Objective Hand osteoarthritis (Hand OA) is a common non-weight-bearing joint degenerative disease. Although age and gender are recognized as the main risk factors, research on the comprehensive impact of common and modifiable risk factors on the onset of Hand OA remains crucial. We aim to evaluate the prospective associations between social determinants, lifestyle, and metabolic factors and the onset of Hand OA. Methods This study included 26,778 adults from the UK Biobank who reported no OA at baseline and no OA other than Hand OA at the final follow-up. The median follow-up duration was 8.85 years. A composite score—the Social, Lifestyle, and Metabolic (SLM) score—was developed based on 14 modifiable factors: 4 social determinants, 5 lifestyle behaviors, and 5 metabolic risk factors. One point was assigned for each adverse exposure (range: 0–14). Cox proportional hazards models and restricted cubic spline analyses were used to examine the association between baseline SLM score and incident Hand OA. Subgroup analyses were performed by age and sex. To improve model robustness, a social–metabolic (SM) score excluding the lifestyle component was additionally constructed for sensitivity analyses. Results A higher baseline SLM score was significantly associated with an increased risk of incident Hand OA in a dose–response manner (P < 0.001). Compared with participants with lower SLM scores, those with higher scores had a 2.37-fold increased risk of developing Hand OA (AHR = 2.37, 95% CI: 1.39–4.03, P = 0.001). In the domain-specific analyses, higher scores for social determinants (AHR = 1.47, 95% CI: 1.07–2.01, P = 0.016) and metabolic factors (AHR = 2.14, 95% CI: 1.49–3.07, P = 3.76 × 10⁻5) were significantly associated with increased Hand OA risk, while lifestyle scores showed a similar trend but were not statistically significant (AHR = 1.02, 95% CI: 0.75–1.38, P = 0.899). After excluding the lifestyle domain, the predictive performance of the SM score further improved (AHR = 2.44, 95% CI: 1.77–3.36, P = 5.21 × 10⁻⁸). Subgroup analyses indicated that the association was more pronounced in women (AHR = 2.47, P = 0.007) and adults under 60 years (AHR = 3.00, P = 0.0003), with a consistent positive trend also observed in men and older adults. Conclusion Beyond unmodifiable factors such as age and sex, targeted health interventions focusing on social and metabolic domains are crucial for preventing Hand OA. The SLM score may serve as a practical risk stratification tool to identify high-risk individuals and guide precision prevention strategies.<Table Float="No" ID="Taba"> <tgroup cols="2"> <colspec align="justify" colname="c1" colnum="1" /> <colspec align="justify" colname="c2" colnum="2" /> <tbody> <row> <entry nameend="c2" namest="c1"> Key Points • The SLM score at baselinewas significantly linearly correlated with the incidence of HandOA at the end of follow-up. • Higher SLM scores at baseline were significantly associated with an increased risk of hand osteoarthritis at the end of follow-up. • Among the three domains of the SLM index, social determinants and metabolic factors demonstrated stronger predictive power for hand OA than lifestyle behaviors. • The SLM index offers a simple yet effective tool for identifying high-risk individuals and may facilitate early intervention strategies for hand OA prevention. </entry> </row> </tbody> </tgroup> </Table>

The association between social determinants, lifestyle, and metabolic factors and the incidence of hand osteoarthritis: A cohort study of British adults

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发表日期：

2026年1月2日

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Huaiyang Liu,
Yu Jin,
Dapeng Zhang,
Jie Mei,
Yao Liu,
Yong Sun,
Jianing Liu,
Qiang He

摘要

Objective

Hand osteoarthritis (Hand OA) is a common non-weight-bearing joint degenerative disease. Although age and gender are recognized as the main risk factors, research on the comprehensive impact of common and modifiable risk factors on the onset of Hand OA remains crucial. We aim to evaluate the prospective associations between social determinants, lifestyle, and metabolic factors and the onset of Hand OA.

Methods

This study included 26,778 adults from the UK Biobank who reported no OA at baseline and no OA other than Hand OA at the final follow-up. The median follow-up duration was 8.85 years. A composite score—the Social, Lifestyle, and Metabolic (SLM) score—was developed based on 14 modifiable factors: 4 social determinants, 5 lifestyle behaviors, and 5 metabolic risk factors. One point was assigned for each adverse exposure (range: 0–14). Cox proportional hazards models and restricted cubic spline analyses were used to examine the association between baseline SLM score and incident Hand OA. Subgroup analyses were performed by age and sex. To improve model robustness, a social–metabolic (SM) score excluding the lifestyle component was additionally constructed for sensitivity analyses.

Results

A higher baseline SLM score was significantly associated with an increased risk of incident Hand OA in a dose–response manner (P < 0.001). Compared with participants with lower SLM scores, those with higher scores had a 2.37-fold increased risk of developing Hand OA (AHR = 2.37, 95% CI: 1.39–4.03, P = 0.001). In the domain-specific analyses, higher scores for social determinants (AHR = 1.47, 95% CI: 1.07–2.01, P = 0.016) and metabolic factors (AHR = 2.14, 95% CI: 1.49–3.07, P = 3.76 × 10⁻⁵) were significantly associated with increased Hand OA risk, while lifestyle scores showed a similar trend but were not statistically significant (AHR = 1.02, 95% CI: 0.75–1.38, P = 0.899). After excluding the lifestyle domain, the predictive performance of the SM score further improved (AHR = 2.44, 95% CI: 1.77–3.36, P = 5.21 × 10⁻⁸). Subgroup analyses indicated that the association was more pronounced in women (AHR = 2.47, P = 0.007) and adults under 60 years (AHR = 3.00, P = 0.0003), with a consistent positive trend also observed in men and older adults.

Conclusion

Beyond unmodifiable factors such as age and sex, targeted health interventions focusing on social and metabolic domains are crucial for preventing Hand OA. The SLM score may serve as a practical risk stratification tool to identify high-risk individuals and guide precision prevention strategies.

Key Points

• The SLM score at baselinewas significantly linearly correlated with the incidence of HandOA at the end of follow-up.

• Higher SLM scores at baseline were significantly associated with an increased risk of hand osteoarthritis at the end of follow-up.

• Among the three domains of the SLM index, social determinants and metabolic factors demonstrated stronger predictive power for hand OA than lifestyle behaviors.

• The SLM index offers a simple yet effective tool for identifying high-risk individuals and may facilitate early intervention strategies for hand OA prevention.