Dietary and lifestyle oxidative balance;  metabolic dysfunction;  and preserved ratio impaired spirometry in Chinese adults: a hospital-based cross-sectional study

Guotao Chang

doi:10.3389/fnut.2026.1878741

Dietary and lifestyle oxidative balance; metabolic dysfunction; and preserved ratio impaired spirometry in Chinese adults: a hospital-based cross-sectional study

2026-08-11

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DOI：10.3389/fnut.2026.1878741

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BackgroundPreserved ratio impaired spirometry (PRISm) is a clinically relevant lung-function phenotype associated with adverse respiratory and systemic outcomes. Oxidative imbalance and metabolic dysfunction may contribute to impaired pulmonary reserve; but evidence from Chinese health examination populations remains limited. We examined the associations of oxidative balance score (OBS) and metabolic dysfunction indices with PRISm in Chinese adults.MethodsThis hospital-based cross-sectional study included 1; 311 adults undergoing routine health examinations between June 2024 and December 2025. PRISm was defined as FEV1/FVC ≥ 0.70 and FEV1 < 80% predicted. The standardized weighted OBS was constructed from dietary and lifestyle antioxidant/pro-oxidant components; and TyG; LAP; and AIP were analyzed as standardized continuous variables and quartiles. Multivariable logistic regression; restricted cubic splines; exploratory mediation analysis; and five-fold cross-validated machine-learning models were applied.ResultsPRISm was identified in 92 participants (7.02%). The cohort mean (SD) values were 22.69 (4.98) for OBS; 8.69 (0.40) for TyG; 33.01 (16.73) for LAP; and 0.05 (0.36) for AIP. In fully adjusted models; higher OBS was associated with lower odds of PRISm (OR per 1-SD increase; 0.61; 95% CI; 0.48–0.77); whereas TyG; LAP; and AIP were positively associated with PRISm; with ORs of 1.52; 1.23; and 1.36; respectively. Restricted cubic splines showed an approximately linear inverse OBS–PRISm association. Higher OBS was also associated with more favorable metabolic profiles. Exploratory pathway analyses showed directionally consistent but statistically non-definitive indirect-effect estimates through metabolic indices. Machine-learning analyses showed modest discrimination and ranked TyG; OBS; LAP; and AIP among the leading predictors.ConclusionFavorable oxidative balance was independently associated with lower PRISm probability; whereas metabolic dysfunction indices were associated with higher PRISm probability. These findings support an oxidative-metabolic profile associated with early lung-function impairment; while longitudinal studies are needed to clarify temporality and causality.

Keywords:

lipid accumulation product

triglyceride-glucose index

metabolic dysfunction

lung function

oxidative balance score

nutritional epidemiology

atherogenic index of plasma

preserved ratio impaired spirometry

Dietary and lifestyle oxidative balance; metabolic dysfunction; and preserved ratio impaired spirometry in Chinese adults: a hospital-based cross-sectional study

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