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Chen, S. ; Zhang, Y.* ; Fan, T.* ; Zeng, M.* ; Yang, Q.* ; Yang, H.* ; Fang, X.* ; Jin, X.* ; Cao, P.* ; Wang, Z.* ; Hunter, D.J.* ; Zhou, Y.* ; Ding, C.* ; Zhu, Z.*

Associations of healthy lifestyle and genetic susceptibility with risks of osteoarthritis: A prospective cohort study.

Rheumatology, DOI: 10.1093/rheumatology/keaf327 (2025)

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Open Access Green: Postprint online verfügbar 07/2026

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OBJECTIVES: To detect the associations of a healthy lifestyle and genetic susceptibility with incident osteoarthritis (OA) in the UK biobank study. METHODS: We included 314 729 participants from UK biobank. Five modifiable lifestyle factors including weight management, diet, physical activity, sleep behavior and sedentary behavior were included to generate an overall lifestyle score. Genetic susceptibility was calculated by using polygenic risk score (PRS) of OA. Participants diagnosed with OA were identified by using ICD-9 and ICD-10. Covariates included age, sex, education, Townsend deprivation index, glucosamine use, analgesics use and comorbidities. Cox regression analyses were performed to examine the associations of genetic susceptibility and healthy lifestyle with incident OA. RESULTS: Adopting a more favorable lifestyle can be beneficial in significantly reducing the risk of incident total, knee and hip OA (all p < 0.01). PRS was significantly associated with greater risks of total, knee and hip OA. Compared with unfavorable lifestyle, favorable lifestyle was significantly associated with a lower risk of total OA across low (HR, 0.64; 95%CI, 0.58-0.70), intermediate (HR, 0.59; 95%CI, 0.56-0.63) and high genetic risk groups (HR, 0.58; 95%CI, 0.53-0.64). Similar results were observed on knee OA and hip OA. No significant interactions were detected between lifestyle and PRS for total, knee or hip OA. CONCLUSION: These data suggest that a healthier lifestyle is consistently associated with a lower risk of OA, regardless of genetic risks. Our findings highlight the importance of adherence to an overall healthy lifestyle in attenuating the risk of OA.

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