Association between the oxidative balance score and all-cause and cardiovascular mortality in patients with diabetes and prediabetes

IF 10.7 1区生物学 Q1 BIOCHEMISTRY & MOLECULAR BIOLOGY Redox Biology Pub Date : 2024-08-23 DOI:10.1016/j.redox.2024.103327

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Abstract

Background

Few studies have examined the link between systemic oxidative stress and mortality risk in diabetes and prediabetes patients. The Oxidative Balance Score (OBS) is a novel measure of systemic oxidative stress, with higher scores indicating greater antioxidant exposure. This study investigates the relationship between OBS and all-cause and cardiovascular mortality in these patients.

Methods

This study analyzed 10,591 diabetes and prediabetes patients from the 1999–2018 National Health and Nutrition Examination Survey (NHANES). The endpoints were all-cause and cardiovascular mortality, determined from the National Death Index (NDI). OBS was calculated using 20 dietary and lifestyle factors. Kaplan-Meier survival analysis, multivariable Cox regression models, restricted cubic splines (RCS), and subgroup analyses were used to assess the relationship between OBS and mortality risks.

Results

Over an average follow-up of 99.8 months, 2900 (26.4 %) participants died, including 765 (8.9 %) from cardiovascular diseases. Kaplan-Meier analysis showed the lowest all-cause and cardiovascular mortality in the highest OBS quartile (Q4) and the highest mortality in the lowest quartile (Q1) (p < 0.001). In the fully adjusted model, multivariable Cox regression revealed that each unit increase in OBS was linked to a 1.8 % decrease in all-cause mortality risk (HR 0.982, 95 % CI 0.976–0.987, p < 0.0001) and a 4 % decrease in cardiovascular mortality risk (HR 0.960, 95 % CI 0.949–0.970, p < 0.0001). Compared to Q1, those in Q4 had significantly lower all-cause mortality (HR 0.719, 95 % CI 0.643–0.804, p < 0.0001, p for trend <0.0001) and cardiovascular mortality (HR 0.567, 95 % CI 0.455–0.705, p < 0.0001, p for trend <0.0001). These findings were consistent across subgroups. RCS curves showed a negative correlation between OBS and both mortality types.

Conclusion

Higher OBS is linked to reduced all-cause and cardiovascular mortality in diabetes and prediabetes patients.

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糖尿病和糖尿病前期患者的氧化平衡评分与全因死亡率和心血管死亡率之间的关系

背景很少有研究探讨糖尿病和糖尿病前期患者全身氧化应激与死亡风险之间的联系。氧化平衡评分（OBS）是衡量全身氧化应激的一种新方法，得分越高表明抗氧化剂暴露越多。本研究调查了 OBS 与这些患者的全因死亡率和心血管死亡率之间的关系。方法本研究分析了 1999-2018 年美国国家健康与营养调查（NHANES）中的 10591 名糖尿病和糖尿病前期患者。研究终点是根据国家死亡指数（NDI）确定的全因死亡率和心血管死亡率。OBS通过20个饮食和生活方式因素计算得出。采用卡普兰-梅耶生存分析、多变量考克斯回归模型、限制性立方样条（RCS）和亚组分析来评估OBS与死亡风险之间的关系。结果在平均99.8个月的随访期间，2900名（26.4%）参与者死亡，其中765人（8.9%）死于心血管疾病。卡普兰-米尔分析显示，OBS最高四分位数（Q4）的全因死亡率和心血管死亡率最低，而最低四分位数（Q1）的死亡率最高（p < 0.001）。在完全调整模型中，多变量 Cox 回归显示，OBS 每增加一个单位，全因死亡风险降低 1.8%（HR 0.982，95 % CI 0.976-0.987，p < 0.0001），心血管死亡风险降低 4%（HR 0.960，95 % CI 0.949-0.970，p < 0.0001）。与第一季度相比，第四季度的全因死亡率（HR 0.719，95 % CI 0.643-0.804，p <0.0001，p for trend <0.0001）和心血管死亡率（HR 0.567，95 % CI 0.455-0.705，p <0.0001，p for trend <0.0001）明显降低。这些结果在不同的亚组中是一致的。RCS曲线显示，OBS与这两种死亡率之间呈负相关。

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来源期刊

Redox Biology BIOCHEMISTRY & MOLECULAR BIOLOGY-

CiteScore

19.90

自引率

3.50%

发文量

318

审稿时长

25 days

期刊介绍： Redox Biology is the official journal of the Society for Redox Biology and Medicine and the Society for Free Radical Research-Europe. It is also affiliated with the International Society for Free Radical Research (SFRRI). This journal serves as a platform for publishing pioneering research, innovative methods, and comprehensive review articles in the field of redox biology, encompassing both health and disease. Redox Biology welcomes various forms of contributions, including research articles (short or full communications), methods, mini-reviews, and commentaries. Through its diverse range of published content, Redox Biology aims to foster advancements and insights in the understanding of redox biology and its implications.