| Title: | Associations of oxidative balance score with mortality and cardiovascular events: cohort study from NHANES and UK Biobank |
| Journal: | BMJ Open |
| Published: | 25 Feb 2026 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/41748168/ |
| DOI: | https://doi.org/10.1136/bmjopen-2025-106954 |
| URL: | http://dx.doi.org/10.1136/bmjopen-2025-106954 |
Publication 17627
WARNING: the interactive features of this website use CSS3, which your browser does not support. To use the full features of this website, please update your browser.
Abstract
OBJECTIVE: To investigate the associations of oxidative balance score (OBS) with all-cause mortality, cardiovascular mortality and cardiovascular disease (CVD) incidence in two large, population-based cohorts.</p>
DESIGN: Cohort study and cross-sectional study were used.</p>
SETTING: The US National Health and Nutrition Examination Survey (NHANES) and the UK Biobank.</p>
PARTICIPANTS: A total of 33 566 adults from NHANES (1998-2018) and 55 760 adults from the UK Biobank were included.</p>
MAIN OUTCOME MEASURES: All-cause mortality, cardiovascular mortality and CVD. Mortality outcomes were ascertained through national death registries. Prevalent CVD was identified in NHANES through questionnaire, and incident CVD events were identified in the UK Biobank using linked hospital admission and death registry data.</p>
RESULTS: Higher OBS was consistently associated with lower all-cause and cardiovascular mortality in both cohorts. In NHANES, participants in the highest OBS quartile (Q4) had a 39% lower risk of all-cause mortality (adjusted HR: 0.61, 95% CI 0.52 to 0.72) and a 45% lower risk of cardiovascular mortality (adjusted HR: 0.55, 95% CI 0.41 to 0.74) compared with those in Q1. Similarly, in the UK Biobank, Q4 was associated with an 18% lower risk of all-cause mortality (adjusted HR: 0.82, 95% CI 0.74 to 0.91) and a 41% lower risk of cardiovascular mortality (adjusted HR: 0.59, 95% CI 0.4 to 0.87). In NHANES, Q4 was associated with lower odds of prevalent CVD (adjusted OR: 0.56, 95% CI 0.46 to 0.67), whereas in the UK Biobank, Q4 was associated with a 19% lower risk of incident CVD during follow-up (adjusted HR: 0.81, 95% CI 0.74 to 0.9). Subgroup analyses in NHANES indicated heterogeneity by ethnicity and socioeconomic status, whereas associations in the UK Biobank followed an L-shaped pattern with a flattening of estimated risk at moderate OBS levels.</p>
CONCLUSION: Higher OBS was associated with more favourable mortality and cardiovascular outcomes. These findings indicate that OBS is a composite indicator associated with cardiovascular health at the population level.</p>
18 Keywords
- Adult
- Aged
- Biological Specimen Banks
- Cardiovascular Diseases
- Cause of Death
- Cohort Studies
- Cross-Sectional Studies
- Female
- Humans
- Incidence
- Male
- Middle Aged
- Nutrition Surveys
- Oxidative Stress
- Risk Factors
- UK Biobank
- United Kingdom
- United States
8 Authors
- Haotian Zhang
- Shi Chen
- Xueke Bai
- Xingtong Zhou
- Fengqing Zhang
- Xiaohu Wang
- Liang Chen
- Xianqiang Wang
1 Application
| Application ID | Title |
|---|---|
| 87841 | Genetic Determinants and Gene-Environment Interactions of Cardiovascular Disease and Cardiometabolic Risk Factors |
Enabling scientific discoveries that improve human health