Vitamin D Levels In Children And Risk Of Dental Caries: A Meta-analysis

ObjectiveTo systematically evaluate the relationship between vitamin D levels and dental caries risk in children..MethodsPubMed,EMBASE,Web of Science,the Cochrane Library,Wanfang Digital Journal Full-text Database,China National Knowledge Infrastructure(CNKI),and database for Chinese Technical Periodicals(VIP)till Mar.2019 were searched for the studies to evaluate the relationship of vitamin D levels in children to the risk of dental caries.Two evaluation staff independently selected the literature,extracted data and evaluated the bias risk of the study.Meta-analysis was performed using Stata15.1software.Pooled relative risks(RRs)with 95% confidence intervals(CIs)were calculated by random-effects models.ResultsA total of 14 studies were included in 10 articles,with high methodological quality.Of the 14 studies,6 cross-sectional studies were grade A,3 cohort studies were grade A,4 case control studies were grade B,and one Mendel randomized study was Grade A.A total of 12596 subjects were included,among them 5338 were caries patients,the caries rate was42.38%;Among 1075 cases of shortage in vitamin D,512 were caries patients,the caries rate was 47.63%;Among 3676 cases of deficiency in vitamin D,1580 were caries patients,the caries rate was 42.98%;Among7845 cases with normal level of vitamin D,3246 were caries patients,thecaries rate was 41.38%.Meta-analysis showed that the suboptimal vitamin D level in children increased the risk of caries by 11%(RR=1.11,95%CI: 1.01-1.21)with statistical significance(P<0.05).The results of subgroup analysis showed that,according to the study area,4 case-control studies showed that the suboptimal vitamin D level in children increased the risk of caries by61%(RR=1.61,95%CI: 1.09~2.39,P=0.01);6 cross-sectional studies and3 cohort studies showed no significant difference in the correlation between the suboptimal vitamin D level and the risk of dental caries.According to the age of the subjects,lack or deficiency of vitamin D level increased the risk of caries by 74% in deciduous teeth group(RR=1.74,95% CI: 1.37-2.21)with statistical significance(P<0.01).There were no significant difference in the correlation between lack or deficiency of vitamin D level and the risk of dental caries in groups of constant teeth period and replacement teeth period.ConclusionThe vitamin D levels in children is associated with the risk of dental caries,and vitamin D shortage or deficiency may increase the risk of dental caries.