Association between RBC folate and odds of osteoarthritis in adults aged 40–60 years

Abstract Although the association between red blood cell (RBC) folate and osteoarthritis (OA) is still controversial, relevant evidence is continuously emerging. This study aimed to examine the relationship between RBC folate levels and the incidence of OA in adults aged 40–60. This cross-sectional...

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Main Authors: Weiqing Zeng, Liangji Zhou, Gangjian Tang, Sheng Chai, Xiaoqiao Che, Hua Wei
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-10727-2
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author Weiqing Zeng
Liangji Zhou
Gangjian Tang
Sheng Chai
Xiaoqiao Che
Hua Wei
author_facet Weiqing Zeng
Liangji Zhou
Gangjian Tang
Sheng Chai
Xiaoqiao Che
Hua Wei
author_sort Weiqing Zeng
collection DOAJ
description Abstract Although the association between red blood cell (RBC) folate and osteoarthritis (OA) is still controversial, relevant evidence is continuously emerging. This study aimed to examine the relationship between RBC folate levels and the incidence of OA in adults aged 40–60. This cross-sectional analysis involved 7708 adults from the National Health and Nutrition Examination Survey 2009–2018. The independent variable was RBC folate, which reflects long-term folate status, and the outcome variable was the odds of OA. A logistic regression model was used to evaluate the association between RBC folate levels and the incidence of OA. Additionally, subgroup analyses were conducted by race, gender, and body mass index. After adjusting for other potential confounding factors, there was a positive association between RBC folate and the incidence of OA (OR 1.0024, 95% CI 1.0012–1.0036, P < 0.0001). When RBC folate was divided into four equal groups, in the fully adjusted model, participants in the highest quartile had a significant higher odds of OA than those in the lowest quartile (OR 1.3157, 95% CI 1.0532–1.6436, P = 0.0191). In adults aged 40 to 60 years, there was a J-shaped relationship between RBC folate and the incidence of OA (turning point: 102 nmol/dL, OR 1.0403, 95% CI 1.0242–1.0566, p < 0.0001). This indicates that when the RBC folate level exceeds 102 nmol/dL, for every 10 nmol/dL increase, the odds of OA rises by 4.03%. Our findings showed a positive association between RBC folate and the incidence of OA in adults aged 40–60. Further studies are required to explore its underlying mechanism and confirm this correlation.
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spelling doaj-art-e6d6f268b4874700b2f77fc2dab9121f2025-08-20T03:43:26ZengNature PortfolioScientific Reports2045-23222025-07-0115111010.1038/s41598-025-10727-2Association between RBC folate and odds of osteoarthritis in adults aged 40–60 yearsWeiqing Zeng0Liangji Zhou1Gangjian Tang2Sheng Chai3Xiaoqiao Che4Hua Wei5Department of Orthopedics, Guilin Municipal Hospital of Traditional Chinese MedicineDepartment of Orthopedics, Guilin Municipal Hospital of Traditional Chinese MedicineDepartment of Orthopedics, Guilin Municipal Hospital of Traditional Chinese MedicineDepartment of Orthopedics, Guilin Municipal Hospital of Traditional Chinese MedicineDepartment of Orthopedics, Guilin Municipal Hospital of Traditional Chinese MedicineDepartment of Orthopedics, Guilin Municipal Hospital of Traditional Chinese MedicineAbstract Although the association between red blood cell (RBC) folate and osteoarthritis (OA) is still controversial, relevant evidence is continuously emerging. This study aimed to examine the relationship between RBC folate levels and the incidence of OA in adults aged 40–60. This cross-sectional analysis involved 7708 adults from the National Health and Nutrition Examination Survey 2009–2018. The independent variable was RBC folate, which reflects long-term folate status, and the outcome variable was the odds of OA. A logistic regression model was used to evaluate the association between RBC folate levels and the incidence of OA. Additionally, subgroup analyses were conducted by race, gender, and body mass index. After adjusting for other potential confounding factors, there was a positive association between RBC folate and the incidence of OA (OR 1.0024, 95% CI 1.0012–1.0036, P < 0.0001). When RBC folate was divided into four equal groups, in the fully adjusted model, participants in the highest quartile had a significant higher odds of OA than those in the lowest quartile (OR 1.3157, 95% CI 1.0532–1.6436, P = 0.0191). In adults aged 40 to 60 years, there was a J-shaped relationship between RBC folate and the incidence of OA (turning point: 102 nmol/dL, OR 1.0403, 95% CI 1.0242–1.0566, p < 0.0001). This indicates that when the RBC folate level exceeds 102 nmol/dL, for every 10 nmol/dL increase, the odds of OA rises by 4.03%. Our findings showed a positive association between RBC folate and the incidence of OA in adults aged 40–60. Further studies are required to explore its underlying mechanism and confirm this correlation.https://doi.org/10.1038/s41598-025-10727-2OsteoarthritisRed blood cell folateVitamin B9National health and nutrition examination survey
spellingShingle Weiqing Zeng
Liangji Zhou
Gangjian Tang
Sheng Chai
Xiaoqiao Che
Hua Wei
Association between RBC folate and odds of osteoarthritis in adults aged 40–60 years
Scientific Reports
Osteoarthritis
Red blood cell folate
Vitamin B9
National health and nutrition examination survey
title Association between RBC folate and odds of osteoarthritis in adults aged 40–60 years
title_full Association between RBC folate and odds of osteoarthritis in adults aged 40–60 years
title_fullStr Association between RBC folate and odds of osteoarthritis in adults aged 40–60 years
title_full_unstemmed Association between RBC folate and odds of osteoarthritis in adults aged 40–60 years
title_short Association between RBC folate and odds of osteoarthritis in adults aged 40–60 years
title_sort association between rbc folate and odds of osteoarthritis in adults aged 40 60 years
topic Osteoarthritis
Red blood cell folate
Vitamin B9
National health and nutrition examination survey
url https://doi.org/10.1038/s41598-025-10727-2
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