Guo Hongpeng, Zhang Junjie, Qi Ying, Sun Chenglin, Wu Ji
Department of General Surgery, Central Hospital Affiliated to Shenyang Medical College, China.
Department of Pathology, Central Hospital Affiliated to Shenyang Medical College, China.
J Int Med Res. 2025 May;53(5):3000605251340616. doi: 10.1177/03000605251340616. Epub 2025 May 15.
ObjectiveOxidative stress likely contributes to the pathogenesis of prediabetes. The oxidative balance score is an emerging metric for quantifying exposure to dietary and lifestyle oxidative stress. This study aimed to investigate the association between oxidative balance score and the prevalence of prediabetes, impaired fasting glucose, and impaired glucose tolerance based on data from the National Health and Nutrition Examination Survey 1999-2018.MethodsIn this cross-sectional study, the oxidative balance score was derived from 16 dietary and 4 lifestyle components, as outlined in previous research. Prediabetes, impaired fasting glucose, and impaired glucose tolerance were diagnosed based on the American Diabetes Association criteria. Multivariate logistic regression models were employed to analyze these associations.ResultsIn total, 22,960 participants with a mean age of 44.7 years were included in this study. In fully adjusted models, dietary oxidative balance score, lifestyle oxidative balance score, and overall oxidative balance score were all inversely associated with the prevalence of prediabetes among the general US adult population (odds ratios and 95% confidence intervals of 0.956 (0.949, 0.963), 0.914 (0.891, 0.937), and 0.957 (0.950, 0.964), respectively; all p <0.0001). Compared with quartile 1, dietary oxidative balance score, lifestyle oxidative balance score, and overall oxidative balance score at quartile 4 were all associated with a significantly lower prevalence of prediabetes (odds ratios and 95% confidence intervals 0.515 (0.449, 0.591), 0.834 (0.740, 0.940), and 0.505 (0.440, 0.579), respectively; all p for trend <0.0001). Similar results were observed for impaired fasting glucose and impaired glucose tolerance. Restricted cubic spline analysis showed that most of the associations were nonlinear and that significant negative correlations were observed only after a certain threshold. Stratified and sensitivity analyses confirmed the robustness of the findings.ConclusionsAdherence to an antioxidant-rich diet and healthy lifestyle may aid in the prevention of prediabetes, impaired fasting glucose, and impaired glucose tolerance among the general US adult population. Further cohort studies are needed to validate these findings.
目的
氧化应激可能在糖尿病前期的发病机制中起作用。氧化平衡评分是一种新兴的指标，用于量化饮食和生活方式中的氧化应激暴露。本研究旨在基于1999 - 2018年美国国家健康与营养检查调查的数据，探讨氧化平衡评分与糖尿病前期、空腹血糖受损和糖耐量受损患病率之间的关联。
方法
在这项横断面研究中，氧化平衡评分源自先前研究中概述的16种饮食和4种生活方式成分。根据美国糖尿病协会标准诊断糖尿病前期、空腹血糖受损和糖耐量受损。采用多变量逻辑回归模型分析这些关联。
结果
本研究共纳入22960名平均年龄为44.7岁的参与者。在完全调整模型中，饮食氧化平衡评分、生活方式氧化平衡评分和总体氧化平衡评分均与美国普通成年人群中糖尿病前期的患病率呈负相关（优势比和95%置信区间分别为0.956（0.949, 0.963）、0.914（0.891, 0.937）和0.957（0.950, 0.964）；所有p < 0.0001）。与第一四分位数相比，第四四分位数的饮食氧化平衡评分、生活方式氧化平衡评分和总体氧化平衡评分均与糖尿病前期患病率显著降低相关（优势比和95%置信区间分别为0.515（0.449, 0.591）、0.834（0.740, 0.940）和0.505（0.440, 0.579）；所有趋势p < 0.0001）。空腹血糖受损和糖耐量受损也观察到类似结果。限制立方样条分析表明，大多数关联是非线性的，且仅在达到一定阈值后才观察到显著的负相关。分层分析和敏感性分析证实了研究结果的稳健性。
结论
坚持富含抗氧化剂的饮食和健康的生活方式可能有助于预防美国普通成年人群中的糖尿病前期、空腹血糖受损和糖耐量受损。需要进一步的队列研究来验证这些发现。
