Central obesity and radiographic severity are associated with symptomatic hand osteoarthritis: a population-based cross-sectional study

To investigate the association between cardiometabolic factors, obesity, radiographic severity, and symptomatic hand osteoarthritis (HOA), as the role of these factors in HOA remains unclear. A cross-sectional analysis in the EPIPorto cohort included participants with HOA (≥ 1 joint with Kellgren-Lawrence (KL) grade ≥ 2 and/or American College of Rheumatology criteria). Cardiovascular risk factors, anthropometric measures, and radiographic severity (sum of KL hand score [0-128]) and number of affected joints [0-32]) were analysed. We tested the association between these factors and symptomatic HOA (≥ 1 joint with KL ≥ 2 and hand pain in the last month) by multivariable logistic regression. Of the 858 participants with HOA (61% women, mean age 59.6 years), 807 met radiographic criteria, and 160 presented symptomatic HOA. Among these, 77% were overweight or obese, 81% hypertensive, 95% had dyslipidaemia, and 20% were diabetic. Body mass index, waist circumference, and waist-to-height ratio, were associated with symptomatic HOA (OR 1.04, 95% CI 1.00; 1.09), (OR 1.02, 95% CI 1.00; 1.04), (OR 1.03, 95% CI 1.01; 1.06). Diabetes, hypertension, and dyslipidaemia showed no association. We observed an association between the KL score, the number of affected joints, and symptomatic HOA (OR 1.09, 95% CI 1.07; 1.12), (OR 1.09, 95% CI 1.06; 1.12). Increased central obesity and radiographic severity are associated with symptomatic HOA, highlighting the potential role of adiposity in HOA pain. These findings underscore the importance of weight management to improve pain outcomes in HOA. Furthermore, assessing radiographic changes may aid monitoring of disease symptoms. Further studies are needed to validate these associations and inform evidence-based clinical practice.