Association of the ADAMTS14 rs4747096 Polymorphism and C‐Reactive Protein Levels With Knee Osteoarthritis Severity: A Cross‐Sectional Study

ABSTRACT Background and Aims The rs4747096 polymorphism in the ADAMTS14 gene and C‐reactive protein (CRP) levels have been associated with knee osteoarthritis (KOA) severity; however, evidence from Vietnam remains limited. This study aimed to investigate the distribution of rs4747096 genotypes, assess CRP levels, and examine their associations with KOA severity. Methods This cross‐sectional study included 120 patients with KOA treated at Tien Giang General Hospital from July to December 2025. rs4747096 genotyping and serum CRP measurement were performed, and radiographic severity was graded using the Kellgren‐Lawrence (KL) classification. Severe KOA was defined as KL grade ≥III. Results The mean age was 51.98 ± 10.24 years. KL grades II, III, and IV were observed in 66/120 (55.0%), 37/120 (30.8%), and 17/120 (14.2%) patients, respectively. KL grade distribution differed significantly by CRP category ( p = 0.008), with grade IV disease more frequent in patients with CRP > 8.0 mg/L than in those with CRP ≤ 8.0 mg/L [12/49 (24.5%) vs. 5/71 (7.0%)]. Genotype frequencies were 41/120 (34.2%) for AA, 52/120 (43.3%) for AG, and 27/120 (22.5%) for GG. In univariable analysis, AG + GG genotypes (OR = 2.32; 95% CI, 1.05–5.13; p = 0.035) and CRP > 8.0 mg/L (OR = 2.67; 95% CI, 1.26–5.64; p = 0.009) were associated with severe KOA. In multivariable analysis, age ≥ 60 years (aOR = 4.59; 95% CI, 1.52–13.90; p = 0.007), overweight or obesity (aOR = 4.86; 95% CI, 1.96–12.06; p < 0.001), dyslipidemia (aOR = 2.81; 95% CI, 1.02–7.76; p = 0.047), and CRP > 8.0 mg/L (aOR = 3.43; 95% CI, 1.24–9.53; p = 0.018) remained independently associated with severe KOA, whereas rs4747096 did not. Conclusion Elevated CRP was independently associated with severe KOA, whereas the association with rs4747096 was attenuated after adjustment. Larger longitudinal studies are needed to clarify the independent role of this polymorphism.