The association between oxidative balance score and all-cause and cardiovascular mortality in patients with arthritis: a retrospective cohort study based on the NHANES database (1999–2018)
Abstract Background and objective No study examined the association of the oxidative balance score (OBS) with mortality in patients with arthritis. This study examined the association between OBS and all-cause and cardiovascular mortality in patients with arthritis. Methods From NHANES, 11,754 patie...
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2025-08-01
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| author | Yiwei Zhang Sen Wang Hengli Lu Lei Liu Rui Chen Binbin Li Yong Li Jingdong Sun Qiuming Gao |
| author_facet | Yiwei Zhang Sen Wang Hengli Lu Lei Liu Rui Chen Binbin Li Yong Li Jingdong Sun Qiuming Gao |
| author_sort | Yiwei Zhang |
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| description | Abstract Background and objective No study examined the association of the oxidative balance score (OBS) with mortality in patients with arthritis. This study examined the association between OBS and all-cause and cardiovascular mortality in patients with arthritis. Methods From NHANES, 11,754 patients with arthritis were included. The patients were from the 1999–2018 period. The OBS was calculated using 16 nutrients and four lifestyle factors. The outcomes were all-cause mortality and cardiovascular diseases (CVD) mortality. CVD mortality was defined as death from ICD-10 codes I00-I09, I11, I13, and I20-I51. The Kaplan-Meier analysis and log-rank test were used to depict the survival rate disparities among different groups of patients. The associations of various variables with all-cause mortality and CVD mortality were evaluated using three multivariable Cox regression models. Results The cohort study included 11,754 patients with arthritis, with a mean (SE) age 59.41 (0.22) years and 4,871 men (weighted, 41.44%). Kaplan-Meier analysis showed lower OBS scores are associated with higher overall mortality and CVD mortality (p < 0.001). Multivariable Cox proportional hazard regression model analysis showed that, after adjusting for multiple confounders, the highest OBS quartile had 30% lower all-cause mortality risk (HR = 0.70, 95%CI: 0.58–0.85) and CVD mortality (HR = 0.70, 95%CI: 0.58–0.85, P < 0.001), compared with the lowest quartile. Restricted cubic spline (RCS) curves showed a negative linear association between OBS and both mortality types (p < 0.001). Similar trends were observed for the lifestyle OBS, while dietary OBS showed no independent inverse association on both mortality types in fully adjusted models. Conclusion Higher OBS might be associated with lower all-cause and cardiovascular mortality in patients with arthritis, highlighting the importance of adhering to an antioxidant lifestyle in patients with arthritis. |
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| institution | DOAJ |
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| language | English |
| publishDate | 2025-08-01 |
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| spelling | doaj-art-e534b8b30a024069a7d03aa2c08a02882025-08-20T03:06:31ZengBMCBMC Public Health1471-24582025-08-0125111210.1186/s12889-025-24041-zThe association between oxidative balance score and all-cause and cardiovascular mortality in patients with arthritis: a retrospective cohort study based on the NHANES database (1999–2018)Yiwei Zhang0Sen Wang1Hengli Lu2Lei Liu3Rui Chen4Binbin Li5Yong Li6Jingdong Sun7Qiuming Gao8Department of Orthopedics, Shanghai Tenth People’s Hospital, Tongji University School of MedicineDepartment of Orthopedics, Shanghai Tenth People’s Hospital, Tongji University School of MedicineDepartment of Orthopedics, Shanghai Tenth People’s Hospital, Tongji University School of MedicineDepartment of Orthopedics, People’s Hospital of Huantai CountyDepartment of Orthopedics, Taihe Hospital, Hubei University of MedicineDepartment of Orthopedics, Taihe Hospital, Hubei University of MedicineDepartment of Orthopedics, Taihe Hospital, Hubei University of MedicineDepartment of Orthopedics, Taihe Hospital, Hubei University of MedicineDepartment of Orthopedics, Shanghai Tenth People’s Hospital, Tongji University School of MedicineAbstract Background and objective No study examined the association of the oxidative balance score (OBS) with mortality in patients with arthritis. This study examined the association between OBS and all-cause and cardiovascular mortality in patients with arthritis. Methods From NHANES, 11,754 patients with arthritis were included. The patients were from the 1999–2018 period. The OBS was calculated using 16 nutrients and four lifestyle factors. The outcomes were all-cause mortality and cardiovascular diseases (CVD) mortality. CVD mortality was defined as death from ICD-10 codes I00-I09, I11, I13, and I20-I51. The Kaplan-Meier analysis and log-rank test were used to depict the survival rate disparities among different groups of patients. The associations of various variables with all-cause mortality and CVD mortality were evaluated using three multivariable Cox regression models. Results The cohort study included 11,754 patients with arthritis, with a mean (SE) age 59.41 (0.22) years and 4,871 men (weighted, 41.44%). Kaplan-Meier analysis showed lower OBS scores are associated with higher overall mortality and CVD mortality (p < 0.001). Multivariable Cox proportional hazard regression model analysis showed that, after adjusting for multiple confounders, the highest OBS quartile had 30% lower all-cause mortality risk (HR = 0.70, 95%CI: 0.58–0.85) and CVD mortality (HR = 0.70, 95%CI: 0.58–0.85, P < 0.001), compared with the lowest quartile. Restricted cubic spline (RCS) curves showed a negative linear association between OBS and both mortality types (p < 0.001). Similar trends were observed for the lifestyle OBS, while dietary OBS showed no independent inverse association on both mortality types in fully adjusted models. Conclusion Higher OBS might be associated with lower all-cause and cardiovascular mortality in patients with arthritis, highlighting the importance of adhering to an antioxidant lifestyle in patients with arthritis.https://doi.org/10.1186/s12889-025-24041-zOxidative balance score, OBSArthritisAll-cause mortalityCardiovascular disease mortalityNHANESCohort study |
| spellingShingle | Yiwei Zhang Sen Wang Hengli Lu Lei Liu Rui Chen Binbin Li Yong Li Jingdong Sun Qiuming Gao The association between oxidative balance score and all-cause and cardiovascular mortality in patients with arthritis: a retrospective cohort study based on the NHANES database (1999–2018) BMC Public Health Oxidative balance score, OBS Arthritis All-cause mortality Cardiovascular disease mortality NHANES Cohort study |
| title | The association between oxidative balance score and all-cause and cardiovascular mortality in patients with arthritis: a retrospective cohort study based on the NHANES database (1999–2018) |
| title_full | The association between oxidative balance score and all-cause and cardiovascular mortality in patients with arthritis: a retrospective cohort study based on the NHANES database (1999–2018) |
| title_fullStr | The association between oxidative balance score and all-cause and cardiovascular mortality in patients with arthritis: a retrospective cohort study based on the NHANES database (1999–2018) |
| title_full_unstemmed | The association between oxidative balance score and all-cause and cardiovascular mortality in patients with arthritis: a retrospective cohort study based on the NHANES database (1999–2018) |
| title_short | The association between oxidative balance score and all-cause and cardiovascular mortality in patients with arthritis: a retrospective cohort study based on the NHANES database (1999–2018) |
| title_sort | association between oxidative balance score and all cause and cardiovascular mortality in patients with arthritis a retrospective cohort study based on the nhanes database 1999 2018 |
| topic | Oxidative balance score, OBS Arthritis All-cause mortality Cardiovascular disease mortality NHANES Cohort study |
| url | https://doi.org/10.1186/s12889-025-24041-z |
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