Association of oxidative balance score with the risk of all-cause and CVD mortality in younger US adults with diabetes
Abstract Oxidative balance score (OBS) is a composite measures that assess the balance between pro-oxidant and antioxidant factors in an individual’s diet and lifestyle, with higher scores indicating greater antioxidant exposure. Despite its potential significance, there is a limited body of researc...
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Nature Portfolio
2025-01-01
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| Online Access: | https://doi.org/10.1038/s41598-025-88132-y |
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| author | Chang Liu Guoan Xiang Dan Liang Xuanbo Zhao Kun Xiao Lixin Xie |
| author_facet | Chang Liu Guoan Xiang Dan Liang Xuanbo Zhao Kun Xiao Lixin Xie |
| author_sort | Chang Liu |
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| description | Abstract Oxidative balance score (OBS) is a composite measures that assess the balance between pro-oxidant and antioxidant factors in an individual’s diet and lifestyle, with higher scores indicating greater antioxidant exposure. Despite its potential significance, there is a limited body of research exploring the relationship between OBS and all-cause and cardiovascular disease (CVD) mortality specifically in younger patients with diabetes. We aimed to investigate the possible relationship between OBS and all-cause and CVD mortality in younger patients with diabetes. Data for this study were obtained from the 2003–2018 NHANES. This study enrolled 3501 participants. The endpoints were all-cause and CVD mortality, determined by the National Death Index (NDI). OBS, which consists of 16 dietary factors and 4 lifestyle factors, is categorized into pro-oxidants and antioxidants. The OBS was categorized into four quartiles (Q1-Q4). We used multivariable Cox proportional hazards regression models to examine the association between continuous and quartile measures of OBS, lifestyle OBS (lifestyle antioxidants such as physical activity, etc., and lifestyle pro-oxidants such as alcohol, smoking, etc.), and dietary OBS (dietary antioxidants such as fiber, β-carotene, riboflavin, etc., and dietary pro-oxidants, such as total fat, etc.) with all-cause and CVD mortality. Additionally, we explored restricted cubic spline (RCS) analysis and also performed subgroup analyses and interaction tests. The occurrence of 409 all-cause deaths (11.7%) and 108 CVD-related deaths (3.1%) was recorded during the follow-up period. Our results found that OBS, lifestyle OBS, and dietary OBS were negatively associated with patients’ all-cause and CVD mortality. The RCS analysis further validated the association of a linear negative correlation between OBS and all-cause and CVD mortality. The results of our subgroup analyses revealed that the negative association between OBS and CVD mortality may be influenced by alcohol use. In conclusion, results from a nationally representative study of younger American patients with diabetes suggest a negative association between OBS, lifestyle OBS, and dietary OBS and all-cause and CVD mortality. Antioxidant-rich diets and lifestyle improvements are essential for reducing all-cause and CVD mortality in patients. |
| format | Article |
| id | doaj-art-d5e14478ffb841a2a5ae7721b985b35a |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj-art-d5e14478ffb841a2a5ae7721b985b35a2025-02-02T12:17:09ZengNature PortfolioScientific Reports2045-23222025-01-0115111210.1038/s41598-025-88132-yAssociation of oxidative balance score with the risk of all-cause and CVD mortality in younger US adults with diabetesChang Liu0Guoan Xiang1Dan Liang2Xuanbo Zhao3Kun Xiao4Lixin Xie5School of Medicine, Nankai UniversityCollege of Pulmonary & Critical Care Medicine, The Eighth Medical Center of Chinese PLA General HospitalDepartment of Endocrine, People’s Hospital of Chongqing Liang Jiang New AreaClinical Medicine College of Henan University of Traditional Chinese MedicineCollege of Pulmonary & Critical Care Medicine, The Eighth Medical Center of Chinese PLA General HospitalSchool of Medicine, Nankai UniversityAbstract Oxidative balance score (OBS) is a composite measures that assess the balance between pro-oxidant and antioxidant factors in an individual’s diet and lifestyle, with higher scores indicating greater antioxidant exposure. Despite its potential significance, there is a limited body of research exploring the relationship between OBS and all-cause and cardiovascular disease (CVD) mortality specifically in younger patients with diabetes. We aimed to investigate the possible relationship between OBS and all-cause and CVD mortality in younger patients with diabetes. Data for this study were obtained from the 2003–2018 NHANES. This study enrolled 3501 participants. The endpoints were all-cause and CVD mortality, determined by the National Death Index (NDI). OBS, which consists of 16 dietary factors and 4 lifestyle factors, is categorized into pro-oxidants and antioxidants. The OBS was categorized into four quartiles (Q1-Q4). We used multivariable Cox proportional hazards regression models to examine the association between continuous and quartile measures of OBS, lifestyle OBS (lifestyle antioxidants such as physical activity, etc., and lifestyle pro-oxidants such as alcohol, smoking, etc.), and dietary OBS (dietary antioxidants such as fiber, β-carotene, riboflavin, etc., and dietary pro-oxidants, such as total fat, etc.) with all-cause and CVD mortality. Additionally, we explored restricted cubic spline (RCS) analysis and also performed subgroup analyses and interaction tests. The occurrence of 409 all-cause deaths (11.7%) and 108 CVD-related deaths (3.1%) was recorded during the follow-up period. Our results found that OBS, lifestyle OBS, and dietary OBS were negatively associated with patients’ all-cause and CVD mortality. The RCS analysis further validated the association of a linear negative correlation between OBS and all-cause and CVD mortality. The results of our subgroup analyses revealed that the negative association between OBS and CVD mortality may be influenced by alcohol use. In conclusion, results from a nationally representative study of younger American patients with diabetes suggest a negative association between OBS, lifestyle OBS, and dietary OBS and all-cause and CVD mortality. Antioxidant-rich diets and lifestyle improvements are essential for reducing all-cause and CVD mortality in patients.https://doi.org/10.1038/s41598-025-88132-yOxidative balance scoreOxidative stressNHANESDiabetesMortality |
| spellingShingle | Chang Liu Guoan Xiang Dan Liang Xuanbo Zhao Kun Xiao Lixin Xie Association of oxidative balance score with the risk of all-cause and CVD mortality in younger US adults with diabetes Scientific Reports Oxidative balance score Oxidative stress NHANES Diabetes Mortality |
| title | Association of oxidative balance score with the risk of all-cause and CVD mortality in younger US adults with diabetes |
| title_full | Association of oxidative balance score with the risk of all-cause and CVD mortality in younger US adults with diabetes |
| title_fullStr | Association of oxidative balance score with the risk of all-cause and CVD mortality in younger US adults with diabetes |
| title_full_unstemmed | Association of oxidative balance score with the risk of all-cause and CVD mortality in younger US adults with diabetes |
| title_short | Association of oxidative balance score with the risk of all-cause and CVD mortality in younger US adults with diabetes |
| title_sort | association of oxidative balance score with the risk of all cause and cvd mortality in younger us adults with diabetes |
| topic | Oxidative balance score Oxidative stress NHANES Diabetes Mortality |
| url | https://doi.org/10.1038/s41598-025-88132-y |
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