Oxidative Balance Score and Overactive Bladder Risk in US Adults: A Negative Dose–Response Association from NHANES 2005–2018

Introduction and Hypothesis: Evidence suggests that oxidative stress might play a key role in the pathogenesis of overactive bladder (OAB). However, the association between oxidative balance scores (OBS) and OAB risk remains unclear. This study was aimed at exploring the potential dose–response association between OBS and OAB. Methods: The data were obtained from the National Health and Nutrition Examination Survey database from 2005 to 2018. OAB was defined as the presence of urge urinary incontinence and nocturia, with a modified overactive bladder symptom score ≥ 3, according to the International Continence Society. A higher OAB score indicates more severe symptoms. OBS was scored by 20 dietary and lifestyle factors, with a higher OBS indicating higher antioxidant status. Associations between OBS and OAB were investigated using multivariate logistic regression, subgroup analysis, and smoothed curve fitting. Results: A total of 26,695 individuals were included in this study, with an OAB prevalence of 19.9%. A higher level of OBS was significantly associated with a reduced risk of OAB. After adjusting for potential variables, compared with the first tertile (T1) of OBS, the risk of OAB in the third tertile (T3) decreased by 12% (OR = 0.88, 95% CI: 0.80–0.97). The smoothing curve fitting showed that a negative and nearly linear correlation between OBS and OAB risk (p for nonlinearity: 0.172). This association remained stable across different subgroups. Conclusions: This study identified a negative linear association between OBS and OAB in the USA.