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...

Full description

Saved in:
Bibliographic Details
Main Authors: Yiwei Zhang, Sen Wang, Hengli Lu, Lei Liu, Rui Chen, Binbin Li, Yong Li, Jingdong Sun, Qiuming Gao
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Public Health
Subjects:
Online Access:https://doi.org/10.1186/s12889-025-24041-z
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849738598177308672
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
collection DOAJ
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.
format Article
id doaj-art-e534b8b30a024069a7d03aa2c08a0288
institution DOAJ
issn 1471-2458
language English
publishDate 2025-08-01
publisher BMC
record_format Article
series BMC Public Health
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
work_keys_str_mv AT yiweizhang theassociationbetweenoxidativebalancescoreandallcauseandcardiovascularmortalityinpatientswitharthritisaretrospectivecohortstudybasedonthenhanesdatabase19992018
AT senwang theassociationbetweenoxidativebalancescoreandallcauseandcardiovascularmortalityinpatientswitharthritisaretrospectivecohortstudybasedonthenhanesdatabase19992018
AT henglilu theassociationbetweenoxidativebalancescoreandallcauseandcardiovascularmortalityinpatientswitharthritisaretrospectivecohortstudybasedonthenhanesdatabase19992018
AT leiliu theassociationbetweenoxidativebalancescoreandallcauseandcardiovascularmortalityinpatientswitharthritisaretrospectivecohortstudybasedonthenhanesdatabase19992018
AT ruichen theassociationbetweenoxidativebalancescoreandallcauseandcardiovascularmortalityinpatientswitharthritisaretrospectivecohortstudybasedonthenhanesdatabase19992018
AT binbinli theassociationbetweenoxidativebalancescoreandallcauseandcardiovascularmortalityinpatientswitharthritisaretrospectivecohortstudybasedonthenhanesdatabase19992018
AT yongli theassociationbetweenoxidativebalancescoreandallcauseandcardiovascularmortalityinpatientswitharthritisaretrospectivecohortstudybasedonthenhanesdatabase19992018
AT jingdongsun theassociationbetweenoxidativebalancescoreandallcauseandcardiovascularmortalityinpatientswitharthritisaretrospectivecohortstudybasedonthenhanesdatabase19992018
AT qiuminggao theassociationbetweenoxidativebalancescoreandallcauseandcardiovascularmortalityinpatientswitharthritisaretrospectivecohortstudybasedonthenhanesdatabase19992018
AT yiweizhang associationbetweenoxidativebalancescoreandallcauseandcardiovascularmortalityinpatientswitharthritisaretrospectivecohortstudybasedonthenhanesdatabase19992018
AT senwang associationbetweenoxidativebalancescoreandallcauseandcardiovascularmortalityinpatientswitharthritisaretrospectivecohortstudybasedonthenhanesdatabase19992018
AT henglilu associationbetweenoxidativebalancescoreandallcauseandcardiovascularmortalityinpatientswitharthritisaretrospectivecohortstudybasedonthenhanesdatabase19992018
AT leiliu associationbetweenoxidativebalancescoreandallcauseandcardiovascularmortalityinpatientswitharthritisaretrospectivecohortstudybasedonthenhanesdatabase19992018
AT ruichen associationbetweenoxidativebalancescoreandallcauseandcardiovascularmortalityinpatientswitharthritisaretrospectivecohortstudybasedonthenhanesdatabase19992018
AT binbinli associationbetweenoxidativebalancescoreandallcauseandcardiovascularmortalityinpatientswitharthritisaretrospectivecohortstudybasedonthenhanesdatabase19992018
AT yongli associationbetweenoxidativebalancescoreandallcauseandcardiovascularmortalityinpatientswitharthritisaretrospectivecohortstudybasedonthenhanesdatabase19992018
AT jingdongsun associationbetweenoxidativebalancescoreandallcauseandcardiovascularmortalityinpatientswitharthritisaretrospectivecohortstudybasedonthenhanesdatabase19992018
AT qiuminggao associationbetweenoxidativebalancescoreandallcauseandcardiovascularmortalityinpatientswitharthritisaretrospectivecohortstudybasedonthenhanesdatabase19992018