Association between the oxidative balance score and risk of microvascular complications in type 2 diabetes: A prospective UK biobank cohort study.

AIMS: Oxidative stress contributes to diabetic microvascular complications (DMCs). This study investigated the association between lifestyle-associated oxidative stress and the risk of DMCs in patients with type 2 diabetes (T2D).

MATERIALS AND

METHODS

Our prospective study analysed data from 5635 individuals with T2D who were free of DMCs at baseline in the UK Biobank cohort. The lifestyle-associated oxidative balance score (OBS) was computed from 20 dietary and lifestyle factors, with a higher OBS indicating a more favourable antioxidant status. Cox proportional hazards and mediation analyses were employed to examine the association between the OBS and the risk of DMCs.

RESULTS

Over a median follow-up period of 11.5 years, 1508 DMC patients were identified, including 873 patients with diabetic kidney disease (DKD), 317 patients with neuropathy, and 646 patients with retinopathy. Higher OBS quartiles were associated with lower risks of composite DMCs (HR: 0.72; 95% CI: 0.60-0.87) and DKD (HR: 0.50; 95% CI: 0.39-0.64). A one-unit increase in the OBS was associated with a 1.9% reduction in the hazard of composite DMCs and a 4.3% reduction in the hazard of DKD. Seven biomarkers, including HbA1c and cystatin C, mediated these associations.

CONCLUSIONS

A higher lifestyle-associated OBS is associated with a reduced risk of DMCs in patients with T2D, underscoring the potential benefits of maintaining oxidative balance in diabetes management.