Liu Chang, Xiang Guoan, Liang Dan, Zhao Xuanbo, Xiao Kun, Xie Lixin
School of Medicine, Nankai University, Tianjin, China.
College of Pulmonary & Critical Care Medicine, The Eighth Medical Center of Chinese PLA General Hospital, Beijing, China.
Sci Rep. 2025 Jan 29;15(1):3609. doi: 10.1038/s41598-025-88132-y.
Oxidative balance score (OBS) is a composite measures that assess the balance between pro-oxidant and antioxidant factors in an individual's diet and lifestyle, with higher scores indicating greater antioxidant exposure. Despite its potential significance, there is a limited body of research exploring the relationship between OBS and all-cause and cardiovascular disease (CVD) mortality specifically in younger patients with diabetes. We aimed to investigate the possible relationship between OBS and all-cause and CVD mortality in younger patients with diabetes. Data for this study were obtained from the 2003-2018 NHANES. This study enrolled 3501 participants. The endpoints were all-cause and CVD mortality, determined by the National Death Index (NDI). OBS, which consists of 16 dietary factors and 4 lifestyle factors, is categorized into pro-oxidants and antioxidants. The OBS was categorized into four quartiles (Q1-Q4). We used multivariable Cox proportional hazards regression models to examine the association between continuous and quartile measures of OBS, lifestyle OBS (lifestyle antioxidants such as physical activity, etc., and lifestyle pro-oxidants such as alcohol, smoking, etc.), and dietary OBS (dietary antioxidants such as fiber, β-carotene, riboflavin, etc., and dietary pro-oxidants, such as total fat, etc.) with all-cause and CVD mortality. Additionally, we explored restricted cubic spline (RCS) analysis and also performed subgroup analyses and interaction tests. The occurrence of 409 all-cause deaths (11.7%) and 108 CVD-related deaths (3.1%) was recorded during the follow-up period. Our results found that OBS, lifestyle OBS, and dietary OBS were negatively associated with patients' all-cause and CVD mortality. The RCS analysis further validated the association of a linear negative correlation between OBS and all-cause and CVD mortality. The results of our subgroup analyses revealed that the negative association between OBS and CVD mortality may be influenced by alcohol use. In conclusion, results from a nationally representative study of younger American patients with diabetes suggest a negative association between OBS, lifestyle OBS, and dietary OBS and all-cause and CVD mortality. Antioxidant-rich diets and lifestyle improvements are essential for reducing all-cause and CVD mortality in patients.
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与抗氧化剂因素之间的平衡，分数越高表明抗氧化剂暴露程度越高。尽管其具有潜在重要性，但专门探讨OBS与全因死亡率及心血管疾病（CVD）死亡率之间关系的研究较少，尤其是在年轻糖尿病患者中。我们旨在研究年轻糖尿病患者中OBS与全因死亡率及CVD死亡率之间的可能关系。本研究的数据来自2003 - 2018年美国国家健康与营养检查调查（NHANES）。本研究纳入了3501名参与者。终点指标为全因死亡率和CVD死亡率，由国家死亡指数（NDI）确定。OBS由16种饮食因素和4种生活方式因素组成，分为促氧化剂和抗氧化剂两类。OBS被分为四个四分位数（Q1 - Q4）。我们使用多变量Cox比例风险回归模型来检验OBS的连续和四分位数指标、生活方式OBS（如体育活动等生活方式抗氧化剂以及酒精、吸烟等生活方式促氧化剂）和饮食OBS（如纤维、β - 胡萝卜素、核黄素等饮食抗氧化剂以及总脂肪等饮食促氧化剂）与全因死亡率和CVD死亡率之间的关联。此外，我们还进行了受限立方样条（RCS）分析，并开展了亚组分析和交互作用检验。在随访期间记录到409例全因死亡（11.7%）和108例CVD相关死亡（3.1%）。我们的结果发现，OBS、生活方式OBS和饮食OBS与患者的全因死亡率和CVD死亡率呈负相关。RCS分析进一步验证了OBS与全因死亡率和CVD死亡率之间线性负相关的关联。我们的亚组分析结果显示，OBS与CVD死亡率之间的负相关可能受饮酒影响。总之，一项针对美国年轻糖尿病患者的具有全国代表性的研究结果表明，OBS、生活方式OBS和饮食OBS与全因死亡率和CVD死亡率之间存在负相关。富含抗氧化剂的饮食和生活方式改善对于降低患者的全因死亡率和CVD死亡率至关重要。
