We aimed to investigate the medium-term associations of periodontitis and the number of missing teeth with serum lipoproteins and their plasma subfractions using follow-up data from the population-based Study of Health in Pomerania (SHIP-TREND).

A total of 2,058 participants with 7-year follow-up data underwent periodontal examinations, serum lipid panel tests, and proton nuclear magnetic resonance (¹H-NMR) spectroscopy of plasma lipoproteins and their subfractions. Generalized models with gamma distribution and loglink were used to analyze associations between periodontal variables and lipoproteins and their subfractions, adjusting for confounders using propensity score weighting.

Periodontal variables were consistently associated with elevated follow-up serum levels of triglycerides, total cholesterol, and low-density lipoprotein cholesterol levels. When plasma lipoprotein subfractions were evaluated, periodontal variables were associated with elevated levels of triglycerides and cholesterol-enriched apolipoprotein B-containing lipoprotein particles, particularly small dense low-density lipoprotein, very-low-density lipoprotein and intermediate density lipoprotein. In addition, altered high-density lipoprotein particle composition was observed, suggesting potential functional changes.

This study provides evidence for causal effects of periodontitis on conventional serum lipids and plasma lipoprotein subfractions. As the underlying biological mechanisms are not fully understood, further research is needed.