Oxidative balance score and mortality: mediating role of insulin resistance across age strata in the NHANES cohort
BackgroundThis study examined the association between oxidative balance score (OBS), a composite measure of oxidative/antioxidative factors, and mortality, while investigating insulin resistance (IR) indices as potential mediators using a nationally representative cohort.MethodsA cohort of 11,849 U....
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Frontiers Media S.A.
2025-06-01
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| Series: | Frontiers in Nutrition |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnut.2025.1604696/full |
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| author | Lin Zhang Lin Zhang Heming Zhang Heming Zhang Hongxia Xiang Jiachen Zhang Wei Gong Junjie Xv Xue Yu |
| author_facet | Lin Zhang Lin Zhang Heming Zhang Heming Zhang Hongxia Xiang Jiachen Zhang Wei Gong Junjie Xv Xue Yu |
| author_sort | Lin Zhang |
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| description | BackgroundThis study examined the association between oxidative balance score (OBS), a composite measure of oxidative/antioxidative factors, and mortality, while investigating insulin resistance (IR) indices as potential mediators using a nationally representative cohort.MethodsA cohort of 11,849 U. S. adults from NHANES (2007–2018) was analyzed. OBS integrated 16 dietary and 4 lifestyle components. Mortality risks (all-cause, cardiovascular, cancer) were assessed via weighted Cox models. Mediation analysis evaluated the indirect effects of five IR indices (TyG index, TG/HDL-C, HOMA-IR, eGDR, VAI) on OBS-mortality associations, with statistical validation of mediation effects. Analyses were stratified by age (<65 vs. ≥65 years) and adjusted for sociodemographic, behavioral, and clinical covariates.ResultsHigher OBS reduced risks of all-cause (HR = 0.652, 95% CI: 0.525–0.81) and cardiovascular mortality (HR = 0.605, 95% CI: 0.408–0.898), but not cancer mortality. Innovatively, eGDR mediated 17% of OBS’s protective effect on all-cause mortality in adults <65 years, while TyG index and HOMA-IR showed weaker mediation. No IR mediation occurred in older adults (≥65 years).ConclusionHigher OBS levels were inversely associated with all-cause and cardiovascular mortality, partially mediated by insulin resistance pathways. These findings highlight OBS as a potential prognostic indicator for mortality risk. |
| format | Article |
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| institution | DOAJ |
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| language | English |
| publishDate | 2025-06-01 |
| publisher | Frontiers Media S.A. |
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| spelling | doaj-art-6f8bdb8ad2a24c8caee6d31d25497abe2025-08-20T03:09:51ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2025-06-011210.3389/fnut.2025.16046961604696Oxidative balance score and mortality: mediating role of insulin resistance across age strata in the NHANES cohortLin Zhang0Lin Zhang1Heming Zhang2Heming Zhang3Hongxia Xiang4Jiachen Zhang5Wei Gong6Junjie Xv7Xue Yu8Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, ChinaCollege of Life Science, University of Chinese Academy of Sciences, Beijing, ChinaDepartment of Anesthesiology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, ChinaDepartment of Anesthesiology, The 963 Hospital of the PLA Joint Logistics Support Force, Jiamusi, ChinaDepartment of Anesthesiology, The 963 Hospital of the PLA Joint Logistics Support Force, Jiamusi, ChinaPeking University Health Science Center, Beijing, ChinaDepartment of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, ChinaHealth Service Department of the Guard Bureau of the General Office of the Central Committee of the Communist Party of China, Beijing, ChinaDepartment of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, ChinaBackgroundThis study examined the association between oxidative balance score (OBS), a composite measure of oxidative/antioxidative factors, and mortality, while investigating insulin resistance (IR) indices as potential mediators using a nationally representative cohort.MethodsA cohort of 11,849 U. S. adults from NHANES (2007–2018) was analyzed. OBS integrated 16 dietary and 4 lifestyle components. Mortality risks (all-cause, cardiovascular, cancer) were assessed via weighted Cox models. Mediation analysis evaluated the indirect effects of five IR indices (TyG index, TG/HDL-C, HOMA-IR, eGDR, VAI) on OBS-mortality associations, with statistical validation of mediation effects. Analyses were stratified by age (<65 vs. ≥65 years) and adjusted for sociodemographic, behavioral, and clinical covariates.ResultsHigher OBS reduced risks of all-cause (HR = 0.652, 95% CI: 0.525–0.81) and cardiovascular mortality (HR = 0.605, 95% CI: 0.408–0.898), but not cancer mortality. Innovatively, eGDR mediated 17% of OBS’s protective effect on all-cause mortality in adults <65 years, while TyG index and HOMA-IR showed weaker mediation. No IR mediation occurred in older adults (≥65 years).ConclusionHigher OBS levels were inversely associated with all-cause and cardiovascular mortality, partially mediated by insulin resistance pathways. These findings highlight OBS as a potential prognostic indicator for mortality risk.https://www.frontiersin.org/articles/10.3389/fnut.2025.1604696/fulloxidative balance scoreinsulin resistancemortalitymediation analysisNHANES |
| spellingShingle | Lin Zhang Lin Zhang Heming Zhang Heming Zhang Hongxia Xiang Jiachen Zhang Wei Gong Junjie Xv Xue Yu Oxidative balance score and mortality: mediating role of insulin resistance across age strata in the NHANES cohort Frontiers in Nutrition oxidative balance score insulin resistance mortality mediation analysis NHANES |
| title | Oxidative balance score and mortality: mediating role of insulin resistance across age strata in the NHANES cohort |
| title_full | Oxidative balance score and mortality: mediating role of insulin resistance across age strata in the NHANES cohort |
| title_fullStr | Oxidative balance score and mortality: mediating role of insulin resistance across age strata in the NHANES cohort |
| title_full_unstemmed | Oxidative balance score and mortality: mediating role of insulin resistance across age strata in the NHANES cohort |
| title_short | Oxidative balance score and mortality: mediating role of insulin resistance across age strata in the NHANES cohort |
| title_sort | oxidative balance score and mortality mediating role of insulin resistance across age strata in the nhanes cohort |
| topic | oxidative balance score insulin resistance mortality mediation analysis NHANES |
| url | https://www.frontiersin.org/articles/10.3389/fnut.2025.1604696/full |
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