Department of Cardiology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China.
Department of Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China.
BMC Public Health. 2024 Sep 27;24(1):2642. doi: 10.1186/s12889-024-20122-7.
Oxidative Balance Scores (OBS) is composite measures that assess the balance between pro-oxidant and antioxidant factors in an individual's diet and lifestyle. Evidence on OBS and cardiovascular disease (CVD) in diabetic patients is scarce. This study investigates the potential association between OBS and CVD-prevalence and all-cause and CVD-related mortality in adult diabetic patients.
Participants were selected from the National Health and Nutrition Examination Survey (NHANES) 2007-2018. OBS-related data collection was initiated by linking the National Death Index to determine mortality due to all-cause and cardiovascular disease until December 31, 2019. Weighted logistic regression analyses explored the relationship between OBS and CVD. In addition, multivariable Cox proportional risk regression models and Kaplan-Meier curves were used to determine the correlation between OBS and mortality, with time to event as the time variable, as well as to estimate hazard ratios (HR) and 95% confidence interval (CI).
A total of 3491 participants were included in the final analysis. Weighted logistic regression analysis of the relationship between OBS and CVD prevalence found that higher OBS was not associated with CVD prevalence compared with lower levels after fully adjustment in model 3 (OR: 0.82, 95% CI: 0.51-1.31, P = 0.39). During 3,491 person-years of follow-up, 408 deaths were recorded, of which 105 deaths were attributed to CVD. In fully adjusted model 3, participants in the highest quartile of OBS had significant reductions in all-cause mortality of 53% [HR: 0.47, 95% CI: 0.29-0.77), P= 0.002] and in cardiovascular disease mortality of 78% [HR: 0.22, 95% CI: 0.08-0.56), P= 0.004], compared with the lowest quartile groups of OBS. The Kaplan-Meier analysis results showed that participants in the highest quartile of OBS had the lowest risk of all-cause and CVD-related mortality and were statistically different (P < 0.05). Subgroup analysis confirmed that P for interaction was significant only concerning the educational level attained and in individuals with a history of CKD (P < 0.05).
Although OBS wasn't very useful for assessing CVD prevalence outcomes, higher OBS was significantly associated with lower all-cause and CVD-related mortality, suggesting that maintaining adequate OBS may reduce mortality in patients with DM.
氧化平衡评分（OBS）是一种综合指标，用于评估个体饮食和生活方式中促氧化剂和抗氧化剂因素之间的平衡。关于糖尿病患者的 OBS 和心血管疾病（CVD）的证据很少。本研究旨在探讨 OBS 与成年糖尿病患者 CVD 患病率以及全因和 CVD 相关死亡率之间的潜在关联。
参与者选自 2007-2018 年全国健康与营养调查（NHANES）。通过将国家死亡指数与 OBS 相关数据相联系，以确定截至 2019 年 12 月 31 日的全因和心血管疾病导致的死亡率，从而开始了 OBS 相关数据的收集。采用加权逻辑回归分析探讨 OBS 与 CVD 之间的关系。此外，多变量 Cox 比例风险回归模型和 Kaplan-Meier 曲线用于确定 OBS 与死亡率之间的相关性，以事件时间作为时间变量，并估计风险比（HR）和 95%置信区间（CI）。
共纳入 3491 名参与者进行最终分析。经过模型 3 的充分调整后，加权逻辑回归分析 OBS 与 CVD 患病率之间的关系发现，与低水平 OBS 相比，高水平 OBS 与 CVD 患病率无显著相关性（OR：0.82，95%CI：0.51-1.31，P=0.39）。在 3491 人年的随访期间，记录了 408 例死亡，其中 105 例归因于 CVD。在充分调整后的模型 3 中，OBS 最高四分位组的全因死亡率显著降低 53%[HR：0.47，95%CI：0.29-0.77，P=0.002]，心血管疾病死亡率显著降低 78%[HR：0.22，95%CI：0.08-0.56，P=0.004]，与 OBS 最低四分位组相比。Kaplan-Meier 分析结果表明，OBS 最高四分位组的全因和心血管疾病相关死亡率风险最低，且差异具有统计学意义（P<0.05）。亚组分析证实，仅在受教育程度和患有 CKD 的个体中，交互 P 值具有统计学意义（P<0.05）。
虽然 OBS 对于评估 CVD 患病率结局的作用不大，但较高的 OBS 与较低的全因和 CVD 相关死亡率显著相关，这表明维持足够的 OBS 可能会降低糖尿病患者的死亡率。
