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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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The fully adjusted logistic regression model indicated a positive association between breakfast skipping and periodontitis (odds ratio [OR]\u00a0=\u00a01.234 (1.026\u20131.483), <jats:italic>p<\/jats:italic>\u00a0=\u00a00.025). This association was highlighted in middle\u2010aged (40\u201360 years), female, highly educated, married individuals with BMI\u00a0&lt;\u00a025\u00a0kg\/m<jats:sup>2<\/jats:sup>, and those in urban areas without diabetes. Blood glucose (<jats:italic>\u03b2<\/jats:italic>\u00a0\u00b1\u00a0SE\u00a0=\u00a00.006\u00a0\u00b1\u00a00.002, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.014), triglycerides (<jats:italic>\u03b2<\/jats:italic>\u00a0\u00b1\u00a0SE\u00a0=\u00a00.004\u00a0\u00b1\u00a00.002, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.033), and white blood cell count (<jats:italic>\u03b2<\/jats:italic>\u00a0\u00b1\u00a0SE\u00a0=\u00a00.011\u00a0\u00b1\u00a00.003, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.003) were identified as partial mediators.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jper.24-0079","type":"journal-article","created":{"date-parts":[[2024,6,8]],"date-time":"2024-06-08T10:58:35Z","timestamp":1717844315000},"page":"1210-1222","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The mediating role of sugar and lipid metabolism and systemic inflammation in the association between breakfast skipping and periodontitis: A population\u2010based study"],"prefix":"10.1002","volume":"95","author":[{"given":"Zhikang","family":"Wang","sequence":"first","affiliation":[{"name":"Stomatology Hospital School of Stomatology Zhejiang University School of Medicine Zhejiang Provincial Clinical Research Center for Oral Diseases Key Laboratory of Oral Biomedical Research of Zhejiang Province Cancer Center of Zhejiang University Engineering Research Center of Oral Biomaterials 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