Gender-specific effects of Oxidative Balance Score on frailty prevalence in US adults: NHANES 2003-2018 analysis

Background : Frailty has been a growing public health concern as the global population ages. The Oxidative Balance Score (OBS) serves as a commonly utilized tool for evaluating an individual’s antioxidant status. However, its relationship with frailty hasn't been thoroughly explored by gender, nor have the specific OBS components linked to frailty been fully identified.. Methods: 6,994participants from the 2003 to 2018 NHANES were included. Weighted multiple logistic regression, subgroup analysis, and restricted cubic spline curves were used to assess the association between OBS, gender, and frailty. LASSO penalized regression was conducted to identify key OBS factors associated with frailty. Results: Compared with tertile1group, the adjusted ORs for tertile3group regarding total OBS, dietary OBS, and lifestyle OBS were 0.66(95%CI:0.51-0.84),0.75(95%CI:0.58-0.96), and 0.41(95%CI:0.30-0.56), respectively. In women, the association between OBS and frailty risk showed an 'L'-shaped pattern, whereas the association with dietary OBS exhibited a 'U'-shaped curve. Conversely, in men, a linear relationship was observed between total OBS, dietary OBS, and lifestyle OBS with the risk of frailty. LASSO regression identified key OBS factors, which were used to build a nomogram with an AUC of 79.2%, indicating strong predictive accuracy. Conclusions: Higher OBS is associated with lower frailty risk, with gender differences. Identifying at-risk populations with high OBS and through antioxidant diet and lifestyle regulation are potential ways to prevent frailty.