Abstract
OBJECTIVE: Oxidative stress is known to play a key role in the progression of asthma. The Oxidative Balance Score (OBS), derived from an analysis of diet and lifestyle choices, provides a measure of the body's oxidative stress levels. This study aims to investigate the clinical relevance of OBS in asthma. METHODS: The study included National Health and Nutrition Examination Survey (NHANES) data from 10,038 individuals between the years 2007 and 2018. We assessed associations of asthma prevalence with the OBS, Dietary Oxidative Balance Score (DOBS), and Lifestyle Oxidative Balance Score (LOBS) using logistic regression and restricted cubic spline (RCS) analyses. Lung function was evaluated through correlation analysis. The Cox proportional hazards models were employed to assess all-cause and cardiovascular-specific mortality by OBS components. Subgroup and interaction analyses were conducted to examine heterogeneity and to validate the findings. RESULTS: After adjusting for confounders, higher OBS [OR = 0.98 (0.97, 0.99), p = 0.003], DOBS [OR = 0.99 (0.97, 0.99), p = 0.016], and LOBS [OR = 0.91 (0.87, 0.96), p < 0.001] were inversely associated with asthma prevalence. A nonlinear relationship was observed between OBS and asthma prevalence (p-for-nonlinear = 0.028). OBS showed positive correlations with lung function parameters, including FEV(1) (r = 0.12, p < 0.001) and FEF(25-75%) (r = 0.06, p < 0.001). Additionally, higher OBS was associated with reduced risks of all-cause mortality [HR = 0.92 (0.89, 0.96), p < 0.001] and cardiovascular mortality [HR = 0.86 (0.80, 0.93), p < 0.001] in asthma individuals. CONCLUSION: Our findings suggest that an antioxidant-rich diet and lifestyle may lower the risk of developing asthma and improve the prognosis for individuals with asthma.