Association Between Oxidative Balance Score and Osteoporosis in U.S. Adults: The National Health and Nutrition Examination Survey (NHANES) 2005-2020

Abstract

Background Osteoporosis (OP) is a prevalent disease that increases the risk of fractures and affects quality of life. Although there are many factors that contribute to OP, there are fewer studies on the relationship between oxidative balance score (OBS) and OP. Methods We conducted a cross-sectional analysis to examine the association of OBS with the prevalence of OP among U.S. adults using National Health and Nutrition Examination Survey (NHANES) data from 2005 to 2020. A final sample of 18,837 participants was included after exclusions. OBS was calculated from dietary and lifestyle data, and OP status was determined using bone mineral density (BMD) measurements. Logistic regression models and restricted cubic spline (RCS) analyses were used to explore the association between OBS and OP after adjusting for confounders. Results Our study demonstrated an inverse association between OBS and the prevalence of OP. For every unit increase in OBS, there was a 3% reduction in the odds of OP after adjustment (OR = 0.97, 95%CI: 0.96–0.99). Higher dietary OBS was associated with reduced OP risk, while an improved lifestyle OBS corresponded to higher OP incidence (P < 0.05). A linear inverse relationship between continuous OBS values and OP risk was observed, and subgroup analyses revealed that females experienced more pronounced protection as OBS increased. Conclusion The present study suggests an inverse relationship between OBS and OP in adults, with dietary OBS inversely linked to OP prevalence and lifestyle OBS positively associated. In addition, the association between OBS and OP differed between sexes.