BACKGROUND: This study investigated the association between atherogenic index of plasma (AIP)-related indices and periodontal diseases in adults without dyslipidemia using healthcare big data from Korea National Health & Nutrition Examination Survey (KNHANES). METHODS: This cross-sectional study analyzed data from 16,343 adults in the 2010-2018 KNHANES. Periodontal status was assessed using the Community Periodontal Index (CPI), while AIP-related indices, including AIP, triglycerides (TG), and high-density lipoprotein cholesterol (HDL), were evaluated. Statistical analyses included chi-square tests and t-tests for group comparisons, multivariate logistic regression to calculate odds ratios (ORs) for periodontitis risk, and receiver operating characteristic (ROC) curve analysis to assess diagnostic accuracy. RESULTS: Higher AIP-related indices (excluding HDL) were associated with an increased risk of periodontitis, while lower HDL levels also correlated with higher disease prevalence. (p < 0.0001). The AIP adjusted with waist-to-height ratio (AIP*WHtR) exhibited the highest diagnostic accuracy among all indices analyzed, with the highest area under the ROC curve (AUC), whereas HDL showed the lowest predictive value. CONCLUSIONS: AIP-related indices were significantly associated with periodontitis in adults without dyslipidemia, with higher AIP-related indices linked to an increased risk of periodontitis. Among these, AIP*WHtR exhibited the highest diagnostic accuracy. However, due to the cross-sectional study design, causality cannot be determined. Thus, longitudinal studies are required to validate the predictive value of AIP-related indices for periodontitis risk.
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