The role of oxidative balance score in Cardiovascular-Kidney-Metabolic syndrome progression and mortality: insights from NHANES 1999–2020

Figures

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  Figure 1. Flowchart of the study, National Health and Nutrition Examination Survey (NHANES), USA, 1999–2020.

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  Figure 2. Trend of each Cardiovascular-Kidney-Metabolic syndrome (CKM) stage across NHANES cycles 1999–2020. Linear fits applied to illustrate the trend over time.

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  Figure 3. Associations of oxidative balance score (OBS) with advanced CKM and severe CKM. The horizontal dashed line represents to the reference odds ratio of 1.0. All of the models were adjusted for age, gender, race, poverty-income ratio (PIR), education level, marital status, log transformed value of white blood cell count and serum uric acid, as well as dietary intakes of energy, protein, carbohydrate, sodium, and potassium. OR, odds ratio; CI, confidence interval; CKM, Cardiovascular-Kidney-Metabolic syndrome.

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  Figure 4. KM curves of OBS on CVD and all-cause mortality in binary CKM stages. KM curve of CVD mortality by OBS quartiles in non-advanced CKM (A) and advanced CKM (B). KM curve of all-cause mortality by OBS quartiles in non-advanced CKM (C) and advanced CKM (D). KM curve, Kaplan–Meier curve; OBS, oxidative balance score; CVD, cardiovascular diseases; CKM, Cardiovascular-Kidney-Metabolic syndrome.

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  Figure 5. Mediation analysis in the association between total OBS and CKM Stages with CVD and all-cause mortality. Mediating role of Ln-WBC and Ln-SUA in the relationship of total OBS with advanced CKM (A) and sever CKM (B). Mediating role of Ln-WBC and Ln-SUA in the relationship of total OBS with CVD mortality (C) and all-cause mortality (D) in non-advanced CKM stages. Ln, log transformed; WBC, white blood cells; SUA, serum uric acid; CVD, cardiovascular diseases; ACME, average causal mediation effect; ADE, average direct effect.