Association between oxidative balance score and metabolic syndrome: a systematic review and meta-analysis

Aliasghar Tabatabaei Mohammadi; Mohammad Reza Farnia; Afsaneh Mirshekari; Sara Rashki Ghalehno; Elham Ahmadipour; Zahra Bazargani; Elham Kebriyaei; Sina Salati; Mehrangiz Ghafari

doi:10.34172/jnp.2025.27622

J Nephropathol. 2025;14(3): e27622.
doi: 10.34172/jnp.2025.27622

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Meta-analysis

Association between oxidative balance score and metabolic syndrome: a systematic review and meta-analysis

Aliasghar Tabatabaei Mohammadi ¹ , Mohammad Reza Farnia ² , Afsaneh Mirshekari ³ , Sara Rashki Ghalehno ⁴ , Elham Ahmadipour ⁵ , Zahra Bazargani ⁶ , Elham Kebriyaei ⁶ , Sina Salati ⁷ , Mehrangiz Ghafari ⁸^*

¹ School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
² Department of Emergency Medicine, Taleghani and Imam Reza Hospitals, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
³ Department of Gastroenterology and Hepatology, School of Medicine, Amir al Momenin Hospital, Zabol University of Medical Sciences, Zabol, Iran
⁴ Department of Cardiology, School of Medicine, Amir al Momenin Hospital, Zabol University of Medical Sciences, Zabol, Iran
⁵ Independent Researcher, Private Clinic, Pezeshkan Street, Alvand Building, Shiraz, Iran
⁶ Clinical Research Development Unit, Department of Pediatric, Valiasr Hospital, Fasa University of Medical Sciences, Fasa, Iran
⁷ Department of Emergency Medicine, Nursing and Midwifery School, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
⁸ Department of Pathology, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran

*Corresponding Author: Mehrangiz Ghafari, Email: ghafari.mehr@yahoo.com

Abstract

Introduction: Most patients with metabolic syndrome (MetS) are at enhanced risk of oxidative stress. This systematic review and meta-analysis assesses the association between oxidative balance score (OBS) and MetS (MetS).

Method: Cochrane, Web of Science, PubMed, ProQuest, Embase, and Google Scholar databases were searched until January 15, 2025. Data were analyzed using IBM SPSS Statistics 19.0 and STATA 14. The results with P<0.05 were considered to be statistically significant.

Results: Elevated OBSs were associated with declined risks of MetS in males (OR:0.88, 95% CI: 0.83, 0.93) and females (OR: 0.81, 95% CI: 0.76, 0.86). Likewise, elevated OBSs declined the risk of MetS in South Korea (OR: 0.75, 95% CI: 0.67, 0.84) and the USA (OR: 0.63, 95% CI: 0.53, 0.74), in the cohort (OR: 0.73, 95% CI: 0.63, 0.85) and cross-sectional (OR: 0.67, 95% CI: 0.58, 0.76) studies, in 40 to 49 years old patients (OR: 0.63, 95% CI: 0.53, 0.74) and patients aged 50 to 59 (OR:0.84, 95% CI: 0.77, 0.91), in the second (OR: 0.75, 95% CI: 0.66, 0.84) and third (OR: 0.50, 95% CI: 0.34, 0.74) tertiles, in the second (OR: 0.84, 95% CI: 0.78, 0.92), third (OR: 0.68, 95% CI: 0.59, 0.79), and fourth (OR: 0.50, 95% CI: 0.41, 0.61) quartiles, and in the fifth quintile (OR: 0.78, 95% CI: 0.63, 0.97). As such, the risk of MetS declined at elevated dietary oxidative balance score (DOBS) (OR: 0.79, 95% CI: 0.62, 1) and lifestyle-based oxidative balance score (LOBS) (OR: 0.39, 95% CI: 0.21, 0.71).

Conclusion: Elevated OBS, DOBS, and LOBS scores mitigate the risk of MetS. MetS risk is lower in the United States females and those in their fourth decade. Collectively, MetS is less probable to occur at elevated OBS levels.

Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO (ID: CRD42025643042 and Research Registry (UIN: reviewregistry1951) websites.

Keywords: Metabolic syndrome, Dysmetabolic syndrome X, Cardiometabolic syndrome, Reaven syndrome X, Oxidative balance score

Implication for health policy/practice/research/medical education:

In a meta-analysis study we found that, elevated oxidative balance scores (OBSs), encompassing dietary and lifestyle-based components, are associated with a reduced risk of metabolic syndrome (MetS). Particularly, higher OBS levels are linked to a lower likelihood of developing MetS, a trend observed mainly in the United States females and individuals in their fourth decade, who exhibit lower MetS risk. Collectively, these findings suggest that maintaining elevated OBS levels can effectively mitigate the occurrence of MetS, highlighting the importance of antioxidant-rich diets and healthy lifestyle choices in preventing this condition.

Please cite this paper as: Tabatabaei Mohammadi A, Farnia MR, Mirshekari A, Rashki Ghalehno S, Ahmadipour E, Bazargani Z, Kebriyaei E, Salati S, Ghafari M. Association between oxidative balance score and metabolic syndrome: a systematic review and meta-analysis. J Nephropathol. 2025;14(3):e27622. DOI: 10.34172/jnp.2025.27622.