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

Abstract

Objectives To detect the associations of a healthy lifestyle and genetic susceptibility with incident 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 behaviour and sedentary behaviour 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 the International Classification of Diseases (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 favourable 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 unfavourable lifestyle, favourable lifestyle was significantly associated with a lower risk of total OA across low [hazard ratio (HR) 0.64; 95% CI 0.58-0.70], intermediate (HR 0.59; 95% CI 0.56-0.63) and high (HR 0.58; 95% CI 0.53-0.64) genetic risk groups. 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.