ArticleBMC cardiovascular disorders2025
Association between the oxidative balance score and all-cause and cardiovascular mortality in patients with cardiovascular-kidney-metabolic syndrome--a retrospective cohort study from the NHANES.
Article in BMC cardiovascular disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Association between oxidative balance score and gallstone risk and gallbladder surgery: A cross-sectional study.The Journal of international medical research · 2026Article
- Mitochondrial Dysfunction at the Intersection of CKM Syndrome: Molecular Mechanisms and Path-to-Target Therapies.International journal of molecular sciences · 2026Review
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Abstract
backgroundThe American Heart Association recently introduced the concept of Cardiovascular-Kidney-Metabolic (CKM) syndrome, underscoring the intricate interplay between metabolic, renal, and cardiovascular diseases. The oxidative balance score (OBS) serves as a comprehensive metric to quantify oxidative stress-related exposures. This study investigates the association between OBS and both all-cause and cardiovascular mortality in these individuals.
methodsThe study cohort analyzed 15,357 CKM patients from the 2003 to 2018 National Health and Nutrition Examination Survey database. Kaplan-Meier survival analysis, multivariable Cox regression models, restricted cubic splines, and subgroup analyses were employed to evaluate the relationship between OBS and mortality risk.
resultsThere were 1,759 all-cause deaths and 459 cardiovascular deaths. Kaplan-Meier analysis revealed that individuals in the highest quartile of OBS (Q4) had the lowest all-cause and cardiovascular mortality rates, whereas the lowest quartile (Q1) exhibited the highest mortality rates (p < 0.001). In fully adjusted models, multivariable Cox regression showed that each one-unit increase in OBS was associated with a 1.1% reduction in the risk of all-cause mortality and a 1.6% reduction in cardiovascular mortality (HR 0.989, 95% CI 0.982-0.996, p = 0.003, HR 0.984, 95% CI 0.970-0.998, p = 0.026, respectively). Compared to Q1, individuals in Q4 had significantly lower risks of both all-cause mortality (HR 0.723, 95% CI 0.607-0.861, p < 0.001) and cardiovascular mortality (HR 0.642, 95% CI 0.439-0.938, p = 0.022). Subgroup analyses indicated that the association between OBS and reduced mortality risk was particularly pronounced among individuals with higher educational attainment, non-chronic kidney disease, high poverty income ratio individuals and more advanced stages of CKM syndrome. In addition, restricted cubic spline modelling identified a graded inverse association between oxidative balance scores (OBS) and mortality risk. This suggests a dose-dependent protective effect of higher OBS, consistently observed across diverse demographic strata and clinical severity levels.
conclusionHigher OBS is linked to reduced all-cause and cardiovascular mortality in CKM patients.
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