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ORIGINAL RESEARCH article

Front. Endocrinol.
Sec. Clinical Diabetes
Volume 15 - 2024 | doi: 10.3389/fendo.2024.1458039
This article is part of the Research Topic Exploring the New Biomarkers and Clinical Indicators for Diabetes: Insights from Real-World Studies View all 23 articles

Association of oxidative balance score with cardiovascular disease and all-cause and cardiovascular mortality in American adults with type 2 diabetes: Data from the National Health and Nutrition Examination Survey 1999-2018

Provisionally accepted
Meilin Fan Meilin Fan 1,2Shina Song Shina Song 3,4*Tingting Chu Tingting Chu 5*Ronghong Li Ronghong Li 2*Miao Yue Miao Yue 2*Jing Yang Jing Yang 1*Xiaofeng Li Xiaofeng Li 6*
  • 1 Department of Endocrinology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China
  • 2 Department of Endocrinology, Linfen City People’s Hospital, Linfen, China
  • 3 Department of Geriatrics, General Hospital of TISCO, Taiyuan, China
  • 4 Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China
  • 5 Other, Linfen, China
  • 6 Department of General Medicine, Linfen City People’s Hospital, Linfen, China

The final, formatted version of the article will be published soon.

    Background: Oxidative stress has an important role in type 2 diabetes (T2D). Oxidative balance score (OBS) is an emerging assessment of dietary and lifestyle oxidative balance. We aimed to explore the association of OBS with cardiovascular disease (CVD) and all-cause and CVD mortality in the T2D population through NHANES 1999-2018.Methods: OBS integrated 16 dietary components and 4 lifestyle components. T2D was diagnosed according to the American Diabetes Association criteria. Multivariate logistic regression and multivariate Cox proportional hazards regression analyses were used to explore the association of OBS with CVD and mortality in T2D, respectively.Results: 3801 adult T2D participants were included. In fully adjusted models, OBS, dietary OBS, and lifestyle OBS were all negatively associated with the prevalence of CVD (odds ratios of 0.98, 0.98, and 0.85, respectively). Higher OBS and lifestyle OBS (p for trend 0.016 and <0.001, respectively) rather than dietary OBS (p for trend = 0.06) were associated with significantly lower odds of CVD. Higher OBS, dietary OBS, and lifestyle OBS were all negatively associated with all-cause mortality (hazard ratios [HR] of 0.98, 0.98, and 0.92, respectively; p for trend of 0.002, 0.009, and 0.035, respectively). Higher OBS and dietary OBS were negatively associated with CVD mortality (HR 0.96 and 0.95, respectively; p for trend both <0.001), whereas lifestyle OBS was not. Restricted cubic spline analysis suggested that most associations were linear. Stratified analyses showed that these associations were influenced by some demographic variables and disease status.Conclusions: Adherence to higher OBS was associated with reduced CVD prevalence and mortality risk in T2D. Antioxidant diet and lifestyle had more significant associations with mortality and CVD prevalence, respectively. However, as these findings are merely associations and do not allow causal inferences to be drawn, future validation in high-quality randomized controlled trials is needed.

    Keywords: Oxidative balance score, type 2 diabetes, Oxidative Stress, Mortality, cardiovascular disease

    Received: 01 Jul 2024; Accepted: 29 Nov 2024.

    Copyright: © 2024 Fan, Song, Chu, Li, Yue, Yang and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Shina Song, Department of Geriatrics, General Hospital of TISCO, Taiyuan, China
    Tingting Chu, Other, Linfen, China
    Ronghong Li, Department of Endocrinology, Linfen City People’s Hospital, Linfen, China
    Miao Yue, Department of Endocrinology, Linfen City People’s Hospital, Linfen, China
    Jing Yang, Department of Endocrinology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China
    Xiaofeng Li, Department of General Medicine, Linfen City People’s Hospital, Linfen, China

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