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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糖脂代谢和全身炎症在跳早餐与牙周炎之间关系中的中介作用：一项基于人群的研究。


背景 本研究使用 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和脂质代谢与全身炎症在这种关联中的中介作用。方法 本研究包括 11,953 名参与者，估计代表 3390 万人。采用复杂样本 logistic 回归评估不吃早餐与牙周炎之间的独立关联。使用年龄、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子进行亚组分析。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介导。结果 完全调整的 logistic 回归模型表明，不吃早餐与牙周炎呈正相关 （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、已婚个体和无糖尿病的城市地区个体中表现突出。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） 被确定为部分介质。结论 已经发现不吃早餐与牙周炎之间存在一个新的独立关联，这部分由糖和脂质代谢以及全身炎症介导。这些发现为定时营养对牙周健康的益处提供了新的见解。