BACKGROUND This study investigated the association between breakfast skipping and periodontitis and the mediating role of sugar and lipid metabolism and systemic inflammation in this association using data from the Korea National Health and Nutrition Examination Survey 2016-2018. METHODS This study included 11,953 participants, representing an estimated 33.9 million people. Complex sample logistic regression was used to assess the independent association between breakfast skipping and periodontitis. Subgroup analysis was conducted with modifiers including age, sex, body mass index (BMI), urban residence, education level, marital status, and diabetes. Structural equation modeling assessed potential mediation by biomarkers related to glucose and lipid metabolism along with systemic inflammation. RESULTS The fully adjusted logistic regression model indicated a positive association between breakfast skipping and periodontitis (odds ratio [OR] = 1.234 (1.026-1.483), p = 0.025). This association was highlighted in middle-aged (40-60 years), female, highly educated, married individuals with BMI < 25 kg/m2, and those in urban areas without diabetes. Blood glucose (β ± SE = 0.006 ± 0.002, p = 0.014), triglycerides (β ± SE = 0.004 ± 0.002, p = 0.033), and white blood cell count (β ± SE = 0.011 ± 0.003, p = 0.003) were identified as partial mediators. CONCLUSIONS A new, independent association between breakfast skipping, and periodontitis has been discovered, which is partially mediated by sugar and lipid metabolism, and systemic inflammation. The findings provide new insights into the benefits of chrononutrition for periodontal health.

中文翻译：

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糖和脂质代谢以及全身炎症在不吃早餐和牙周炎之间的关联中的中介作用：一项基于人群的研究。


背景本研究利用 2016-2018 年韩国国家健康与营养检查调查的数据，调查了不吃早餐与牙周炎之间的关联，以及糖脂代谢和全身炎症在该关联中的中介作用。方法 这项研究包括 11,953 名参与者，估计相当于 3390 万人。使用复杂样本逻辑回归来评估不吃早餐和牙周炎之间的独立关联。采用年龄、性别、体重指数（BMI）、城市居住、教育水平、婚姻状况和糖尿病等修饰因素进行亚组分析。结构方程模型评估了与葡萄糖和脂质代谢以及全身炎症相关的生物标志物的潜在调节作用。结果完全调整的逻辑回归模型表明，不吃早餐与牙周炎之间呈正相关（比值比 [OR] = 1.234 (1.026-1.483)，p = 0.025）。这种关联在 BMI < 25 kg/m2 的中年（40-60 岁）、女性、受过高等教育、已婚人士以及城市地区无糖尿病的人士中尤为突出。血糖（β±SE = 0.006±0.002，p = 0.014）、甘油三酯（β±SE = 0.004±0.002，p = 0.033）和白细胞计数（β±SE = 0.011±0.003，p = 0.003）被确定为部分中介。结论 不吃早餐与牙周炎之间存在一种新的独立关联，该关联部分是由糖和脂质代谢以及全身炎症介导的。这些发现为了解计时营养对牙周健康的益处提供了新的见解。