ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1604696
This article is part of the Research TopicImpact of Oxidation on Nutrition: Source, Absorption and Health EffectsView all 8 articles
Oxidative Balance Score and Mortality: Mediating Role of Insulin Resistance Across Age Strata in the NHANES Cohort
Provisionally accepted
- 1Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China
- 2Beijing Hospital, Beijing, Beijing, China
- 3The 963 Hospital of the PLA Joint Logistics Support Force, Jiamusi, China
- 4Tangdu Hospital, Air Force Medical University, Xi'an, Shaanxi Province, China
- 5The 963 hospital of the PLA joint logistics support force, Jiamusi, China
- 6Health Science Centre, Peking University, Beijing, Beijing Municipality, China
- 7Health Service Department of the Guard Bureau of the General Office of the Central Committee of the Communist Party of China, Beijing, China
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BackgroundThis study examined the association between oxidative balance score (OBS)，a composite measure of oxidative/antioxidative factors，and mortality, while investigating insulin resistance (IR) indices as potential mediators using a nationally representative cohort.MethodsA cohort of 11,849 U.S. adults from NHANES (2007–2018) was analyzed. OBS integrated 16 dietary and 4 lifestyle components. Mortality risks (all-cause, cardiovascular, cancer) were assessed via weighted Cox models. Mediation analysis evaluated the indirect effects of five IR indices (TyG index, TG/HDL-C, HOMA-IR, eGDR, VAI) on OBS-mortality associations, with statistical validation of mediation effects. Analyses were stratified by age (<65 vs. ≥65 years) and adjusted for sociodemographic, behavioral, and clinical covariates.ResultsHigher OBS reduced risks of all-cause (HR=0.652, 95% CI:0.525–0.81) and cardiovascular mortality (HR=0.605, 95% CI:0.408–0.898), but not cancer mortality. Innovatively, eGDR mediated 17% of OBS’s protective effect on all-cause mortality in adults <65 years, while TyG index and HOMA-IR showed weaker mediation. No IR mediation occurred in older adults (≥65 years).ConclusionsHigher OBS levels were inversely associated with all-cause and cardiovascular mortality, partially mediated by insulin resistance pathways. These findings highlight OBS as a potential prognostic indicator for mortality risk.
Keywords: Oxidative balance score, Insulin Resistance, Mortality, Mediation analysis, NHANES
Received: 02 Apr 2025; Accepted: 23 May 2025.
Copyright: © 2025 Zhang, Zhang, Xiang, Zhang, Gong, Xv and Yu. 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:
Wei Gong, Beijing Hospital, Beijing, 100730, Beijing, China
Junjie Xv, Health Service Department of the Guard Bureau of the General Office of the Central Committee of the Communist Party of China, Beijing, China
Xue Yu, Beijing Hospital, Beijing, 100730, Beijing, China
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