ArticleBMC psychiatry2026
Association between the oxidative balance score and depressive symptoms in adults with metabolic syndrome: a cross-sectional study from NHANES.
Article in BMC psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThis study investigated the association between the Oxidative Balance Score (OBS) and the odds of depressive symptoms in adults with metabolic syndrome (MetS) using National Health and Nutrition Examination Survey data (2007-2018), and employed machine learning to enhance predictive insights.
methodsWe analyzed 6,244 U.S. adults with MetS. Multivariable logistic regression assessed the relationship between the OBS and the odds of depressive symptoms in U.S. adults with MetS, with subgroup and Restricted cubic spline (RCS) regression analyses. Four machine learning models (Decision Tree, k-Nearest Neighbors (KNN), Random Forest, and Extreme Gradient Boosting (XGBoost)) were developed and interpreted using Shapley Additive Explanations (SHAP).
resultsAmong the participants, 1052 individuals (16.85%) were identified as having depressive symptoms. Significant differences were observed between participants with MetS with depressive symptoms and those with MetS alone in terms of age, gender, race, poverty-to-income ratio (PIR), smoking status, educational level, marital status, hypertension, diabetes, and OBS. No significant difference was found in abdominal obesity. In the unadjusted model, partially adjusted models, and the fully adjusted model, higher OBS were consistently associated with reduced odds of depressive symptoms with MetS. Subgroup analyses revealed no significant differences in the association between OBS and depressive symptoms across the examined strata among adults with MetS. RCS indicated a linear negative correlation. Machine learning models demonstrated strong performance, with Random Forest achieving the highest AUC (0.914). SHAP analysis identified educational level, marital status, and gender as the top predictors.
conclusionA higher OBS is associated with reduced odds of depressive symptoms in U.S. adults with MetS, highlighting the significant role of socioeconomic factors. These findings align with existing evidence and warrant prospective validation.
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