Lin Yucui, Wang Yunxia, Liu Cailing, Ye Danjie, Huang Ziran, Ou Yangbin, Gu Wenjun, Ma Jianhong
Department of Laboratory Medicine, Heyuan People's Hospital, Guangdong Provincial People's Hospital, Heyuan Hospital, Heyuan, China.
Department of Pharmacy, Huizhou Third People's Hospital, Guangzhou Medical University, Huizhou, China.
Front Nutr. 2025 Jun 25;12:1618184. doi: 10.3389/fnut.2025.1618184. eCollection 2025.
Cardio-renal-metabolic (CRM) conditions are increasingly recognized as a major public health challenge, with oxidative stress playing a pivotal role in poor prognosis. The oxidative balance score (OBS) is used to assess the body's oxidative stress status, but its link to all-cause and cardiovascular mortality in CRM patients remains unclear.
We used data from participants (≥ 20 years old) in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. The patients were divided into four groups based on OBS using the weighted quartiles method. The relationship between OBS and both all-cause and cardiovascular mortality in CRM patients was assessed using multivariable Cox regression and restricted cubic spline (RCS) models. The differences in cumulative survival between groups were examined using Kaplan-Meier analysis and log-rank tests. Sensitivity analysis and subgroup analysis were also performed.
During a median follow-up of 7.9 years, there were 3,838 (25.2%) and 1,412 (8.9%) patients who died from all-cause and cardiovascular mortality, respectively. After adjusting for potential confounders, elevated OBS level was negatively related to the risk of all-cause mortality [Q2, Q3, Q4: adjusted hazard ratio (aHR) (95 confidence interval (CI%)) = 0.85 (0.75-0.96), 0.87 (0.77-0.98), 0.74 (0.62-0.88), respectively; P for trend<0.001]. Moreover, Higher OBS quartiles were linked to a decreased risk of cardiovascular mortality, while no significant reduction was observed in the lower quartiles [model 3: Q2, Q3, Q4: aHR (95CI%) = 0.96(0.77-1.19), 0.78 (0.63-0.97), 0.70 (0.53-0.93), respectively; P for trend = 0.003]. Kaplan-Meier survival analysis also indicated that patients in the highest quartile of OBS had the lowest risk of both all-cause mortality and cardiovascular mortality (log-rank test < 0.001). Furthermore, restricted cubic spline analyses revealed an inverse relationship between OBS levels and the risk of both all-cause and cardiovascular death. The sensitivity analyses confirmed the stability of our findings.
Elevated levels of OBS were negatively related to the risk of all-cause and cardiovascular mortality among CRM patients, which may offer valuable information on the role of oxidative stress status for risk stratification of mortality in CRM patients.
心肾代谢（CRM）疾病日益被视为一项重大的公共卫生挑战，氧化应激在不良预后中起关键作用。氧化平衡评分（OBS）用于评估机体的氧化应激状态，但其与CRM患者全因死亡率和心血管死亡率之间的关联仍不明确。
我们使用了1999年至2018年美国国家健康与营养检查调查（NHANES）中年龄≥20岁参与者的数据。采用加权四分位数法根据OBS将患者分为四组。使用多变量Cox回归和受限立方样条（RCS）模型评估CRM患者中OBS与全因死亡率和心血管死亡率之间的关系。使用Kaplan-Meier分析和对数秩检验检查组间累积生存率的差异。还进行了敏感性分析和亚组分析。
在中位随访7.9年期间，分别有3838例（25.2%）和1412例（8.9%）患者死于全因和心血管疾病。在调整潜在混杂因素后，OBS水平升高与全因死亡风险呈负相关[Q2、Q3、Q4：调整后风险比（aHR）（95%置信区间（CI%））分别为0.85（0.75 - 0.96）、0.87（0.77 - 0.98）、0.74（0.62 - 0.88）；趋势P<0.001]。此外，较高的OBS四分位数与心血管死亡风险降低相关，而在较低四分位数中未观察到显著降低[模型3：Q2、Q3、Q4：aHR（95%CI%）分别为0.96（0.77 - 1.19）、0.78（0.63 - 0.97）、0.70（0.53 - 0.93）；趋势P = 0.003]。Kaplan-Meier生存分析还表明，OBS最高四分位数的患者全因死亡率和心血管死亡率风险最低（对数秩检验<0.001）。此外，受限立方样条分析显示OBS水平与全因和心血管死亡风险之间存在负相关。敏感性分析证实了我们研究结果的稳定性。
OBS水平升高与CRM患者的全因死亡率和心血管死亡率风险呈负相关，这可能为氧化应激状态在CRM患者死亡风险分层中的作用提供有价值的信息。
