title: Oxidative Balance Score and the Risk of End-Stage Renal Disease and Cardiovascular Disease.
abstract: BACKGROUND
  Oxidative balance score (OBS) is a composite measure of oxidative stress-related exposures. The aim of this study was to investigate the association between OBS, end-stage renal disease (ESRD), and cardiovascular disease (CVD).
  
  
  METHODS
  Using data from the Chronic Renal Insufficiency Cohort, we calculated the main exposure OBS by summing up 12 apriori-defined pro- and antioxidant factors obtained from the diet history questionnaire and lifestyle assessment. We divided OBS into quartiles (Q1-Q4), with Q1 (predominance of pro-oxidants) as the reference. We analyzed OBS quartiles as an ordinal variable. Crude and adjusted hazards ratios (HRs) and 95% CIs were estimated using Cox proportional hazards models for time to ESRD and CVD.
  
  
  RESULTS
  Compared to Q1, Q4 (high antioxidant) was associated with ESRD in the crude model (HR 1.35, 95% CI 1.08-1.69) and adjusting for age, sex, and race (HR 1.36, 95% CI 1.09-1.71) but not in the fully adjusted model (HR 1.12, 95% CI 0.84-1.51). HR of ESRD increased as the OBS quartiles increased in the crude model (ptrend < 0.05) but not in the fully adjusted model (ptrend = 0.30). Compared to Q1, Q4 was associated with CVD in the crude (HR 1.33, 95% CI 1.06-1.68) but not adjusted models. The HR of CVD increased with an increase in OBS quartiles in the crude model (ptrend < 0.05).
  
  
  CONCLUSIONS
  The reverse association between OBS and progression to ESRD suggests that perhaps the effect of oxidative balance-related exposure is different in the setting of established chronic kidney disease.
authors.affiliation: Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Titilayo O
authors.initials: TO
authors.lastname: Ilori
authors.forename: Xiao
authors.initials: X
authors.lastname: Wang
authors.forename: Morong
authors.initials: M
authors.lastname: Huang
authors.forename: Orlando M
authors.initials: OM
authors.lastname: Gutierrez
authors.forename: K M Venkat
authors.initials: KM
authors.lastname: Narayan
authors.forename: Michael
authors.initials: M
authors.lastname: Goodman
authors.forename: William
authors.initials: W
authors.lastname: McClellan
authors.forename: Laura
authors.initials: L
authors.lastname: Plantinga
authors.forename: Akinlolu O
authors.initials: AO
authors.lastname: Ojo
mesh_terms: D000368:Aged; D000975:Antioxidants / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000473:pathology; D015331:Cohort Studies; D004034:Diet Surveys; D000074341:Dietary Exposure / Q000009:adverse effects; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000473:pathology; D008019:Life Style; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D016016:Proportional Hazards Models; D017382:Reactive Oxygen Species / Q000378:metabolism*; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D000975:Antioxidants; D017382:Reactive Oxygen Species