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ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutrition and Metabolism
Volume 12 - 2025 |
doi: 10.3389/fnut.2025.1536024
This article is part of the Research Topic Dietary Patterns and Oxidative Stress: Implications for Obesity, T2D, and Cancer Management View all 4 articles
Association of Oxidative Balance Score with All-Cause and Cardiovascular Mortality in Overweight and Obese
Provisionally accepted- Department of Nutrition, Hangzhou Third People's Hospital, Zhejiang Chinese Medical University, hangzhou, China
The Oxidative Balance Score (OBS) combines diverse dietary components with lifestyle factors to comprehensively evaluate oxidative stress. The investigation focuses on the link between the OBS and mortality outcomes, including cardiovascular and all-cause deaths, in overweight and obese individuals.The analysis utilized data from the National Health and Nutrition Examination Survey (NHANES), covering the period from 1999 to 2018. Mortality information, categorized into all-cause and cardiovascular deaths, was gathered from the National Death Index (NDI). Kaplan-Meier survival analysis, along with multivariate Cox regression and restricted cubic spline (RCS) modeling, were utilized to explore the link between OBS and mortality risks. Subgroup analysis and sensitivity analysis were used to assess the robustness of the results and possible effect modifiers. Mediation analysis identifies pathways through which the independent variable affects the dependent variable.Results: In this study, 26,219 participants with overweight or obesity were enrolled, with an average age of 49.8 ± 17.4 years. During a median follow-up duration of 115 months, 2,239 participants (8.5%) died, including 837 (3.2%) from cardiovascular disease. According to Kaplan-Meier analysis, mortality was highest among participants in the lowest OBS quartile (Q1) and lowest among those in the highest quartile (Q4). Participants in the fourth OBS quartile experienced a 21.7% decrease in the risk of mortality from all causes and a 29.5% decrease in cardiovascular mortality risk, according to fully adjusted results, compared to those in the first quartile. These results were validated through subgroup analyses. The analysis of RCS revealed a notable inverse association between OBS and mortality outcomes. Mediation analysis indicates that white blood cell count (WBC) and gammaglutamyl transferase (GGT) serve as significant mediators in the association between OBS and mortality risk.Elevated levels of OBS were strongly linked to reduced potential for both cardiovascular and all-cause mortality among individuals who are overweight or obese.
Keywords: Oxidative balance score, Mortality, Overweight, Obesity, Cardiovascular mortality
Received: 28 Nov 2024; Accepted: 15 Jan 2025.
Copyright: © 2025 Ying, Ding, Chen and Zheng. 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:
Hongyan Ding, Department of Nutrition, Hangzhou Third People's Hospital, Zhejiang Chinese Medical University, hangzhou, China
Yanjin Chen, Department of Nutrition, Hangzhou Third People's Hospital, Zhejiang Chinese Medical University, hangzhou, China
Su Zheng, Department of Nutrition, Hangzhou Third People's Hospital, Zhejiang Chinese Medical University, hangzhou, China
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