Television viewing, oxidative stress, and kidney stone risk in males: a cross-sectional study with mediation analysis of the NHANES data (2011-2018 years)

PurposeTo explore the association between television viewing time (TV-hours) and dietary oxidative balance score (DOBS) with the kidney stone risk in males.MethodsWe analyzed age, poverty to income ratio, race, education, hypertension, diabetes, smoke, alcohol use, triglycerides, TV-hours, and DOBS data in the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018. Multivariable logistic regression was uesd to evaluate the associations between TV-hours, lifestyle OBS (LOBS), DOBS, Total OBS (TOBS), and the risk of kidney stones. Interaction terms between subgroup measures were used to test for effect modification across subgroups. Mediation analysis was performed to explore the mediating effect of DOBS on the association between TV-hours and kidney stones. The restricted cubic spline (RCS) was applied to describe dose-response relationships between TV-hours and risk of kidney stones as well.ResultsThe study included 4167 males aged 20 and older, including 417 patients with kidney stones. The results showed that five or more TV-hours a day was associated with a higher risk of kidney stones [odds ratio (OR) = 1.16, (95% CI: 1.04-1.29), p = 0.01], and higher DOBS level was associated with a lower risk of kidney stones [OR = 0.97, (95% CI: 0.95-0.99), p = 0.004]. This association was remarkably consistent across TV-hours subgroups by age, race, alcohol use, hypertension and diabetes. According to the mediation analysis results, prolonged TV-hours is associated with an increased risk of kidney stones, this association is not mediated by DOBS. In other words, the impact of TV-hours on kidney stones risk is mainly a direct effect. When TV-hours is more than 2 hours, the odds ratio began to be greater than 1.ConclusionsOverall, TV-hours was positively associated with kidney stones in males, whereas low DOBS was associated with kidney stones in males. This study suggests that an antioxidant diet and reduced television viewing time may be effective measures to prevent kidney stones in males.