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Background <p>Myocardial infarction (MI) poses a serious health threat to diabetic patients, who are particularly vulnerable due to heightened oxidative stress. The dietary oxidative balance score (DOBS) quantifies the overall oxidative profile of the diet and may reflect diet-related cardiovascular risk.</p> Objective <p>This study aimed to evaluate the association between DOBS and the risk of MI among diabetic individuals using a nationally representative U.S. population.</p> Methods <p>We analyzed data from 5,002 diabetic participants in the NHANES 1999–2018 cycles. DOBS was calculated based on 16 pro- and antioxidant nutrients using two 24-hour dietary recalls. Logistic regression models and 1:1 propensity score matching (PSM) were employed to assess the association between DOBS and self-reported history of MI, adjusting for demographic, clinical, and lifestyle covariates. Restricted cubic spline (RCS) models were used to evaluate potential nonlinear relationships.</p> Results <p>A one-point increase in DOBS was associated with a 3% lower odds of MI in both unadjusted and fully adjusted models (adjusted OR = 0.97, 95% CI: 0.95–0.99). Participants in the highest DOBS tertile had a 38% lower odds of MI compared to the lowest tertile (OR = 0.62, 95% CI: 0.43–0.87), and this association remained consistent in the matched cohort (OR = 0.72, 95% CI: 0.48–0.88). While formal tests for nonlinearity were not significant, RCS curves suggested a threshold effect with diminishing benefits at higher DOBS levels. Subgroup and sensitivity analyses confirmed the robustness of the findings.</p> Conclusion <p>Higher DOBS is associated with a lower likelihood of MI among diabetic patients. These findings highlight the potential value of antioxidant-rich dietary patterns in cardiovascular risk assessment. However, given geographic and cultural variability in diet, further validation is needed in diverse populations and prospective study settings.</p>

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Association between dietary oxidative balance scores and myocardial infarction in diabetic patients: insights from NHANES 1999–2018

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月1日

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  • Xu Li,
  • Yashi Li,
  • Zehao Jin,
  • Zitong Chen,
  • Xinyi Yang,
  • Lan He

摘要

Background

Myocardial infarction (MI) poses a serious health threat to diabetic patients, who are particularly vulnerable due to heightened oxidative stress. The dietary oxidative balance score (DOBS) quantifies the overall oxidative profile of the diet and may reflect diet-related cardiovascular risk.

Objective

This study aimed to evaluate the association between DOBS and the risk of MI among diabetic individuals using a nationally representative U.S. population.

Methods

We analyzed data from 5,002 diabetic participants in the NHANES 1999–2018 cycles. DOBS was calculated based on 16 pro- and antioxidant nutrients using two 24-hour dietary recalls. Logistic regression models and 1:1 propensity score matching (PSM) were employed to assess the association between DOBS and self-reported history of MI, adjusting for demographic, clinical, and lifestyle covariates. Restricted cubic spline (RCS) models were used to evaluate potential nonlinear relationships.

Results

A one-point increase in DOBS was associated with a 3% lower odds of MI in both unadjusted and fully adjusted models (adjusted OR = 0.97, 95% CI: 0.95–0.99). Participants in the highest DOBS tertile had a 38% lower odds of MI compared to the lowest tertile (OR = 0.62, 95% CI: 0.43–0.87), and this association remained consistent in the matched cohort (OR = 0.72, 95% CI: 0.48–0.88). While formal tests for nonlinearity were not significant, RCS curves suggested a threshold effect with diminishing benefits at higher DOBS levels. Subgroup and sensitivity analyses confirmed the robustness of the findings.

Conclusion

Higher DOBS is associated with a lower likelihood of MI among diabetic patients. These findings highlight the potential value of antioxidant-rich dietary patterns in cardiovascular risk assessment. However, given geographic and cultural variability in diet, further validation is needed in diverse populations and prospective study settings.