Wu Juan, Han Yingdong, Yao Menghui, Zhao He, Li Zhikai, Xie Tiange, Zhang Yun, Zeng Xuejun
Department of family medicine & Division of General Internal Medicine, Department of internal medicine, Peking Union Medical College Hospital, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Chinese Academy of Medical Sciences, Beijing, China.
BMC Cancer. 2025 Jan 23;25(1):133. doi: 10.1186/s12885-025-13531-3.
Oxidative stress is a crucial pathophysiological mechanism in chronic diseases and mortality. While individual oxidative markers have been studied, the comprehensive impact of oxidative balance on mortality risks remains unclear, particularly among cancer survivors. We aimed to investigate the associations of Oxidative Balance Score (OBS) with mortality in both the general population and cancer survivors.
This study included 37,317 adults (52% female) from the National Health and Nutrition Examination Survey (2001-2018). OBS was calculated based on antioxidant and pro-oxidant exposures and categorized into quartiles. Survey-weighted Cox proportional hazards models were used to estimate hazard ratios for mortality risks. Restricted cubic spline analyses were performed to examine potential non-linear relationships. Stratified analyses were conducted to further refine the findings.
During a mean follow-up of 9.1 years, 5,092 deaths occurred. Compared with the lowest quartile, the highest quartile of total OBS was associated with lower risks of all-cause mortality (HR 0.68) and cancer mortality (HR 0.55). Among cancer survivors, similar associations were observed with all-cause mortality (HR 0.66). Component analysis revealed consistent protective effects of antioxidant OBS (HR 0.60 for all-cause mortality), while higher pro-oxidant OBS showed varying associations across mortality causes.
Higher OBS was associated with lower mortality risks, particularly cancer-related mortality, in both the general population and cancer survivors. While antioxidant exposures showed consistent protective effects, the impact of pro-oxidant exposures varied by mortality causes.
氧化应激是慢性疾病和死亡率的关键病理生理机制。虽然已对个体氧化标志物进行了研究，但氧化平衡对死亡风险的综合影响仍不明确，尤其是在癌症幸存者中。我们旨在研究氧化平衡评分（OBS）与一般人群和癌症幸存者死亡率之间的关联。
本研究纳入了来自国家健康与营养检查调查（2001 - 2018年）的37317名成年人（52%为女性）。OBS根据抗氧化剂和促氧化剂暴露情况计算得出，并分为四分位数。采用调查加权的Cox比例风险模型来估计死亡风险的风险比。进行受限立方样条分析以检查潜在的非线性关系。进行分层分析以进一步细化研究结果。
在平均9.1年的随访期间，发生了5092例死亡。与最低四分位数相比，总OBS的最高四分位数与全因死亡率（风险比0.68）和癌症死亡率（风险比0.55）较低相关。在癌症幸存者中，观察到与全因死亡率有类似的关联（风险比0.66）。成分分析显示抗氧化剂OBS具有一致的保护作用（全因死亡率的风险比为0.60），而较高的促氧化剂OBS在不同死因中的关联有所不同。
在一般人群和癌症幸存者中，较高的OBS与较低的死亡风险相关，尤其是与癌症相关的死亡率。虽然抗氧化剂暴露显示出一致的保护作用，但促氧化剂暴露的影响因死因而异。
