ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutrition and Metabolism
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1597693
The Role of Oxidative Balance Score in Cardiovascular-Kidney-Metabolic Syndrome Progression and Mortality: Insights from NHANES 1999-2020
Provisionally accepted
- Fuzhou First Hospital, Fuzhou, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
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.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.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.Conclusions: 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.
Keywords: Oxidative balance score, cardiovascular-kidney-metabolic syndrome, NHANES, Mediation analysis, Mortality
Received: 21 Mar 2025; Accepted: 20 Jun 2025.
Copyright: © 2025 Liu, Xie, You, Yang and Li. 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: Fengmin Liu, Fuzhou First Hospital, Fuzhou, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.