中国实用口腔科杂志

中国实用口腔科杂志 ›› 2026, Vol. 19 ›› Issue (4): 446-450.DOI: 10.19538/j.kq.2026.04.010

• 论著 • 上一篇    下一篇

绝经后妇女血清雌二醇与25-羟基维生素D缺乏对牙周健康影响研究

李    慧，赵宏宠，齐    迹，刘    昕，杜子龙   

  1. 北京市密云区医院口腔科，北京 101500
  • 出版日期:2026-07-30 发布日期:2026-07-30
  • 基金资助:
    北京市密云区医院科研基金（2023-001）

  • Online:2026-07-30 Published:2026-07-30

摘要： 目的    研究绝经后妇女血清雌二醇（estradiol，E2）与25-羟基维生素D［25-hydroxyvitamin D，25（OH）D］缺乏对牙周健康的影响，为临床评估与多学科管理提供参考。方法    选取2024年5月至2025年7月于北京市密云区医院健康管理中心体检的绝经后妇女80例。经血清学检测，将所有研究对象依据血清E2浓度（≥ 30 pmol/L记为高E2，< 30 pmol/L记为低E2）和血清25（OH）D质量浓度（≥ 20 μg/L记为高VD，< 20 μg/L记为低VD）分为高E2高VD组（20例）、高E2低VD组（25例）、低E2高VD组（12例）、低E2低VD组（23例）。收集一般资料（年龄、身高、体质量）、绝经年龄、绝经年限、受教育程度、月收入、牙石清洁史等项目信息，并行口腔卫生不良评分、牙周临床检查，记录探诊深度（probing depth，PD）、临床附着丧失（attachment loss，AL）、出血指数（bleeding index，BI）和缺牙数（第三磨牙除外）。结果    4组一般资料比较，差异均无统计学意义（均P > 0.05）。4组PD、AL、BI和缺牙数比较，差异均有统计学意义（均P < 0.05）；其中，低E2低VD组以上4项指标均大于高E2高VD组和低E2高VD组，其AL、BI和缺牙数还大于高E2低VD组，差异均有统计学意义（均P < 0.05）。两因素析因设计资料的方差分析结果显示，血清E2浓度和血清25（OH）D质量浓度的高、低2个水平间AL比较，差异均有统计学意义（均P < 0.05）；未发现两因素存在显著交互作用（P = 0.060）。多元线性回归分析结果显示，高E2、高VD、有牙石清洁史与较小的AL相关，年龄增长、口腔卫生不良评分增加与AL增加相关（均P < 0.05），其他项目不是AL的独立影响因素；回归模型校正R2 = 0.418，F =7.065，P < 0.001。结论    绝经后妇女血清E2与25（OH）D共同缺乏对牙周健康产生不利影响，需规范其口腔卫生行为，加强口腔卫生宣教，并探索口腔科与妇科、内分泌科等多学科协作管理模式。

关键词: 绝经, 雌二醇, 25-羟基维生素D, 牙周健康, 多学科管理

Abstract: Objective    To investigate the effect of serum estradiol（E2）and 25-hydroxyvitamin D ［25（OH）D］ deficiency on periodontal health in postmenopausal women，and to provide references for clinical evaluation and multidisciplinary management. Methods    A total of 80 postmenopausal women who underwent health examinations at the Health Management Center of Beijing Miyun District Hospital from May 2024 to July 2025 were enrolled. Based on serological testing，participants were divided into four groups according to serum E2 concentration（high E2 ≥ 30 pmol/L，low E2 < 30 pmol/L）and serum 25（OH）D concentration（high VD ≥ 20 μg/L，low VD < 20 μg/L）：high E2/high VD group（n = 20），high E2/low VD group（n = 25），low E2/high VD group（n = 12），and low E2/low VD group（n = 23）. General data（age，height，body mass），age at menopause，years since menopause，education level，monthly income，and history of dental calculus removal were collected. Oral hygiene assessment（poor oral hygiene score）and periodontal clinical examination were performed，and probing depth（PD），clinical attachment loss（AL），bleeding index（BI），and number of missing teeth（excluding third molars）were recorded. Results    No statistically significant differences were observed in general data among the four groups（all P > 0.05）. Statistically significant differences were found in PD，AL，BI，and number of missing teeth among the four groups（all P < 0.05）. The low E2/low VD group had significantly higher values in all the above four indicators compared with the high E2/high VD group and the low E2/high VD group，and the values in AL，BI，and number of missing teeth were also higher than those of the high E2/low VD group（all P < 0.05）. Two-way factorial analysis of variance showed statistically significant differences in AL between the high and low levels of serum E2 concentration and serum 25（OH）D concentration（both P < 0.05），while no significant interaction between the two factors was detected（P = 0.060）. The results of multiple linear regression analysis showed that high E2，high VD，and a history of dental calculus removal were associated with smaller AL，and increase in age and score of poor oral hygiene was associated with increase in AL（all P < 0.05）；other variables were not independent influencing factors for AL. The adjusted R2 of the regression model was 0.418，with F = 7.065 and P < 0.001. Conclusion    The deficiency in both serum E2 and 25（OH）D in postmenopausal women adversely affects periodontal health. It is necessary to standardize oral hygiene behaviors，strengthen oral health education，and explore a multidisciplinary collaborative management model involving dentistry，gynecology，and endocrinology.

Key words: menopause, estradiol, 25-hydroxyvitamin D, periodontal health, multidisciplinary management