Abstract:
Objective To explore the association between waist-to-height ratio (WHtR), a novel obesity measurement index, and risk of knee osteoarthritis (KOA) prevalence.
Methods A multicenter prospective cohort design was employed, with the baseline WHtR as exposure variable and the KOA diagnosis as outcome variable. The adjusted covariates included the demographic characteristics (age, gender, education), metabolic indicators (blood glucose, blood lipid, uric acid) and lifestyle factors (smoking, drinking). The associations were evaluated through multivariate Cox regression and stratified analysis, and the potential nonlinear relationships were explored by RCS analysis.
Results A total of 3718 participants were included in the study, with a follow-up period of 9 years. Among them, 1375 cases were diagnosed with KOA, and 2343 non-KOA cases served as the control group. There were statistically significant differences in the levels of creatinine, uric acid, body mass index (BMI), WHtR, diabetes, stroke, hypertension and education, insurance status, smoking and gender between two groups (P < 0.05 to P < 0.01). The results of logistic analysis showed that in the non-adjusted model, the WHtR was significantly correlated with KOA (P < 0.01); After adjusting the gender, age, education, marital status and place of residence, the effect of WHtR weakened, but which was still significant (P < 0.01). After further adjustment for alcohol consumption, smoking, diabetes, hypertension, stroke, blood glucose, uric acid, BMI, creatinine, cystatin C, glycated hemoglobin, cholesterol, low-density lipoprotein and C-reactive protein, the WHtR remained an independent risk factor of KOA (P < 0.05). The RCS analysis did not find a significant dose-response relationship between WHtR and KOA (Poverall = 0.14, Pnon−linear = 0.63). Among participants with a BMI < 28 kg/m2 and rural populations, the association between WHtR and risk of KOA was more significant (P < 0.01).
Conclusions WHtR is an important predictor of KOA risk, which is more pronounced among non-obese and rural residents.