᰤ㣴⣲ࡢᙳ㡪ࢆㄪࡿ
㝿ࡣࠊࡇࢀࡽࡢᙳ㡪ࢆ࡛ࡁࡿࡔࡅྲྀࡾ㝖ࡃᚲせࡀ࠶ࡿࠋࡲࡓࠊ⮫ᗋ⌧ሙ࡛ᑟධ
ࡀ㐍ࡵࡽࢀ࡚࠸ࡿṑ࿘࣏ࢣࢵࢺ⅖㠃✚㸦Periodontal Inflamed Surface Area 㸸PISA㸧
24)ࡣࠊ
ᚑ᮶ࡢṑ⫗⅖ᣦᩘ࡛࠶ࡿࣉ࣮ࣟࣅࣥࢢࡢฟ⾑㸦Bleeding
on Probing: BOP㸧
࡛ࡣ⾲⌧ࡋࡁࢀ࡞ࡗࡓᐃ㔞ⓗ࡞ᣦᶆࡋ࡚ࠊṑ⫗ࡢ⅖ࡢᗈࡀࡾࢆᩘ್ࡋࡓࡶ
ࡢ࡛࠶ࡿࠋPISA ⢾ᒀࢆࡣࡌࡵࡍࡿ㌟⅖ᛶᝈࡢ㛵㐃ࡀ᳨ウࡉࢀ࡚࠸ࡿࡀ
25), 26)ࠊ㣗ࡢ㛵㐃ᛶࢆㄪࡓሗ࿌ࡣࢇ࡞࠸ࠋࡑࡇ࡛ᮏ◊✲ࡣࠊṑࡀ
20 ᮏ௨
ୖ࠶ࡾࠊ⢾ᒀࡸႚ↮Ṕࡢ↓࠸᪥ᮏேࢆᑐ㇟ࡋ࡚ࠊ⩦័ⓗ࡞㣗ᦤྲྀ㔞ࡽ᥎ᐃࡋ
1
ࡓࣅࢱ࣑ࣥࠊ࣑ࢿࣛࣝࠊ㣗≀⧄⥔ࢆࡣࡌࡵࡍࡿྛ✀ᰤ㣴⣲ᦤྲྀ㔞 BOPࠊPISAࠊ࠾
ࡼࡧ࣏ࢣࢵࢺୖ⓶ࡢ⾲㠃✚㸦periodontal epithelial surface area㸸PESA㸧ࡢ㛵㐃
ࡘ࠸࡚᫂ࡽࡍࡿࡇࢆ┠ⓗࡋࡓࠋ
2
ϩ㸬᪉ἲ
㸯㸬⌮ᑂᰝ࠾ࡼࡧ⌮ⓗ㓄៖
ᮏ◊✲ࡣࠊᗈᓥዪᏛ㝔Ꮫ⌮ᑂᰝጤဨ࡛ᑂᰝࡉࢀࠊᢎㄆࢆཷࡅࡓࡶࡢ࡛࠶ࡿ
㸦ᑂᰝ␒ྕ㸸2015-6㸧
ࠋᐇ࠶ࡓࡗ࡚ࡣࠊ࣊ࣝࢩࣥ࢟ᐉゝ࠾ࡼࡧᗈᓥዪᏛ㝔Ꮫ
⌮ᑂᰝጤဨつ⛬ᚑ࠸ࠊᑐ㇟⪅◊✲ࡢ᪨ࡸ᪉ἲࢆㄝ᫂ᚋࠊྠពࢆᚓ࡚ᐇࡋ
ࡓࠋࡲࡓࠊㄪᰝྠពࡋ࡞ࡃ࡚ࡶ┈ࢆᚓ࡞࠸ࡇࡸྠពᚋ࡛ࡶྠពࢆ᧔ᅇ࡛ࡁࡿ
ࡇࢆㄝ᫂ࡋࠊྠពࡼࡿ⮬⏤ཧຍࢆཎ๎ࡋࡓࠋ
㸰㸬◊✲ཧຍ⪅ࡢເ㞟
ᑐ㇟⪅ࡢເ㞟ࡣࠊᗈᓥ┴ෆࡢṑ⛉་㝔ࢆゼၥࡋࡓᝈ⪅ᑐࡋ࡚⾜ࡗࡓࠋ◊✲ཧຍ⪅
ࡢເ㞟ሗࡣࠊ㝔ෆ࡛ࡢ࣏ࢫࢱ࣮ᥖ♧࠾ࡼࡧṑ⛉ࢫࢱࢵࣇࡼࡿኌࡅࡼࡾ⾜ࡗࡓࠋ
ཧຍࢆᕼᮃࡋࡓᝈ⪅ㄪᰝࡢෆᐜࡸ⌮ⓗ㓄៖ࡘ࠸࡚ㄝ᫂ࡋࠊྠពࢆᚓࡓ 103 ྡࡀ
◊✲ཧຍࡋࡓࠋ
㸱㸬ཱྀ⭍ෆࡢ᳨ᰝ
ཱྀ⭍ෆࡢ᳨ᰝࡣࠊṑ࿘ࢆᑓ㛛ࡍࡿṑ⛉་ࡲࡓࡣṑ⛉⾨⏕ኈࡀ⾜ࡗࡓࠋ࡚ࡢṑ
ࡘ࠸࡚ 6 Ⅼἲࡼࡾ BOPࠊࣉ࣮ࣟࣅࣥࢢ࣏ࢣࢵࢺ῝ࡉ㸦Probing pocket depth㸸
PPD㸧
ࠊࣉ࣮ࣛࢡࢥࣥࢺ࣮ࣟࣝࣞࢥ࣮ࢻ㸦PCR㸧
ࠊṧṑᩘࢆホ౯ࡋࡓࠋPISA ࠾ࡼࡧ PESA
ࡢィ⟬ࡣࠊ᪥ᮏṑ࿘Ꮫࡢ Web ࢧࢺ
27)බ㛤ࡉࢀ࡚࠸ࡿ
PISA ࠾ࡼࡧ PESA ⟬
ฟ⏝ࡢ Excel ࢩ࣮ࢺ㸦ᅗ㸯㸧ࢆ⏝࠸ࠊPPD ࠾ࡼࡧ BOP ࡢᩘ್ࢆධຊࡋ࡚⟬ฟࡋࡓࠋ
3
ᅗ㸯㸬PISA ཬࡧ PESA ࡢィ⟬⏝࢚ࢡࢭࣝࢩ࣮ࢺ 27)
㸲㸬㣗ㄪᰝ
⩦័ⓗ࡞ᰤ㣴⣲ᦤྲྀ㔞ࡣࠊ㐣ཤ 1 ࣨ᭶㛫ࡢ⩦័ⓗ࡞㣗ᦤྲྀ㔞ࢆㄪᰝࡍࡿ⡆᫆ᆺ⮬
グᘧ㣗Ṕἲ㉁ၥ⚊㸦brief-type self-administered diet history questionnaire㸸BDHQ㸧
28), 29)ࢆ⏝࠸࡚᥎ᐃࡋࡓࠋࡇࡢ
BDHQ ࡣࠊA4 ∧ࢧࢬ࡛ 4 ࣮࣌ࢪศࡢศ㔞ࡀ࠶ࡾࠊ15 ศ
⛬ᗘ࡛ᅇ⟅࡛ࡁࡿࡶࡢ࡛࠶ࡿࠋ㧗㱋⪅ࡀᅇ⟅ࡍࡿࡣ⟶⌮ᰤ㣴ኈࡼࡿࢧ࣏࣮ࢺࡀᚲせ࡞
ሙྜࡀ࠶ࡿࡀࠊࡑࢀ௨እࡢᑐ㇟⪅ࡘ࠸࡚ࡣ⮬ศ࡛ᅇ⟅࡛ࡁࡿෆᐜ࡛࠶ࡿࠋᮏ◊✲࡛ࡶᅇ
⟅ࡢࢧ࣏࣮ࢺࡀᚲせ࡞ᑐ㇟⪅ࡣࠊ⟶⌮ᰤ㣴ኈࡀᨭࡋࠊᅇ⟅ᚋࡣṇࡋࡃグධ࡛ࡁ࡚࠸ࡿ
ࢆ☜ㄆࡋࡓࠋBDHQ ࡢ㉁ၥ㡯┠ࡣࠊ᪥ᮏேࡀ୍⯡ⓗᦤྲྀࡍࡿ 58 ✀㢮ࡢ㣗ရࡢᦤྲྀ㔞
㢖ᗘࢆグධࡍࡿࡼ࠺࡞ࡗ࡚࠾ࡾࠊㄪ⌮᪉ἲࡸႴዲᛶࠊࡅࡢ⃰ࡉࠊ㣗ࡿ㏿ࡉ࡞
ࡶホ౯ࡉࢀࡿࠋᅇ⟅ࡣᑓ⏝ࡢࣇ࢛࣮࣐ࢵࢺධຊࡋࠊBDHQ ࢆᥦ౪ࡍࡿ DHQ ࢧ࣏࣮ࢺࢭ
ࣥࢱ࣮ࡀ BDHQ ࡢຍ㔜ಀᩘࢆྵࡴࢻ࣍ࢵࢡࢥࣥࣆ࣮ࣗࢱ࣮ࣝࢦࣜࢬ࣒ࢆ⏝ࡋࡓࢩ
ࢫࢸ࣒࡛ᰤ㣴⣲ᦤྲྀ㔞࠾ࡼࡧ㣗ရ⩌ูᦤྲྀ㔞ࢆィ⟬ࡋࠊ᥎ᐃ್ࢆᚓࡓࠋ
4
㸳㸬ࡑࡢࡢㄪᰝ㡯┠
᪤ Ṕࠊႚ↮≧ἣࠊṑ⛉་㝔࡛ࡢཱྀ⭍࣓ࣥࢸࢼࣥࢫࡢ᭷↓ࠊᮅ㣗ᦤྲྀ㢖ᗘࠊࢧࣉ
࣓ࣜࣥࢺࡢ⏝ࡢ᭷↓ࠊ౽≧ἣࠊ㌟㛗ࠊయ㔜࡞ࡢᑐ㇟⪅ࡢᇶᮏሗࡣၥデ⚊࠾ࡼ
ࡧ BDHQ ࡢࣇ࢙ࢫࢩ࣮ࢺࡼࡾᢕᥱࡉࢀࡓࠋ
㸴㸬ゎᯒᑐ㇟⪅ࡢᢳฟ
◊✲ྠពࡋࡓཧຍ⪅ 103 ྡࡢෆࠊṑᩘࡀ 20 ᮏᮍ‶ࠊ⢾ᒀࠊႚ↮⪅㸦㐣ཤႚ↮⪅
⌧ႚ↮⪅ࢆྵࡴ㸧ࠊྠពࡢ᧔ᅇࠊṑ࿘ࡢホ౯࠾ࡼࡧ㣗ㄪᰝ➼ࢹ࣮ࢱࡢḞⴠࡀ࠶
ࡗࡓ⪅ 42 ྡࢆ㝖እࡋࠊ22㹼90 ṓࡢ 61 ྡࡢࢹ࣮ࢱࢆゎᯒᑐ㇟ࡋࡓ㸦ᅗ㸰㸧ࠋ
Participants
N=103
Exclusion criteria 䠄N=42䠅
9
9
9
9
9
Number of teeth < 20 (N=12)
Diabetes (N=5)
Smoker䠄including ex-smoker and current smoker䠅(N=24)
Withdrawing their consent (N=3)
Missing data in the periodontal assessment or
questionnaires. ...