The Relationship Between Central Obesity and Osteoarthritis in US Adults: The Mediating Role of Biological Aging Acceleration

Abstract

Objective This study aims to investigate the association between central obesity and the risk of osteoarthritis, and the mediating role of biological age and biological aging advance in this relationship. Methods The study is based on data from the National Health and Nutrition Examination Survey (NHANES) for the years 2005–2018. Thirteen commonly used clinical traits were used to calculate the Klemera-Doubal method age (KDM-Age) and phenotypic age (Pheno-Age) as two measures of biological aging. Additionally, KDM-Age advance and Pheno-Age advance were calculated as two measures of biological aging advance. Weighted multivariable logistic regression was used to analyze the association between central obesity and the risk of osteoarthritis (OA). Mediation analysis was then applied to elucidate the role of biological aging and biological aging advance in this relationship. Results A total of 31,162 subjects aged ≥20 years were included in this study, of which 3,964 subjects reported having OA (14%). Compared to the Non-OA group, the OA group showed significantly higher proportions of central obesity, KDM-Age, KDM-Age advance, PhenoAge, and PhenoAge advance. Compared to the Non-central obesity group, the central obesity group had higher KDM-Age, KDM-Age advance, PhenoAge, PhenoAge advance, and a higher risk of OA (p < 0.05). Additionally, higher KDM-Age, KDM-Age advance, PhenoAge, and PhenoAge advance were positively correlated with the risk of OA (p < 0.05). Mediation analysis revealed that part of the association between central obesity and the risk of OA was mediated by KDM-Age, KDM-Age advance, PhenoAge, and PhenoAge advance (p < 0.05). Conclusion Central obesity increases the risk of OA, with part of this association being mediated by biological aging and biological aging advance.