Relationship between oxidative balance score and all-cause mortality in patients with nonalcoholic fatty liver disease

Abstract

Abstract Background and Aims: The Oxidative Balance Score (OBS) emerges as a novel index for assessing the state of oxidative stress. Previous studies have reported the possible links between oxidative stress and the development of non-alcoholic fatty liver disease (NAFLD), but the relationship between OBS and NAFLD remains unclear. Methods Data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018 was used in this study, and survival data was obtained from the National Death Index (NDI). The OBS was determined by calculating dietary nutrient consumption and lifestyle practices. The US Fatty Liver Index (USFLI) served as the basis for diagnosing NAFLD. Cox regression and restricted cubic spline (RCS) methods were employed to evaluate the associations between OBS and the risk of all-cause mortality in NAFLD patients. Results Fully adjusted Cox regression analysis indicated that higher total OBS (hazards ratio [HR]: 0.97, 95%CI: 0.95, 0.99) and dietary OBS (hazards ratio [HR]: 0.97, 95%CI: 0.95, 0.99)were associated with the lower risks of all-cause mortality in NAFLD (both P < 0.05). In the categorical analysis of the OBS, findings revealed that, as compared to the lowest quartile of OBS, the top quartile's adjusted HR for total and dietary OBS was 0.55 (95% CI: 0.34, 0.88) and 0.55(95% CI: 0.33, 0.94), respectively (both P < 0.05). Subgroup analysis indicated an inverse relationship between total/dietary OBS and mortality from all causes only in females with NAFLD. Conclusion The increase in OBS was correlated with a reduced risk of all-cause mortality in NAFLD, suggesting the advantages of adopting an antioxidant-rich diet and lifestyle behaviors in managing NAFLD.