Evidence mapPaperPMID 41514246Full record

ArticleNutrition & metabolism2026

The association between life's crucial 9 and osteoarthritis in US adults: the mediating role of central adiposity.

Feng Luo, Jia-Jie Guo, Fu-Zhen Jiang, Xue-Mei Yuan, Heng Zhou, Qiu-Yi Wang, Chang-Ming Chen, Xue-Ming Yao, Wu-Kai Ma

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Article in Nutrition & metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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9 authors.

Feng Luo *Guizhou University of Traditional Chinese Medicine, Guiyang, 550025, China.
Jia-Jie Guo *The Second School of Clinical Medicine, Guangzhou Medical University, Guangzhou, 511436, China.
Fu-Zhen JiangDepartment of Artificial Intelligence, School of Automation, Hangzhou Dian zi University, Hangzhou, 310018, China.
Xue-Mei YuanGuizhou University of Traditional Chinese Medicine, Guiyang, 550025, China.
Heng ZhouDepartment of Traditional Chinese Medicine, The Second People's Hospital of Guizhou Province, Guiyang, 550004, China.
Qiu-Yi WangGuizhou University of Traditional Chinese Medicine, Guiyang, 550025, China.
Chang-Ming ChenGuizhou University of Traditional Chinese Medicine, Guiyang, 550025, China.
Xue-Ming YaoGuizhou University of Traditional Chinese Medicine, Guiyang, 550025, China. yxming19@foxmail.com.
Wu-Kai MaGuizhou University of Traditional Chinese Medicine, Guiyang, 550025, China. walker55@163.com.

Funding

Guizhou University of Traditional Chinese Medicine, 2024 "Youth Sailing Program" (Natural Sciences) GZY-KYHT-QNYFZK[2024]14Guizhou University of Traditional Chinese Medicine, Graduate Scientific Research Fund Project YCXKYB2024014Guizhou University of Traditional Chinese Medicine, innovative training project Guizhou TCM Dachuang Hezi ( 2024 ) No.57National and Provincial Science and Technology Innovation Talent Team Training Program of Guizhou University of Traditional Chinese Medicine Gui Zhong Yi TD He Zi [2022] No. 004"Sanhang" Talent Training Program of the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine SHRC-KY2024005the National Natural Science Foundation of China 82160869, 82374494the National Natural Science Foundation of China 82274678, 8247155344Youth Science and Technology Talent Development Project of Guizhou Provincial Department of Education Qianjiaoji [2024] No. 122
6 · The paper itself

Abstract

backgroundOsteoarthritis (OA), a prevalent degenerative joint disorder characterized by progressive cartilage loss and secondary low-grade inflammation, is recognized to be associated with cardiovascular diseases (CVD). Building upon the cardiovascular assessment framework of Life’s Essential 8 (LE8), emerging guidelines propose the integration of psychological health metrics (Patient Health Questionnaire-9, PHQ-9) into the expanded Life’s Crucial 9 (LC9) model. While LC9 demonstrates cardiovascular predictive capacity, its role in OA pathogenesis remains inadequately substantiated.

methodsThis study analyzed data from 21,196 National Health and Nutrition Examination Survey (NHANES) participants (2005–2018). Survey-weighted logistic regression, weighted quantile sum (WQS) regression, and restricted cubic splines (RCS) assessed the LC9–OA association with prespecified confounders. Subgroup analyses were also conducted. Mediation analysis was performed to assess the potential mediating effects of central adiposity, specifically the Body Roundness Index (BRI) and Waist-to-Height Ratio (WHtR).

resultsEach 10-point higher LC9 was associated with lower odds of OA (OR = 0.79; 95% CI 0.74–0.84; P < 0.001). Interactions suggested stronger inverse associations in younger adults (≤ 40 years) and in women. WQS regression identified body mass index (33.00%), nicotine exposure (28.40%), and depressive symptoms (13.60%) as the largest contributors to OA risk. While LC9 and LE8 showed comparable discriminatory accuracy (AUC: 0.616 vs. 0.607, P = 0.077), LC9 demonstrated superior reclassification performance (NRI = 0.02, P = 0.002). Mediation analyses indicated that central adiposity accounted for a substantial proportion of the association (WHtR 39.63%; BRI 37.82%). Findings were robust in analyses restricted to adults ≥ 40 years.

conclusionHigher LC9 scores were associated with lower odds of OA, partly mediated by central adiposity. Cardiovascular health metrics that incorporate psychological health may be relevant to OA burden. Prospective studies are needed to establish temporality and causal pathways.

Indexed as

Body roundness indexCardiovascular healthCentral adiposityLife’s crucial 9NHANESOsteoarthritisWaist-to-height ratio index

Identifiers

PMID41514246
PMCPMC12882590

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.