The association between oxidative balance score and risk of developing prediabetes and type 2 diabetes in adults: a 12-year population-based cohort study

This study examined the potential relationship between the oxidative balance score (OBS) and the incidence of prediabetes (Pre-DM) as well as type 2 diabetes mellitus (T2DM) over a 12-year observation period. In this prospective cohort investigation, data were analyzed from 1,950 healthy adults (without T2DM and Pre-DM) and 2,325 individuals free of T2DM, who participated in the third phase of the Tehran Lipid and Glucose Study (2006–2008) and were followed up for a median of 7.3 and 9.6 years, respectively. The OBS was derived through summing the values assigned to dietary antioxidants and pro-oxidants, and non-dietary components including physical activity, smoking, and obesity. Cox proportional hazards regression was applied to determine hazard ratios (HRs) and 95% confidence intervals (CIs) for the development of Pre-DM and T2DM across OBS tertiles. Over the follow-up period, 44.3% of participants progressed to Pre-DM, while 14.6% developed to T2DM. A higher overall OBS was significantly linked to a lower risk of both Pre-DM (HR = 0.81, 95% CI = 0.67–0.99, P for trend = 0.045) and T2DM (HR = 0.61, 95% CI = 0.43–0.86, P for trend = 0.005). The participants in the highest tertile of lifestyle OBS also revealed a substantially lower risk of T2DM (HR = 0.59, 95% CI = 0.45–0.78, P for trend = 0.001). No statistically meaningful relationship was observed between dietary OBS and the risk of either condition. These findings suggest that a higher OBS, indicating a greater predominance of antioxidant over pro-oxidant exposures, serves as a protective factor for development of both incidence of Pre-DM and T2DM. Not applicable.