Zhang Lin, Zhang Heming, Xiang Hongxia, Zhang Jiachen, Gong Wei, Xv Junjie, Yu Xue
Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
College of Life Science, University of Chinese Academy of Sciences, Beijing, China.
Front Nutr. 2025 Jun 9;12:1604696. doi: 10.3389/fnut.2025.1604696. eCollection 2025.
This study examined the association between oxidative balance score (OBS), a composite measure of oxidative/antioxidative factors, and mortality, while investigating insulin resistance (IR) indices as potential mediators using a nationally representative cohort.
A cohort of 11,849 U. S. adults from NHANES (2007-2018) was analyzed. OBS integrated 16 dietary and 4 lifestyle components. Mortality risks (all-cause, cardiovascular, cancer) were assessed via weighted Cox models. Mediation analysis evaluated the indirect effects of five IR indices (TyG index, TG/HDL-C, HOMA-IR, eGDR, VAI) on OBS-mortality associations, with statistical validation of mediation effects. Analyses were stratified by age (<65 vs. ≥65 years) and adjusted for sociodemographic, behavioral, and clinical covariates.
Higher OBS reduced risks of all-cause (HR = 0.652, 95% CI: 0.525-0.81) and cardiovascular mortality (HR = 0.605, 95% CI: 0.408-0.898), but not cancer mortality. Innovatively, eGDR mediated 17% of OBS's protective effect on all-cause mortality in adults <65 years, while TyG index and HOMA-IR showed weaker mediation. No IR mediation occurred in older adults (≥65 years).
Higher OBS levels were inversely associated with all-cause and cardiovascular mortality, partially mediated by insulin resistance pathways. These findings highlight OBS as a potential prognostic indicator for mortality risk.
本研究探讨了氧化平衡评分（OBS，一种氧化/抗氧化因子的综合测量指标）与死亡率之间的关联，同时使用具有全国代表性的队列研究调查胰岛素抵抗（IR）指标作为潜在的中介因素。
分析了来自美国国家健康与营养检查调查（NHANES，2007 - 2018年）的11849名美国成年人队列。OBS整合了16种饮食和4种生活方式成分。通过加权Cox模型评估死亡风险（全因、心血管、癌症）。中介分析评估了五个IR指标（TyG指数、甘油三酯/高密度脂蛋白胆固醇、稳态模型评估胰岛素抵抗（HOMA-IR）、估算肾小球滤过率（eGDR）、内脏脂肪指数（VAI））对OBS-死亡率关联的间接影响，并对中介效应进行了统计学验证。分析按年龄（<65岁与≥65岁）分层，并对社会人口统计学、行为和临床协变量进行了调整。
较高的OBS降低了全因死亡率（风险比（HR）=0.652，95%置信区间（CI）：0.525 - 0.81）和心血管死亡率（HR = 0.605，95% CI：0.408 - 0.898），但未降低癌症死亡率。创新性地，eGDR介导了<65岁成年人中OBS对全因死亡率保护作用的17%，而TyG指数和HOMA-IR的中介作用较弱。在老年人（≥65岁）中未发生IR介导作用。
较高的OBS水平与全因死亡率和心血管死亡率呈负相关，部分由胰岛素抵抗途径介导。这些发现凸显了OBS作为死亡风险潜在预后指标的作用。
