Du Changyu, Zhou Tingting, Ji Xiang, Tang Xiaofu, Yang Honghao, Ma Zheng, Kuang Mingjie, Chen Liangkai, Li Xiaofeng, Wang Hongfei, Yang Chengrui, Li Xiaoming, Zhao Jianyong, Xia Yang
Department of Orthopedics, Hebei Province Cangzhou Hospital of Integrated Traditional Chinese Medicine-Western Medicine, Cangzhou, China.
Hebei Key Laboratory of Integrated Traditional and Western Medicine in Osteoarthrosis Research, Cangzhou, China.
Front Nutr. 2025 Sep 5;12:1642749. doi: 10.3389/fnut.2025.1642749. eCollection 2025.
Osteoarthritis (OA) is a prevalent joint disorder with significant health and economic impacts. While individual cardiovascular health (CVH) factors have been linked to OA, a comprehensive understanding of how overall cardiovascular health influences OA risk is lacking. Life's Essential 8 (LE8) offers a holistic measure incorporating physical activity, body mass index, diet, sleep, blood pressure, blood sugar, lipids, and nicotine exposure. The inclusion of LE8 in OA research is crucial to better understand the broader cardiovascular health-OA association.
The present study was conducted using data from the UK Biobank, which initially included more than 500,000 participants. After applying exclusion criteria, a total of 242,278 participants without hip and/or knee OA at baseline were included in the final analyses. Genetic risk scores (GRSs) for hip, knee, and hip/knee OA were derived from 70, 83, and 87 single-nucleotide polymorphisms, respectively. Restricted cubic splines (RCS) were utilized to explore the potential non-linear associations of GRSs with the risks of OA. Cox proportional hazards models were applied to assess the associations between LE8, GRSs, and the risk of OA. Both combined effect and interaction analyses were conducted to evaluate how LE8 and GRSs jointly influence OA risk.
During a median follow-up period of 12.12 years, 18,767 participants developed hip and/or knee OA. LE8 was found to be negatively associated with the risks of hip, knee, and hip/knee OA. CVH, as measured by LE8 scores, was categorized into three groups based on the following boundary values: high CVH (80-100 points), moderate CVH (50-79 points), and low CVH (0-49 points). Compared to the participants with low CVH, the HRs (95% CIs) of hip, knee, and hip/knee OA for those with high CVH were 0.71 (0.64, 0.79), 0.48 (0.44, 0.52), and 0.56 (0.52, 0.60), respectively. These associations were not modified by GRSs. In the joint association analyses, the lowest HR (hip OA: 0.48, 0.41-0.55; knee OA: 0.34, 0.30-0.39; hip/knee OA: 0.43, 0.39-0.47) of events were observed in those with both high CVH and low GRSs, compared to those low CVH and high GRSs.
Our findings underscore the importance of maintaining the maximum CVH to prevent the onset of OA, irrespective of genetic predisposition.
骨关节炎（OA）是一种常见的关节疾病，对健康和经济有重大影响。虽然个体心血管健康（CVH）因素与OA有关，但缺乏对整体心血管健康如何影响OA风险的全面理解。生命必需的8项指标（LE8）提供了一种综合衡量方法，包括身体活动、体重指数、饮食、睡眠、血压、血糖、血脂和尼古丁暴露。将LE8纳入OA研究对于更好地理解更广泛的心血管健康与OA的关联至关重要。
本研究使用了英国生物银行的数据，该数据库最初包括超过50万名参与者。应用排除标准后，最终分析纳入了242,278名基线时无髋部和/或膝部OA的参与者。髋部、膝部和髋/膝OA的遗传风险评分（GRS）分别来自70、83和87个单核苷酸多态性。使用受限立方样条（RCS）来探索GRS与OA风险之间潜在的非线性关联。应用Cox比例风险模型来评估LE8、GRS与OA风险之间的关联。进行了联合效应和交互分析，以评估LE8和GRS如何共同影响OA风险。
在中位随访期12.12年期间，18,767名参与者发生了髋部和/或膝部OA。发现LE8与髋部、膝部和髋/膝OA的风险呈负相关。根据LE8评分衡量的CVH分为三组，边界值如下：高CVH（80 - 100分）、中CVH（50 - 79分）和低CVH（0 - 49分）。与低CVH的参与者相比，高CVH的参与者发生髋部、膝部和髋/膝OA的HR（95%CI）分别为0.71（0.64, 0.79）、0.48（0.44, 0.52）和0.56（0.52, 0.60）。这些关联不受GRS的影响。在联合关联分析中，与低CVH和高GRS的参与者相比，高CVH和低GRS的参与者发生事件的HR最低（髋部OA：0.48, 0.41 - 0.55；膝部OA：0.34, 0.30 - 0.39；髋/膝OA：0.43, 0.39 - 0.47）。
我们的研究结果强调了维持最大心血管健康以预防OA发病的重要性，无论遗传易感性如何。
