Introduction To identify metabolic-inflammatory profiles in US adults and assess their cross-sectional associations with self-reported osteoarthritis (OA) and lower-extremity functional limitation. Methods We analyzed six National Health and Nutrition Examination Survey cycles from 2007–2008 to 2017–2018. Latent class analysis used body mass index, waist circumference, systolic blood pressure, diabetes, and log-transformed neutrophil-to-lymphocyte ratio. Survey-weighted logistic regression assessed prevalent OA in 9770 adults and lower-extremity functional limitation in 2189 adults with available Physical Functioning Questionnaire data. Results Among 9770 participants, 559 met the study definition of OA. Three profiles were identified: relatively healthy, intermediate metabolic, and highest metabolic-inflammatory burden. After full adjustment, the intermediate profile was not associated with OA (OR 1.34, 95% CI 0.93–1.95), whereas the highest-burden profile was associated with higher odds of OA (OR 1.76, 95% CI 1.34–2.32). Among 2189 participants with functional data, 1239 had functional limitation; the highest-burden profile was associated with this outcome (OR 3.25, 95% CI 2.39–4.41). Seven-indicator and leave-one-adiposity-indicator-out analyses retained positive associations for the highest-burden profile, although class distributions and intermediate-profile estimates varied. Conclusions The highest-burden profile was associated with prevalent self-reported OA and lower-extremity functional limitation in this nationally representative cross-sectional sample. These findings do not establish temporality or causality. Prospective studies with joint-specific OA ascertainment are needed to determine whether combined systemic risk profiling can inform prevention, rehabilitation, or risk stratification. <Table Float="No" ID="Taba"> <tgroup cols="2"> <colspec align="left" colname="c1" colnum="1" /> <colspec align="left" colname="c2" colnum="2" /> <tbody> <row> <entry align="left" nameend="c2" namest="c1"> Key Points • NHANES data identified three metabolic-inflammatory profiles among US adults. • The profile with the highest combined systemic burden was associated with prevalent self-reported osteoarthritis. • The same profile was associated with lower-extremity functional limitation among 2,189 participants with available questionnaire data. • The cross-sectional design precludes causal inference; longitudinal, joint-specific validation is required. </entry> </row> </tbody> </tgroup> </Table>

Metabolic-inflammatory phenotypes, osteoarthritis, and lower-extremity functional limitation in US adults: a NHANES 2007–2018 study

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发表日期：

2026年8月1日

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Haotian Yang,
Kuike Yu,
Yu Chen,
Zhenlin Sun,
Wei Wang,
Ran Tao

摘要

Introduction

To identify metabolic-inflammatory profiles in US adults and assess their cross-sectional associations with self-reported osteoarthritis (OA) and lower-extremity functional limitation.

Methods

We analyzed six National Health and Nutrition Examination Survey cycles from 2007–2008 to 2017–2018. Latent class analysis used body mass index, waist circumference, systolic blood pressure, diabetes, and log-transformed neutrophil-to-lymphocyte ratio. Survey-weighted logistic regression assessed prevalent OA in 9770 adults and lower-extremity functional limitation in 2189 adults with available Physical Functioning Questionnaire data.

Results

Among 9770 participants, 559 met the study definition of OA. Three profiles were identified: relatively healthy, intermediate metabolic, and highest metabolic-inflammatory burden. After full adjustment, the intermediate profile was not associated with OA (OR 1.34, 95% CI 0.93–1.95), whereas the highest-burden profile was associated with higher odds of OA (OR 1.76, 95% CI 1.34–2.32). Among 2189 participants with functional data, 1239 had functional limitation; the highest-burden profile was associated with this outcome (OR 3.25, 95% CI 2.39–4.41). Seven-indicator and leave-one-adiposity-indicator-out analyses retained positive associations for the highest-burden profile, although class distributions and intermediate-profile estimates varied.

Conclusions

The highest-burden profile was associated with prevalent self-reported OA and lower-extremity functional limitation in this nationally representative cross-sectional sample. These findings do not establish temporality or causality. Prospective studies with joint-specific OA ascertainment are needed to determine whether combined systemic risk profiling can inform prevention, rehabilitation, or risk stratification.

Key Points

• NHANES data identified three metabolic-inflammatory profiles among US adults.

• The profile with the highest combined systemic burden was associated with prevalent self-reported osteoarthritis.

• The same profile was associated with lower-extremity functional limitation among 2,189 participants with available questionnaire data.

• The cross-sectional design precludes causal inference; longitudinal, joint-specific validation is required.