The role of oxidative balance score in Cardiovascular-Kidney-Metabolic syndrome progression and mortality: insights from NHANES 1999–2020
Year: 2025
Type: article
Abstract: Aims Cardiovascular-Kidney-Metabolic Syndrome (CKM) is a significant public health issue. This research explored the link between oxidative balance score (OBS) and the advancement of CKM, and assessed mortality risks across CKM stages in a U. S. cohort. Methods Data from 10 NHANES cycles (1999–2020) were analyzed, including 19,433 participants for primary analysis and 16,467 for survival analysis. Multinomial regression, Cox models, survival analysis and mediation analysis were employed to evaluate the relationships. Results The OBS was robustly associated with CKM stages, with each increment reducing the odds of CKM stages 1–4 (OR 0.93–0.90, all p < 0.001). The highest OBS quartile (Q4) lowered advanced CKM odds (OR 0.77, 95% CI 0.59–0.99, p = 0.045). Higher OBS values were associated with a lower risk of all-cause mortality (HR 0.97, 95%CI 0.95–0.99, p < 0.001) and cardiovascular disease (CVD) mortality (HR 0.96, 95% CI 0.93–0.99, p = 0.012) in individuals with non-advanced chronic kidney disease (CKD), and with a lower risk of CVD mortality (HR 0.97, 95% CI 0.94–0.99, p = 0.014) in those with advanced CKD. Kaplan–Meier curves showed better survival in higher OBS quartiles, especially for non-advanced CKM. Inflammatory markers (Ln-WBC and Ln-SUA) mediated 26.08 and 15.17% of the total effect in advanced CKM. Conclusion Improving oxidative balance may mitigate CKM progression and mortality risks. Additional studies are required to clarify the mechanisms and public health significance of OBS in CKM.
Source: Frontiers in Nutrition
Language: English
Subfield: Nephrology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
Funder: Fujian Medical University
OpenAlex ID: W4411916118