Department of Nephrology, Dongfang Hospital of Beijing University of Chinese Medicine, Beijing, China.
Graduate School of Beijing University of Chinese Medicine, Beijing, China.
Front Endocrinol (Lausanne). 2024 Jul 31;15:1412823. doi: 10.3389/fendo.2024.1412823. eCollection 2024.
The oxidative balance score (OBS) is a comprehensive concept that includes 20 oxidative stressors and can be used to assess individual pro-oxidant versus antioxidant exposure, and the aim of the present study was to investigate the association between OBS and the risk of diabetic kidney disease (DKD), low estimated glomerular filtration rate (low-eGFR) and albuminuria in patients with diabetes mellitus (DM).
This cross-sectional study included nationally representative consecutive National Health and Nutrition Examination Survey DM patients aged 18 years and older from 2003-2018. The continuous variable OBS was converted into categorical variables by quartiles, and weighted multiple logistic regression analyses and restricted triple spline models were used to explore the relationships. We also performed subgroup analyses and interaction tests to verify the stability of the results.
A total of 5389 participants were included, representing 23.6 million non-institutionalized US residents. The results from both multivariate logistic regression analysis and restricted cubic spline models indicated that OBS and dietary OBS levels were negatively associated with the risk of DKD, low-eGFR, and albuminuria, without finding a significant correlation between lifestyle OBS and these clinical outcomes. Compared to the lowest OBS quartile group, the prevalence risk of DKD (OR = 0.61, 95% CI: 0.46-0.80), low-eGFR (OR = 0.46, 95% CI: 0.33-0.64) and albuminuria (OR = 0.68, 95% CI: 0.51-0.92) decreased by 39%, 54% and 32%, respectively, in the highest OBS quartile group. The results remained stable in subgroup analyses and no interaction between subgroups was found.
Higher levels of OBS and dietary OBS were associated with a lower risk of DKD, low-eGFR, and albuminuria. These findings provided preliminary evidence for the importance of adhering to an antioxidant-rich diet and lifestyle among individuals with diabetes.
氧化平衡评分（OBS）是一个综合概念，包含 20 种氧化应激因素，可以用于评估个体的促氧化剂与抗氧化剂暴露情况。本研究旨在探讨 OBS 与糖尿病患者发生糖尿病肾脏疾病（DKD）、估算肾小球滤过率（eGFR）降低和白蛋白尿的风险之间的关系。
本横断面研究纳入了 2003 年至 2018 年全国健康与营养调查（NHANES）中年龄在 18 岁及以上的、具有全国代表性的连续糖尿病患者。将连续变量 OBS 按四分位数转换为分类变量，并使用加权多因素逻辑回归分析和限制三次样条模型进行探讨。我们还进行了亚组分析和交互检验，以验证结果的稳定性。
共纳入 5389 名参与者，代表了 2360 万非住院的美国居民。多因素逻辑回归分析和限制三次样条模型的结果均表明，OBS 和膳食 OBS 水平与 DKD、eGFR 降低和白蛋白尿的风险呈负相关，而生活方式 OBS 与这些临床结局之间没有显著相关性。与 OBS 最低四分位组相比，OBS 最高四分位组的 DKD 患病率风险（OR=0.61，95%CI：0.46-0.80）、eGFR 降低（OR=0.46，95%CI：0.33-0.64）和白蛋白尿（OR=0.68，95%CI：0.51-0.92）的风险分别降低了 39%、54%和 32%。在亚组分析中结果保持稳定，且未发现亚组间存在交互作用。
较高的 OBS 和膳食 OBS 水平与 DKD、eGFR 降低和白蛋白尿的风险降低相关。这些发现为糖尿病患者坚持富含抗氧化剂的饮食和生活方式的重要性提供了初步证据。
