Oxidative balance score is inversely associated with the incidence of non-alcoholic fatty liver disease

The Mediating Role of Oxidative Stress on the Association Between Oxidative Balance Score and Cancer-Related Cognitive Impairment in Lung Cancer Patients: A Cross-Sectional Study

OBJECTIVES

To explore the association between the oxidative balance score (OBS) and cancer-related cognitive impairment (CRCI) in patients with lung cancer, as well as the oxidative stress biomarkers involved.

METHODS

In this cross-sectional study, 315 lung cancer patients were recruited, from whom 142 blood samples were collected to determine oxidative stress biomarkers. Dietary intake was assessed using 3-day, 24 h dietary recalls. The OBS was calculated by summing up pro- and antioxidant factors from a diet and lifestyles assessment. CRCI was evaluated using the Montreal Cognitive Assessment (MoCA) test.

RESULTS

A total of 103 patients (32.7%) developed CRCI, with significantly lower OBS and dietary OBS and lower superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities than non-CRCI patients (p < 0.05). For every 1-point increase in OBS, the risk of CRCI was reduced by 10.6% (OR = 0.894; 95% CI 0.819, 0.977; p = 0.013). Both vitamin E (OR = 0.922; 95% CI 0.868, 0.980; p = 0.009) and dietary fiber (OR = 0.909; 95% CI 0.832, 0.992; p = 0.032) were significantly inversely related to CRCI. The association between the total OBS and CRCI was mediated by SOD (ACME = -0.0061; 95% CI -0.0170, -0.0004; p = 0.015) and GPx (ACME = -0.0069; 95% CI -0.0203, -0.0002; p = 0.032), respectively.

CONCLUSIONS

Lung cancer patients with a greater balance of antioxidant to pro-oxidant diet, especially rich in dietary fiber and vitamin E, may decrease their CRCI in part by affecting SOD and GPx activities.

The association between oxidative balance score and muscular dystrophies

Introduction

This research utilized data from the NHANES 2011-2018 study to investigate the connection between the Oxidative Balance Score (OBS) and muscular dystrophies.

Methods

This study is a cross-sectional, observational, secondary analysis utilizing data from the NHANES 2011-2018. Spearman's correlation, chi-square tests, logistic regression, and restricted cubic spline plots were employed for statistical analyses.

Results

This association remained significant after adjustment for various demographic and medical history factors (For continuous OBS: crude model, odds ratio [OR], 0.95, 95% confidence interval [CI:] 0.94, 0.97, p < 0.001; Model 1, OR, 0.94, 95% CI: 0.92, 0.96, p < 0.001; Model 2, OR, 0.95, 95% CI: 0.93, 0.97, p < 0.001; Model 3, OR, 0.95, 95% CI: 0.93, 0.97, p < 0.001; In quartile Q4 vs. Q1: Crude model, OR, 0. 42, 95% CI: 0.26, 0.66, p < 0.001; Model 1, OR, 0.33, 95% CI: 0.21, 0.52, p < 0.001; Model 2, OR, 0.37, 95% CI: 0.23, 0.58, p < 0.001; Model 3, OR, 0.38, 95% CI: 0.23, 0.60, p < 0.001). Restricted cubic spline (RCS) analysis further supported this inverse relationship, suggesting that OBS values above 10 may confer protection against muscular dystrophies (p for overall <0.001, p for non-linear = 0.536). However, the relationship between OBS and muscular dystrophies was not statistically significant in the subgroups with education level below high school, presence of cancer, or diabetes (p = 0.735, p = 0.574, p = 0.409, respectively).

Conclusion

The study found a significant inverse correlation between the OBS and muscular dystrophies, suggesting that individuals with higher oxidative balance had a lower risk of developing muscular dystrophies. The study highlights the potential role of oxidative balance in muscular dystrophies prevention and management.

Association between oxidative balance score and resistant hypertension and arterial stiffness among US adults: A population-based study

BACKGROUND AND AIMS

Prior studies have established the correlation between oxidative balance score (OBS) and hypertension (HTN). While the association between OBS and resistant hypertension (RHT) as well as arterial stiffness among individuals with hypertension remains undisclosed.

METHODS AND RESULTS

In this study, total of 15,910 adults diagnosed with hypertension were enrolled from NHANES 2001-2018. OBS was calculated and categorized into quartiles. Weighted regression model, stratified analyses and restricted cubic spline (RCS) were employed to evaluate the association between OBS and RHT, major adverse cardiovascular events (MACEs) and arterial stiffness in individuals with hypertension. Among enrolled participants, high OBS quartiles consistently demonstrated a negative association with resistant hypertension across all models (all p < 0.05), indicating robust stability. Compared with the lowest OBS quartile, the risk of resistant hypertension in the highest OBS quartile was decreased by 30.8% (95%CI 0.471-0.995, p = 0.049). After dividing OBS into dietary OBS and lifestyle OBS, a significant inverse association with lifestyle OBS and RHT was observed. With regard to MACEs, the inverse association was also found in participants with high OBS. Besides, the potential relation between OBS and arterial stiffness was explored and we found OBS was significantly associated with decreased arterial stiffness (β for ePWV, -0.014; 95%CI -0.026 to -0.001; p = 0.032). RCS analysis confirmed a nonlinear association between OBS and RHT, MACEs, cardiovascular death and nonfatal MI among participants with hypertension.

CONCLUSION

Elevated OBS was negatively associated with the risk of RHT and arterial stiffness among US adults with hypertension.

Associations between the oxidative balance score and constipation: a cross-sectional study of the NHANES, 2005-2010

OBJECTIVE

The oxidative balance score (OBS) reflects the overall burden of oxidative stress in an individual, with a higher OBS indicating greater antioxidant exposure. This study aimed to explore the association between constipation and OBS.

METHODS

Variables were extracted from participants who completed a constipation questionnaire as part of the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2010. The OBS was developed based on dietary and lifestyle factors, encompassing 16 nutrients and 4 lifestyle variables. Weighted logistic regression and restricted cubic spline (RCS) analyses were employed to evaluate the association between OBS and constipation.

RESULTS

After adjusting for all covariates, weighted multivariate logistic regression analysis revealed a 4% reduction in the incidence of constipation for each additional unit of OBS (OR: 0.96, 95% CI: 0.95-0.97, p < 0.001). In the OBS subgroup, the risk of constipation significantly decreased compared to that in the lowest quartile (Q2: 0.72, P = 0.024; Q3: 0.59, P < 0.001; Q4: 0.54, P < 0.001).

CONCLUSIONS

The present study demonstrated a significant association between constipation and the oxidative balance score (OBS), particularly dietary OBS, and that an increase in OBS may reduce the risk of developing constipation, in which oxidative stress may play an important role. This finding suggested that dietary modification could be an important approach for preventing constipation.

Association between oxidative balance score and rheumatoid arthritis in female: a cross-sectional study

OBJECTIVE

Although oxidative stress is a recognized factor of inflammation, the correlation between oxidative balance score (OBS), a biomarker indicating the balance of oxidation and antioxidant, and rheumatoid arthritis (RA), an immune system disease that tends to occur in women, remains unexplored. Hence, the aim of this study was to investigate the potential association between OBS and RA in women.

METHODS

Observational surveys were performed by employing information extracted from the National Health and Nutrition Examination Survey (NHANES) for the period 2007-2018. Various statistical techniques were employed to investigate the association between OBS and RA, encompassing multivariable logistic regression analysis, subgroup analyses, smooth curve fitting, and threshold effect analysis.

RESULTS

The study included 8219 female participants, including 597 patients with RA. The results showed that higher Total OBS (TOBS) significantly correlated with lower RA prevalence in the entirely modified model [odd ratio (OR) = 0.968; 95% confidence interval (CI) = 0.952 to 0.984; P = 0.0001]. Dietary OBS (DOBS) and lifestyle OBS (LOBS) also negatively correlated with RA. This association was remarkably consistent across TOBS subgroups by age, race, education level, family poverty-to-income ratio (PIR), hypertension and diabetes. Smooth curve fitting and threshold effect analysis also revealed the linear relationship between OBS and RA.

CONCLUSIONS

Overall, OBS was negatively associated with RA in female. This study suggested that an antioxidant diet and lifestyle may be promising measures to prevent RA in female.

Oxidative Balance Score and New-Onset Type 2 Diabetes Mellitus in Korean Adults without Non-Alcoholic Fatty Liver Disease: Korean Genome and Epidemiology Study-Health Examinees (KoGES-HEXA) Cohort

The oxidative balance score (OBS) is a novel composite of pro- and anti-oxidative markers for assessing the risk of cardiometabolic diseases and non-alcoholic fatty liver disease (NAFLD). However, it has not yet been established whether the OBS is related to type 2 diabetes mellitus (T2DM), especially in a population without NALFD. Therefore, we aimed to investigate the longitudinal effect of the OBS on T2DM in a large cohort of Korean adults without NALFD. Data were assessed from 9798 participants without NALFD from the Korean Genome and Epidemiology Study-Health Examinees (KoGES-HEXA) cohort. The participants were divided into three groups according to OBS tertiles, identified as T1-T3. We prospectively assessed the hazard ratios (HRs) with 95% confidence intervals (CIs) for new-onset T2DM using multivariable Cox proportional hazard regression models over 6 years following the baseline survey. During the mean 3.5 years of follow-up, 145 individuals (1.48%; 56 men and 89 women) developed T2DM. The HRs of T2DM for the OBS tertiles were 0.79 (95% CI, 0.53-1.18) and 0.60 (95% CI, 0.39-0.93) in the T2 and T3 groups after adjusting for metabolic parameters in subjects without NALFD, respectively; however, the T2 group did not show statistical significance toward a decrease in incident T2DM. A low OBS may be a useful predictive marker in new-onset T2DM for middle-aged and older subjects without NALFD. This implies that the OBS could be an additional valuable tool for assessing the incidence of T2DM among individuals without NAFLD.

Associations of oxidative balance score with total abdominal fat mass and visceral adipose tissue mass percentages among young and middle-aged adults: findings from NHANES 2011-2018

Objective

This study aimed to explore the association of the oxidative balance score (OBS) with total abdominal fat mass (TAFM) and visceral adipose tissue mass (VATM) percentages among young and middle-aged U.S. adults.

Methods

Young and middle-aged adults in the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018 were included. Analysis of variance and Rao-Scott adjusted chi-square tests were used to compare the characteristics across quartiles of OBS. Univariate and multivariate weighted logistic regression models were employed to explore the relationship between OBS and the risks of high TAFM or high VATM percentage in the general population and subgroups, while the interaction effects were tested with a likelihood test. Weighted restricted cubic spline analyses were utilized to assess the non-linear association of OBS with TAFM and VATM percentages.

Results

The final sample included 8,734 young and middle-aged non-institutionalized U.S. adults representing 134.7 million adults. Compared with adults in the first quartile of OBS, those with higher OBS were less likely to have a high TAFM percentage; the ORs and 95% CI for adults in the second, third, and highest quartiles of OBS were 0.70 (0.53-0.94), 0.49 (0.36-0.60), and 0.25 (0.18-0.36), respectively. Similar trends were observed in the association between OBS and VATM percentages. Moreover, similar effects were confirmed in the sensitivity analyses and subgroup analyses according to demographic characteristics. Regarding the OBS subclass, higher dietary OBS and lifestyle OBS were also correlated with decreased ORs of high TAFM and VATM percentages.

Conclusion

This study strongly suggests that higher OBS, as well as higher dietary OBS and lifestyle OBS, are significantly correlated with lower risks of abdominal obesity and visceral fat accumulation. The findings highlight the importance of an antioxidant-rich diet and maintaining a healthy lifestyle in reducing the risks.

Associations of dietary oxidative balance score with femur osteoporosis in postmenopausal women: data from the National Health and Nutrition Examination Survey

We used data from the NHANES to explore associations of DOBS with femur BMD and osteoporosis in postmenopausal women. We found that DOBS was positively associated with femur BMD and negatively associated with the risk of osteoporosis in postmenopausal women.

PURPOSE

The study aimed to investigate the relationship between dietary oxidative balance score (DOBS) and the risk of osteoporosis in American postmenopausal women.

METHODS

A total of 3043 participants were included in this study. The linear relationship between DOBS and femur BMD was evaluated using a weighted multivariate linear regression model. The association between DOBS and the risk of osteoporosis was assessed using a weighted logistic regression model, with odds ratios (ORs) and 95% confidence intervals (CIs) calculated. Moreover, the relationship was further characterized through smooth curve fitting (SCF) and weighted generalized additive model (GAM) analysis.

RESULTS

After adjusting for all covariates, the weighted multivariable linear regression models showed a positive correlation between DOBS and femur BMD. Moreover, the weighted logistic regression model demonstrated that compared to the first tertile of DOBS, the highest tertile of DOBS was significantly associated with a lower risk of osteoporosis, with ORs of 0.418 (95% CI, 0.334, 0.522) for individuals under the age of 70 and 0.632 (95% CI, 0.506, 0.790) for individuals aged 70 or above. Similar trends were also observed in SCF and GAM models.

CONCLUSION

The present study indicated that postmenopausal women with a higher DOBS have a lower risk of femur osteoporosis. This finding may highlight the potential protective role of an antioxidant-rich diet for the bones of the postmenopausal population. Moreover, DOBS may also be a valuable tool in identifying individuals with osteoporosis. Screening and early intervention for osteoporosis may be essential for postmenopausal women with low DOBS.

Trends in Oxidative Balance Score and Prevalence of Metabolic Dysfunction-Associated Steatotic Liver Disease in the United States: National Health and Nutrition Examination Survey 2001 to 2018

BACKGROUND

Most studies have primarily focused on assessing the association between diet or exercise patterns and metabolic dysfunction-associated steatotic liver disease (MASLD). This study adopted a more comprehensive approach by introducing the oxidative balance score (OBS) to evaluate the combined effects of diet and lifestyle on the body's antioxidant ability. Our main objective was to investigate the association between OBS and the burden of MASLD in the United States.

METHODS

Participants with complete information from 2001 to 2018 were included. In the absence of other definite liver injury factors, the United States fatty liver index (us-FLI) ≥ 30 was used as the diagnostic criterion for MASLD. We first calculated the weighted prevalence for each cycle and stratified it according to demographic and metabolic-related disease characteristics. Subsequently, weighted multiple logistic regression was used to evaluate the relationship between OBS and MASLD. In addition, we explored the body's inflammatory state and the level of insulin resistance (IR) in mediating OBS and MASLD.

RESULTS

From 2001 to 2018, the prevalence of MASLD in the U.S. population as a whole increased from 29.76% to 36.04%, and the rate was higher in people with metabolic-related diseases. Notably, OBS exhibited a negative correlation with MASLD. Participants in the highest tertile of OBS had a significantly lower prevalence of MASLD compared to those in the lowest tertile [OR: 0.72, 95%CI: (0.57, 0.92), p < 0.001]. Moreover, a high OBS is associated with a lower inflammatory state and level of IR. The body's inflammatory state and IR level mediated the association between OBS and MASLD by 5.2% and 39.7%, respectively (both p < 0.001).

CONCLUSIONS

In this study, we observed an increasing prevalence of MASLD over the years. A higher OBS was associated with a lower risk of MASLD, especially when OBS ≥ 25. The body's inflammatory state and IR level mediate the association between OBS and MASLD, but the mechanism needs to be further investigated.