Association between oxidative balance score and kidney stone in United States adults: analysis from NHANES 2007-2018

Assessment of oxidative balance score with hypertension and arterial stiffness in children and adolescents: NHANES 2001-2018

OBJECTIVE

To investigate the complex relationship between oxidative balance score (OBS), hypertension (HTN) and arterial stiffness in children and adolescents utilizing data gathered from the National Health and Nutrition Examination Survey (NHANES).

STUDY DESIGN

Through utilizing NHANES data (2001-2018), OBS, comprising dietary and lifestyle components, was calculated and categorized into tertiles. The correlation between OBS and HTN was explored employing weighted multivariate logistic regression. Stratified analyses were further performed to evaluate the associations across different subgroups.

RESULTS

A total of 11,754 children and adolescents were ultimately enrolled in analyses. High OBS tertiles demonstrated a consistent negative association with HTN across models. Compared with the lowest OBS tertile, the risk of HTN in the highest OBS tertile was decreased by 37% (95% CI 0.44-0.90, p = 0.011). After dividing OBS into dietary OBS and lifestyle OBS, Lifestyle OBS exhibited a significant inverse association with HTN, while dietary OBS showed no significant correlation. Stratified analyses notably revealed the protective impacts of OBS on the risk of HTN in males. Restricted cubic spline analysis confirmed a nonlinear association between OBS and HTN. Moreover, the elevated OBS was significantly associated with decreased ePWV, indicating a potential link between arterial stiffness and OBS.

CONCLUSION

In summary, the risk of HTN was inversely correlated with high OBS. Adopting a wholesome lifestyle enriched with antioxidants to boost OBS may help shield children from HTN risk.

Oxidative balance is associated with diabetic kidney disease and mortality in adults with diabetes mellitus: Insights from NHANES database and Mendelian randomization

OBJECTIVE

To explore and validate the association between the oxidative balance and prevalence of diabetic kidney disease (DKD) and mortality in patients with diabetes.

STUDY DESIGN

A large and representative sample from the National Health and Nutrition Examination Survey (NHANES) from 2013 to 2016 was analyzed to study the potential association between Oxidative Balance Score (OBS) and prognosis of DKD in adult diabetic patients. Weighted multivariate logistic regression analysis was conducted to examine the relationship between OBS and DKD risk. Subgroup analysis, sensitivity analysis, and mediation effect analysis were conducted to explore the effect of the covariates and assess the robustness of the findings. Mendelian randomization (MR) was employed to evaluate the correlated relationship between mitochondrial reactive oxygen species (ROS) levels and DKD at the genetic level.

RESULT

The highest OBS quartile showed the most significant negative correlation with DKD compared to the lowest OBS quartile (OR = 0.62, 95% CI 0.41-0.92, P = 0.017). Higher OBS was associated with a reduced risk of DKD (OR = 0.96; 95% CI = 0.93, 0.98; P < 0.001) and mortality (P = 0.021 by log-rank) in diabetic patients. This association remained robust even after excluding individual OBS components. Subgroup analysis revealed the interaction of metabolic syndrome on OBS was significant. Mediation analyses revealed that OBS's effect on DKD was independent of blood uric acid and cholesterol. Restricted cubic spline (RCS) analysis indicated a typical L-shaped relationship between OBS and DKD risk. The physical activity was identified as the core variable predicting DKD risk by two machine learning algorithms. MR showed a potential correlated relationship between ROS and microalbuminuria in DKD.

CONCLUSIONS

The high level of oxidative balance score was negatively correlated with the risk of DKD and mortality in diabetic patients.

Integrated proteomics reveals enrichment of oxidative stress and inflammatory proteins in the urine and stone matrix of calcium oxalate stone formers

Nephrolithiasis is a multifactorial disease associated with urinary and matrix proteins that become a focal point of research for diagnostic and preventative strategies. The functional relevance of these proteins in lithogenesis, along with their origins and impacts, remains a major subject of ongoing lithogenic research. Here, an integrated analysis was done on multiple proteome datasets compiled from various studies of normal urine (NU), urine from calcium oxalate stone formers (SFU), and calcium oxalate stone matrix (SM). Functional annotation and network analysis revealed the profound enrichment of proteins associated with oxidative stress and inflammation only in the stone-related samples (both "SFU but not NU" and "SM but not NU" cohorts). The oxidative stress and inflammation-related proteins were most abundant in the "SM but not NU" cohort and had higher proportions in the "SFU but not NU" cohort than the "NU only" cohort. KEGG pathway analysis corroborated such observation and highlighted the inclusion of proteins in the complement and coagulation pathways, particularly in SM. The findings of this study inform some mechanistic insights into the roles of calcium oxalate stone-related proteins and may help develop effective prevention and treatment strategies for nephrolithiasis.

Relationship between oxidative balance indicators and Chronic Kidney Disease

INTRODUCTION

Chronic Kidney Disease (CKD) is a growing global health issue, affecting approximately 9.1% of the world's population. Oxidative stress is believed to play a key role in CKD development, with indicators such as the Oxidative Balance Score (OBS), Pro-Oxidant-Antioxidant Balance (PAB), and Total Antioxidant Capacity (TAC) being of particular interest. However, their association with CKD remains unclear.

METHODS

This study conducted a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES) 2009-2018. A total of 18,951 participants were included after applying specific inclusion criteria. Logistic regression models and restricted cubic spline regression were employed to examine the associations between these oxidative balance indicators and CKD. Subgroup and interaction analyses were also conducted for further data analyses. Finally, ROC curve analysis was used to assess the predictive performance of these indicators for CKD risk.

RESULTS

After adjusting for various confounding factors, higher levels of OBS and PAB were significantly associated with a reduced risk of CKD (OR = 0.97, 95% CI: 0.96-0.99, P < 0.001; OR = 0.94, 95% CI: 0.92-0.97, P < 0.001, respectively). The ORs for the highest quartiles of OBS and PAB were 0.60 (95% CI: 0.49-0.75, P < 0.001) and 0.77 (95% CI: 0.63-0.94, P = 0.013), respectively. In contrast, TAC showed no significant association with CKD. ROC curve analysis further indicated that OBS had a superior predictive ability for CKD risk (AUC = 0.579) compared to PAB (AUC = 0.519) and TAC (AUC = 0.492).

CONCLUSION

The study suggests that oxidative balance indicators, particularly OBS and PAB, are inversely associated with CKD risk, while TAC showed no significant link. OBS demonstrated the strongest predictive ability among the indicators. These findings highlight the potential role of oxidative balance in CKD prevention. Further research is needed to confirm these associations in diverse populations and to explore the underlying mechanisms.

Association between oxidative balance score and cardiovascular diseases: mediating analysis of methylmalonic acid based on the NHANES database

Aim

To explore the association between oxidative balance score (OBS) and cardiovascular diseases (CVD) in patients with hypertension, and further clarify the mediating role of methylmalonic acid (MMA) in the relationship between OBS and CVD risk.

Methods

We included 4,137 participants with hypertension from the 2011-2014 National Health and Nutrition Examination Survey cohort. The study endpoint was the incidence of CVD in patients with hypertension. OBS was calculated based on 16 dietary and 4 lifestyle components. Weighted multivariable logistic regression models were adopted to assess the associations between OBS and CVD risk, OBS and MMA levels, and MMA levels and CVD risk. Odds ratios (OR) and 95% confidence interval (CI) were estimated. We used distribution-of-product method to test for mediation effect, with a presence of mediation indicated by 95% CI that does not include 0 for the distribution-of-product method and 95% CI that does not include 1 for the indirect effect.

Results

Totally 812 developed CVD. In weighted multivariable logistic regression models, lower OBS category (OBS < 15.72) was associated with increased odds of CVD (OR = 1.53, 95%CI: 1.17-2.01) and MMA levels (OR = 1.32, 95%CI: 1.06-1.65), respectively, compared with higher OBS category as reference. A positive relationship between higher MMA levels (≥154.90 nmol/L) and CVD risk was observed (OR = 1.34, 95%CI: 1.07-1.68). Importantly, according to the distribution-of-product test, a potential mediating effect of MMA on the relationship between OBS and CVD was found (OR = 1.08, 95%CI: 1.01-1.19), with a 95% CI for distribution-of-product of 0.08 (95% CI: 0.01-0.17). The mediated proportion was 17.8%. Subgroup analysis revealed a mediating effect of MMA in individuals with dyslipidemia, with a mediated proportion of 14.9%.

Conclusion

MMA plays a critical mediating role in the pathway between OBS and CVD risk.

The Role of the Gut Microbiome in Kidney Stone Disease

Microbiome dysbiosis is closely related to the etiology of kidney stone disease (KSD) and influences a multitude of pathways. Due to our knowledge gaps on this topic, it is still unclear if microbiome interventions can be translated to demonstrate clinical efficacy. Current evidence suggests that the enhancement of butyrate-producing pathways should be the next step for KSD research. While we are not yet at a point where we can make clinical recommendations for KSD, there are many simple dietary or supplement-based approaches that could be applied in the future for prophylaxis or treatment of KSD.

Association between oxidative balance score and heart failure in the older adults: Results from the NHANES 2005-2018

BACKGROUND

Heart failure (HF) imposes a substantial burden on older adults, and healthy diets and lifestyles may bring with benefits. However, quantifiable studies on the dietary and lifestyle risk factors for HF are scant. The Oxidative Balance Score (OBS) reflects the oxidative stress status of dietary components and lifestyle factors, but its relationship with HF risk is unclear.

OBJECTIVE

We aims to explore the association between OBS and the prevalence of HF.

METHODS

Using data from the National Health and Nutrition Examination Survey (NHANES) 2005-2018, the association between OBS and the HF prevalence was analyzed by weighted logistic regression and restricted cubic splines (RCS). Subgroup and sensitivity analyses assessed the stability of the results.

RESULTS

The prevalence of HF in the cohort of 6238 older adults was 5.55 %. Compared to the lowest quintile, the adjusted ORs for HF in the highest quintile of OBS and lifestyle OBS were 0.57 (95 % CI: 0.33,0.97) and 0.21 (95 %CI: 0.09,0.50), respectively. The association between OBS and HF prevalence remained stable across different models and subgroups. RCS revealed a potential inflection point. Sensitivity analysis validated the negative association between OBS and HF prevalence, and the correlation analysis between OBS and serum γ-glutamyltransferase (γ-GGT) confirmed the reliability of the study design.

CONCLUSION

The OBS is negatively associated with HF prevalence in older adults, and may help prevent HF in this population.

Association between cardiometabolic index and kidney stone from NHANES: a population-based study

Purpose

The Cardiometabolic Index (CMI) is a novel marker of visceral obesity and dyslipidemia. Our study aimed to explore the association between CMI and kidney stones among US adults.

Methods

This cross-sectional study was conducted among adults with complete records of CMI and kidney stones information from the 2011 to 2018 National Health and Nutrition Examination Survey (NHANES). Inverse probability treatment weighting (IPTW) was used to balance the baseline characteristics of the study population. The independent relationship between CMI and kidney stones was evaluated using IPTW-adjusted multivariate logistic regression, restricted cubic splines (RCS), and subgroup analysis.

Results

A total of 9,177 participants, with an average CMI of 0.72 (0.99), were included in this study. The IPTW-adjusted logistic regression revealed that CMI was an independent risk factor for kidney stones. The adjusted odds ratio (OR) for kidney stones were 1.39 (95% CI: 1.24 - 1.56, P < 0.001) for the second CMI tertile and 1.31 (95% CI: 1.17 - 1.47, P < 0.001) for the third CMI tertile, compared with the first CMI tertile. A linear relationship between CMI levels and kidney stone risk was observed in the RCS analysis. Subgroup analysis showed that the association between CMI levels and kidney stone risk remained stable across groups.

Conclusions

A positive association between CMI level and the risk of kidney stones was observed among US adults in our study. Further large-scale prospective studies are needed to validate our findings.

Association of the oxidative balance score and chronic kidney disease: insights from the national health and nutrition examination survey 2009-2018

Introduction

Oxidative stress plays a pivotal role in the pathogenesis of chronic kidney disease (CKD). The oxidative balance score (OBS) was devised to quantify the overall oxidative state, integrating pro-oxidant and antioxidant influences from both dietary intake and lifestyle practices. The aim of this study was to delve into the relationship between the OBS and CKD within the adult population of the United States.

Methods

Utilizing data from the National Health and Nutrition Examination Survey (NHANES) spanning 2009-2018, we derived the OBS from 16 dietary and four lifestyle factors. We employed weighted multivariate regression to probe the link between OBS and CKD. Additionally, we undertook subgroup analyses and applied Restricted Cubic Spline Regression (RCS) for further data analyses.

Results

This study encompassed 19,444 participants. Logistic regression analysis consistently demonstrated a protective effect of higher OBS on CKD. In Model 3, each unit increase in OBS was associated with a 2% reduction in the risk of CKD (95% CI: 0.97-0.99, p < 0.001) and a 4% reduction in the risk of reduced estimated glomerular filtration rate (eGFR) (95% CI: 0.95-0.98, p < 0.001). The highest OBS quintile (Q4) also showed significant reductions in the risk of CKD (OR: 0.66, 95% CI: 0.53-0.82, p < 0.001) and reduced eGFR (OR: 0.51, 95% CI: 0.37-0.69, p < 0.001) in Model 3. RCS analysis revealed a linear relationship between OBS and CKD. Subgroup analyses indicated significant associations between OBS and CKD in most subgroups, except for those without hypertension or with cardiovascular disease. Additionally, interaction analyses demonstrated that age, hypertension, and diabetes significantly modify the association between OBS and CKD risk.

Conclusion

An elevated OBS, reflecting a predominance of antioxidants, correlates with a diminished CKD risk in the American adult demographic. These insights emphasize the potential influence of oxidative equilibrium on the development of CKD.

Association of oxidative balance score, cardiovascular, and all-cause mortality among patients with type 2 diabetes mellitus

Background

To investigate the association between oxidative balance score (OBS), cardiovascular mortality (CVM), and all-cause mortality (ACM) in type 2 diabetes mellitus (T2DM) patients.

Methods

We included 6,119 participants with T2DM from the 2005-2020 National Health and Nutrition Examination Surveys (NHANES). The status of CVM and ACM of participants was followed through December 31, 2019. Multivariable Cox regression models, Kaplan-Meier curves, log-rank test, restricted cubic spline regression, and subgroup analysis, were used to evaluate the relationship between OBS, CVM, and ACM.

Results

During a median of 100.9 months follow-up, 1,790 ACM cases had occurred, 508 of which were due to cardiovascular disease. The T2DM participants were divided into four groups based on the quartiles of OBS. Participants with Q4 tended to be younger, financially better-off, married, highly educated, had lower alcohol consumption rates, were non-smokers, and exhibited a lower likelihood of ACM and CVM. In multivariate Cox regression models, compared with the patients with Q4, those with Q1 had a 30% increased risk for ACM (Q1, reference; Q4, HR: 0.70, 95%CI: 0.58-0.86) and a 43% increased risk for CVM (Q1, reference; Q4, HR: 0.57, 95%CI: 0.36-0.88). The restricted cubic spline regression models have no nonlinear relationship between OBS, CVM, and ACM. Kaplan-Meier survival curves showed that patients with Q4 had a lower risk of ACM and CVM (log-rank P < 0.05).

Conclusions

We find that ACM and CVM increase with higher OBS in T2DM patients. Moreover, there are linear relationships between OBS, ACM, and CVM.

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.

Association between oxidative balance score and risk of gout: The NHANES cross-sectional study, 2007-2018

BACKGROUND

The Oxidative Balance Score (OBS) is a systematic tool to assess the effects of diet and lifestyle in relation to oxidative stress. The association between OBS and gout has not been reported previously. We conducted a cross-sectional study to investigate the complex association between OBS and gout in US adults.

METHODS

In all, 10 492 participants were included in this study. The exposure variable was OBS, which was scored by 16 dietary and four lifestyle factors. Multivariate logistic regression, subgroup analysis, and restricted cubic spline (RCS) regression were used to analyze the association between OBS and gout.

RESULTS

Compared with the lowest OBS quartile group (Q1), the multivariate corrected odds ratio (OR) (95% confidence interval [C]) for the highest quartile of OBS (Q4) was 0.72 (0.52-1.00) (p = .13 for trend); furthermore, the RCS showed a negative linear relationship between OBS and gout (p-nonlinear = .606).

CONCLUSION

In conclusion, the risk of gout is higher with high OBS. The prevalence of gout decreased with higher OBS. Diabetes may alter this negative correlation.

Association of oxidative balance score with hearing loss and tinnitus: NHANES 1999-2018

Background

Oxidative stress is associated with the occurrence of hearing loss and tinnitus. The oxidative balance score (OBS), a composite indicator evaluating the balance between antioxidant and pro-oxidative components across various dietary and lifestyle factors, indicates the overall oxidative balance status. However, the association of OBS with hearing loss and tinnitus has not been reported previously.

Methods

Cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) 1999-2018 were analyzed. Weighted multivariable logistic regression, weighted multivariable linear regression, and restricted cubic spline curve (RCS) regression were employed to explore the relationship between OBS and hearing loss at speech, low, and high frequencies, along with tinnitus. Subgroup analysis and sensitivity analysis were used to ascertain the consistency across subgroups and stability of the results.

Results

We included 13,715 and 21,644 individuals to investigate the association between OBS and hearing loss, as well as between OBS and tinnitus, respectively. The second, third, and fourth quartiles of OBS were significantly associated with a lower risk of hearing loss at speech, low, and high frequencies, as well as tinnitus, compared to the lowest quartile. The RCS regression analysis indicated a negative linear association of OBS with hearing loss and tinnitus. Most associations were maintained in subgroup analysis and sensitivity analysis. Additionally, the dietary and lifestyle OBS independently contribute to the protection against hearing loss and tinnitus.

Conclusion

OBS is negatively correlated with the risk of hearing loss and tinnitus. The findings suggest that combined antioxidant diet and lifestyle hold promise as potential strategies for reducing the prevalence of hearing loss and tinnitus.

Association of the oxidative balance score with sarcopenia among young and middle-aged adults: findings from NHANES 2011-2018

Background

Sarcopenia is associated with oxidative stress. The Oxidative Balance Score (OBS) is commonly used to assess dietary and lifestyle exposure to oxidative stress. However, few studies in the literature have assessed the correlation between sarcopenia and OBS.

Aim

This study aimed to assess the association between OBS and sarcopenia among young and middle-aged adults in the United States using data from the National Health and Nutrition Examination Survey (NHANES).

Method

Weighted logistic regression analysis was used to investigate the association between OBS and sarcopenia based on data from NHANES 2011-2018. Subgroup analyses were performed to observe the consistency of the outcomes, and the stability of the results was tested using sensitivity analyses.

Result

The final sample included 5,525 young and middle-aged American adults. A higher OBS was associated with a lower risk of sarcopenia. In the fully adjusted model, the second (odds ratio [OR]: 0.62, 95% confidence interval [CI]: 0.41, 0.94; p = 0.023), third (OR: 0.50; 95% CI: 0.34, 0.74; p < 0.001), and highest quartiles (OR: 0.18; 95% CI: 0.11, 0.28; p < 0.001) of the OBS were associated with higher risks of sarcopenia when compared to the lowest quartile. This association was consistent across both dietary and lifestyle OBS scores. Our subgroup analysis revealed no significant differences between the subgroups of variables included in the interaction analysis. Sensitivity analyses revealed similar results.

Conclusion

Our study showed that higher antioxidant and lower antioxidant exposure may decrease the risk of developing sarcopenia. Higher OBS scores may indicate greater protection against sarcopenia; however, further clinical studies are warranted to confirm these findings.

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.

Cymbopogon proximus and Petroselinum crispum seed ethanolic extract/Gum Arabic nanogel emulsion: Preventing ethylene glycol and ammonium chloride-induced urolithiasis in rats

Urolithiasis is a prevalent urological disorder that contributes significantly to global morbidity. This study aimed to assess the anti-urolithic effects of Cymbopogon proximus (Halfa Bar) and Petroselinum crispum (parsley) seed ethanolic extract /Gum Arabic (GA) emulsion, and its nanogel form against ethylene glycol (EG) and ammonium chloride (AC)-induced experimental urolithiasis in rats. Rats were divided into four groups: group 1 served as the normal control, group 2 received EG with AC in drinking water for 14 days to induce urolithiasis, groups 3 and 4 were orally administered emulsion (600 mg/kg/day) and nanogel emulsion (600 mg/kg/day) for 7 days, followed by co-administration with EG and AC in drinking water for 14 days. Urolithiatic rats exhibited a significant decrease in urinary excreted magnesium, and non-enzymic antioxidant glutathione and catalase activity. Moreover, they showed an increase in oxalate crystal numbers and various urolithiasis promoters, including excreted calcium, oxalate, phosphate, and uric acid. Renal function parameters and lipid peroxidation were intensified. Treatment with either emulsion or nanogel emulsion significantly elevated urolithiasis inhibitors, excreted magnesium, glutathione levels, and catalase activities. Reduced oxalate crystal numbers, urolithiasis promoters' excretion, renal function parameters, and lipid peroxidation while improving histopathological changes. Moreover, it decreased renal crystal deposition score and the expression of Tumer necrosis factor-α (TNF-α) and cleaved caspase-3. Notably, nanogel emulsion showed superior effects compared to the emulsion. Cymbopogon proximus (C. proximus) and Petroselinum crispum (P. crispum) seed ethanolic extracts/GA nanogel emulsion demonstrated protective effects against ethylene glycol induced renal stones by mitigating kidney dysfunction, oxalate crystal formation, and histological alterations.