ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
This article is part of the Research TopicDietary Prevention and Management of Type-2 DiabetesView all 7 articles
Association of the Oxidative Balance Score with Diabetic Kidney Disease in Diabetes Mellitus Patients: Insights from NHANES 2011-2018
Provisionally accepted
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Background: Oxidative stress is crucial in the onset and progression of DKD. Oxidative Balance Score (OBS) evaluates dietary and lifestyle exposure to oxidative stress. The association between OBS and DKD remains uncertain. This study aimed to evaluate the association between OBS and DKD in patients with diabetes mellitus (DM). Methods: A cross-sectional study recruited 1,882 participants, representing 19.5 million individuals with DM, from the National Health and Nutrition Examination Survey (NHANES) collected between 2011-2018. The OBS was scored based on twenty dietary and lifestyle factors. The diagnosis of DKD is based on impaired glomerular filtration rate (eGFR< 60 mL/min/1.73 m2), albuminuria (ACR≥30 mg/g), or both in DM patients. The relationship between OBS and DKD examined using weighted logistic regression and subgroup analyses. Results: OBS was negatively associated with DKD. The multivariable-adjusted odds ratio (OR) for DKD per unit increase in the OBS as a continuous variable was 0.92 (95%CI:0.85-0.99). When analyzed as a categorical variable, participants in the highest OBS quartile had a significantly lower odds of DKD (OR:0.26, 95%CI:0.07-0.98) compared to those in the lowest quartile (p < 0.05). Further analysis revealed dietary OBS, but not lifestyle OBS, was significantly associated with DKD. The OBS had significant correlations with DKD among male patients. Dietary fiber, Carotene, Niacin, Vitamin C, Calcium, Magnesium were identified as the dietary factors most strongly associated with DKD. Conclusions: Our findings suggest a significant negative association between OBS levels and the presence of DKD in DM patients. Suggesting that a higher antioxidant-rich diet score is associated with a lower likelihood of DKD. Future prospective studies are needed to confirm whether adopting such a lifestyle could serve as a strategy for DKD prevention.
Keywords: Oxidative balance score, Diabetic kidney disease, Diabetes Mellitus, dietary, lifestyle
Received: 11 Sep 2025; Accepted: 30 Nov 2025.
Copyright: © 2025 Li, Wang, Yang, Wang, Yu, Guo, Zihan, Liang, Dongxu and Tang. 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: Lin Tang
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