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This study investigated the association between lifestyle\u2010associated oxidative stress and the risk of DMCs in patients with type 2 diabetes (T2D).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Our prospective study analysed data from 5635 individuals with T2D who were free of DMCs at baseline in the UK Biobank cohort. The lifestyle\u2010associated oxidative balance score (OBS) was computed from 20 dietary and lifestyle factors, with a higher OBS indicating a more favourable antioxidant status. Cox proportional hazards and mediation analyses were employed to examine the association between the OBS and the risk of DMCs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over a median follow\u2010up period of 11.5\u2009years, 1508 DMC patients were identified, including 873 patients with diabetic kidney disease (DKD), 317 patients with neuropathy, and 646 patients with retinopathy. Higher OBS quartiles were associated with lower risks of composite DMCs (HR: 0.72; 95% CI: 0.60\u20130.87) and DKD (HR: 0.50; 95% CI: 0.39\u20130.64). A one\u2010unit increase in the OBS was associated with a 1.9% reduction in the hazard of composite DMCs and a 4.3% reduction in the hazard of DKD. Seven biomarkers, including HbA1c and cystatin C, mediated these associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A higher lifestyle\u2010associated OBS is associated with a reduced risk of DMCs in patients with T2D, underscoring the potential benefits of maintaining oxidative balance in diabetes management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70566","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T12:01:41Z","timestamp":1771416101000},"page":"3861-3871","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between the oxidative balance score and risk of microvascular complications in type 2 diabetes: A prospective\n                    <scp>UK<\/scp>\n                    biobank cohort study"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9874-6633","authenticated-orcid":false,"given":"Jianping","family":"Hu","sequence":"first","affiliation":[{"name":"Department of Ophthalmology State Key Laboratory of Eye Health, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine  Shanghai China"},{"name":"Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology  Shanghai China"},{"name":"Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tongxin","family":"Ge","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology State Key Laboratory of Eye Health, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine  Shanghai China"},{"name":"Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology  Shanghai 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