Associations of physical activity with the risks of osteoarthritis and subtypes: a population-based cohort study of UK Biobank data

Aims: This study aimed to investigate the relationship between physical activity (PA) and the risk of osteoarthritis (OA) and its subtypes. Methods: We included participants from the UK Biobank aged 37 to 73 years from February 2006 to June 2010. Baseline PA levels were categorized as high (≥ 3,000...

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Main Authors: Huijie Gu, Rong Chen, Tingting Fang, Jun Xu, Yiming Zhang, Chong Bian, Xiangyang Cheng, Xiaofan Yin, Chuhuai Wang, Guangnan Chen
Format: Article
Language:English
Published: The British Editorial Society of Bone & Joint Surgery 2025-07-01
Series:Bone & Joint Research
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Online Access:https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.147.BJR-2024-0529.R1
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author Huijie Gu
Rong Chen
Tingting Fang
Jun Xu
Yiming Zhang
Chong Bian
Xiangyang Cheng
Xiaofan Yin
Chuhuai Wang
Guangnan Chen
author_facet Huijie Gu
Rong Chen
Tingting Fang
Jun Xu
Yiming Zhang
Chong Bian
Xiangyang Cheng
Xiaofan Yin
Chuhuai Wang
Guangnan Chen
author_sort Huijie Gu
collection DOAJ
description Aims: This study aimed to investigate the relationship between physical activity (PA) and the risk of osteoarthritis (OA) and its subtypes. Methods: We included participants from the UK Biobank aged 37 to 73 years from February 2006 to June 2010. Baseline PA levels were categorized as high (≥ 3,000 metabolic equivalent of task (MET)-min/week), moderate (600 to < 3,000 MET-min/week), or low PA (< 600 MET-min/week) based on current public health guidelines. The associations between PA and OA and its main subtypes (hand, hip, and knee OA) were analyzed using Cox-proportional hazard models. The mediating role of BMI was tested under a causal counterfactual framework. Results: The median follow-up period was 12.50 years, with 25,036 incident total OA cases. Compared to low PA, we found no significant association between moderate PA and total OA risk. However, high PA significantly increased the risk of total OA by 19% (hazard ratio (HR) 1.19, 95% CI 1.15 to 1.23). This result is consistent with knee OA and hip OA, where HR was 1.25 (95% CI 1.19 to 1.31) for knee OA risk and 1.17 (95% CI 1.10 to 1.24) for hip OA risk, respectively. Moderate PA was associated with 14% (HR 0.86, 95% CI 0.76 to 0.97) reduction in the risk of hand OA. Moreover, we found that BMI mediated the association between PA and OA risk, with the mediating proportion for total OA, hand OA, knee OA, and hip OA, at 75.48%, 2.42%, 10.20%, and 51.39%, respectively. Conclusion: These findings suggest that high levels of PA increased the risk of total OA, as well as knee and hip OA, while moderate levels of PA significantly mitigate the risk of hand OA. BMI appears to mediate the relationship between PA and OA risk. Future research should elucidate the underlying mechanisms. Cite this article: Bone Joint Res 2025;14(7):656–665.
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publishDate 2025-07-01
publisher The British Editorial Society of Bone & Joint Surgery
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series Bone & Joint Research
spelling doaj-art-c2c8811b6f7a4ebd9f9e5fc73df7b2042025-08-20T03:58:49ZengThe British Editorial Society of Bone & Joint SurgeryBone & Joint Research2046-37582025-07-0114765666510.1302/2046-3758.147.BJR-2024-0529.R1Associations of physical activity with the risks of osteoarthritis and subtypes: a population-based cohort study of UK Biobank dataHuijie Gu0Rong Chen1Tingting Fang2Jun Xu3Yiming Zhang4Chong Bian5Xiangyang Cheng6Xiaofan Yin7Chuhuai Wang8Guangnan Chen9Department of Orthopedics, Minhang Hospital, Fudan University, Shanghai, ChinaDepartment of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, ChinaDepartment of Infectious Diseases, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Orthopedics, Minhang Hospital, Fudan University, Shanghai, ChinaDepartment of Orthopedics, Minhang Hospital, Fudan University, Shanghai, ChinaDepartment of Orthopedics, Minhang Hospital, Fudan University, Shanghai, ChinaDepartment of Orthopedics, Minhang Hospital, Fudan University, Shanghai, ChinaDepartment of Orthopedics, Minhang Hospital, Fudan University, Shanghai, ChinaDepartment of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, ChinaDepartment of Orthopedics, Minhang Hospital, Fudan University, Shanghai, ChinaAims: This study aimed to investigate the relationship between physical activity (PA) and the risk of osteoarthritis (OA) and its subtypes. Methods: We included participants from the UK Biobank aged 37 to 73 years from February 2006 to June 2010. Baseline PA levels were categorized as high (≥ 3,000 metabolic equivalent of task (MET)-min/week), moderate (600 to < 3,000 MET-min/week), or low PA (< 600 MET-min/week) based on current public health guidelines. The associations between PA and OA and its main subtypes (hand, hip, and knee OA) were analyzed using Cox-proportional hazard models. The mediating role of BMI was tested under a causal counterfactual framework. Results: The median follow-up period was 12.50 years, with 25,036 incident total OA cases. Compared to low PA, we found no significant association between moderate PA and total OA risk. However, high PA significantly increased the risk of total OA by 19% (hazard ratio (HR) 1.19, 95% CI 1.15 to 1.23). This result is consistent with knee OA and hip OA, where HR was 1.25 (95% CI 1.19 to 1.31) for knee OA risk and 1.17 (95% CI 1.10 to 1.24) for hip OA risk, respectively. Moderate PA was associated with 14% (HR 0.86, 95% CI 0.76 to 0.97) reduction in the risk of hand OA. Moreover, we found that BMI mediated the association between PA and OA risk, with the mediating proportion for total OA, hand OA, knee OA, and hip OA, at 75.48%, 2.42%, 10.20%, and 51.39%, respectively. Conclusion: These findings suggest that high levels of PA increased the risk of total OA, as well as knee and hip OA, while moderate levels of PA significantly mitigate the risk of hand OA. BMI appears to mediate the relationship between PA and OA risk. Future research should elucidate the underlying mechanisms. Cite this article: Bone Joint Res 2025;14(7):656–665.https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.147.BJR-2024-0529.R1physical activityosteoarthritisuk biobankosteoarthritis (oa)hipsbmiknee osteoarthritiskneescox proportional hazards modelsdiabetes mellitusobesityhypertensiondepression
spellingShingle Huijie Gu
Rong Chen
Tingting Fang
Jun Xu
Yiming Zhang
Chong Bian
Xiangyang Cheng
Xiaofan Yin
Chuhuai Wang
Guangnan Chen
Associations of physical activity with the risks of osteoarthritis and subtypes: a population-based cohort study of UK Biobank data
Bone & Joint Research
physical activity
osteoarthritis
uk biobank
osteoarthritis (oa)
hips
bmi
knee osteoarthritis
knees
cox proportional hazards models
diabetes mellitus
obesity
hypertension
depression
title Associations of physical activity with the risks of osteoarthritis and subtypes: a population-based cohort study of UK Biobank data
title_full Associations of physical activity with the risks of osteoarthritis and subtypes: a population-based cohort study of UK Biobank data
title_fullStr Associations of physical activity with the risks of osteoarthritis and subtypes: a population-based cohort study of UK Biobank data
title_full_unstemmed Associations of physical activity with the risks of osteoarthritis and subtypes: a population-based cohort study of UK Biobank data
title_short Associations of physical activity with the risks of osteoarthritis and subtypes: a population-based cohort study of UK Biobank data
title_sort associations of physical activity with the risks of osteoarthritis and subtypes a population based cohort study of uk biobank data
topic physical activity
osteoarthritis
uk biobank
osteoarthritis (oa)
hips
bmi
knee osteoarthritis
knees
cox proportional hazards models
diabetes mellitus
obesity
hypertension
depression
url https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.147.BJR-2024-0529.R1
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