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Dental enamel defects predict adolescent health indicators: A cohort study among the Tsimane’ of Bolivia
Author(s) -
Masterson Erin E.,
Fitzpatrick Annette L.,
Enquobahrie Daniel A.,
Mancl Lloyd A.,
Eisenberg Dan T. A.,
Conde Esther,
Hujoel Philippe P.
Publication year - 2018
Publication title -
american journal of human biology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.559
H-Index - 81
eISSN - 1520-6300
pISSN - 1042-0533
DOI - 10.1002/ajhb.23107
Subject(s) - medicine , glycated hemoglobin , anthropometry , hemoglobin , cohort , cohort study , physiology , dentistry , diabetes mellitus , type 2 diabetes , endocrinology
Objectives Bioarchaeological findings have linked defective enamel formation in preadulthood with adult mortality. We investigated how defective enamel formation in infancy and childhood is associated with risk factors for adult morbidity and mortality in adolescents. Methods This cohort study of 349 Amerindian adolescents (10‐17 years of age) related extent of enamel defects on the central maxillary incisors (none, less than 1/3, 1/3 to 2/3, more than 2/3) to adolescent anthropometrics (height, weight) and biomarkers (hemoglobin, glycated hemoglobin, white blood cell count, and blood pressure). Risk differences and 95% confidence intervals were estimated using multiple linear regression. Enamel defects and stunted growth were compared in their ability to predict adolescent health indicators using log‐binomial regression and receiver operating characteristics (ROCs). Results Greater extent of defective enamel formation on the tooth surface was associated with shorter height (–1.35 cm, 95% CI: −2.17, −0.53), lower weight (−0.98 kg, 95% CI: −1.70, −0.26), lower hemoglobin (−0.36 g/dL, 95% CI: −0.59, −0.13), lower glycated hemoglobin (−0.04 %A 1c , 95% CI: −0.08, −0.00008), and higher white blood cell count (0.74 10 9 /L, 95% CI: 0.35, 1.14) in adolescence. Extent of enamel defects and stunted growth independently performed similarly as risk factors for adverse adolescent outcomes, including anemia, prediabetes/type II diabetes, elevated WBC count, prehypertension/hypertension, and metabolic health. Conclusions Defective enamel formation in infancy and childhood predicted adolescent health outcomes and may be primarily associated with infection. Extent of enamel defects and stunted growth may be equally predictive of adverse adolescent health outcomes.