Oxidative balance scores and overactive bladder: mediating effects of oxidative stress and inflammatory factors

BACKGROUND: Few studies have investigated the comprehensive impact of dietary and lifestyle factors on overactive bladder (OAB). This study aimed to explore the associations of the Oxidative Balance Score (OBS) and its components-dietary OBS (DOBS) and lifestyle OBS (LOBS)-with OAB and their underlying mechanisms. METHODS: Data were extracted from the 2007-2018 National Health and Nutrition Examination Survey (NHANES). Weighted multivariate logistic regression was employed to evaluate associations between OBS/DOBS/LOBS and OAB. Mediation analyses were conducted to assess the potential mediating roles of oxidative stress and inflammatory factors. RESULTS: The study included 16,493 participants, including 2,950 OAB patients. Weighted multivariate analysis revealed a consistent inverse association between LOBS and OAB (OR: 0.89; 95% CI: 0.86-0.92; P < 0.001), while no stable correlations were observed for OBS or DOBS. Mediation analyses demonstrated significant mediating effects of albumin, bilirubin, white blood cells (WBC), neutrophils, monocytes, Systemic Immunity-Inflammation Index (SII), and Systemic Inflammatory Response Index (SIRI) in the LOBS-OAB association, with mediation proportions of 15.6%, 7.7%, 9.0%, 8.1%, 4.1%, 1.2%, and 3.5%, respectively. CONCLUSIONS: Higher LOBS was inversely associated with OAB risk, partially explained by oxidative stress and inflammatory factors, whereas neither OBS nor DOBS showed stable associations with OAB.