Abstract
Oxidative stress is an essential contributor to the progression of chronic obstructive pulmonary disease (COPD). A systematic assessment of diet patterns and lifestyle with the oxidative balance score (OBS) to reflect oxidative stress levels will help predict the risk of COPD. This study conducted a cross-sectional analysis to assess the link between OBS and COPD. 5162 participants were collected from 2013 to 2018 from the National Health and Nutrition Examination Survey (NHANES). Multivariate logistic regression models were applied to assess the relationship between OBS and COPD prevalence. The linearity of the association was explored using smoothed curve fitting. In addition, further subgroup analysis and interaction tests were conducted to ascertain the consistency of the relationship across diverse populations. Results of the multivariate logistic regression models indicated a negative association between OBS and the odds of COPD prevalence. Each incremental unit in OBS correlated with a 3% reduction in the odds of COPD in the fully adjusted model (OR 0.97, 95% CI 0.95-0.99). Further analysis by OBS tertiles indicated that individuals in the highest OBS tertile (T3) had a 17% lower probability of COPD compared to those in the lowest tertile (T1) in the fully adjusted model (OR 0.83, 95% CI 0.64-0.97). The smoothed curve fitting supported the negative association between OBS and COPD. Subgroup analyses revealed that the protective effect of OBS was notably pronounced among the non-hypertensive and non-diabetic populations. These findings suggest a negative link between OBS and COPD, underscoring the importance of antioxidant-rich diets and lifestyles in preventing COPD.