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ORIGINAL RESEARCH article

Front. Med.
Sec. Rheumatology
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1425210

The association between sex hormones and prevalence of OA in US adults

Provisionally accepted
Xiaoyuan Tian Xiaoyuan Tian Bocheng Zhang Bocheng Zhang *
  • Second Affiliated Hospital of Dalian Medical University, Dalian, China

The final, formatted version of the article will be published soon.

    Background: Age and gender are commonly recognized as risk factors for osteoarthritis (OA), implying a potential association between sex hormones and OA pathogenesis. However, the precise role of sex hormones in OA remains elusive. Meanwhile, testosterone to estradiol (TT/E2) ratio is a new biomarker of sex hormone milieu. In this study, we aimed to investigate the relationship between sex hormones, specifically TT/E2 ratio, and the prevalence of OA among adults in the United States. Methods: This study is a cross-sectional study, and the data sourced from the National Health and Nutrition Examination Survey (NHANES) 2013–2016 cycles. This study primarily focuses on individuals aged 50 and above, employing multivariable logistic regression to examine the association between sex hormones and OA. Results: We included 2,615 participants (972 females). No significant association was observed between testosterone or estradiol levels and OA prevalence when analyzed separately. However, the TT/E2 ratio exhibited a robust inverse association with OA, particularly in females (adjusted OR = 0.61, 95% CI: 0.41–0.91, P = 0.02). A nonlinear relationship was observed in females, with a threshold effect indicating reduced OA risk when the TT/E2 ratio exceeded 0.3. Conclusion: The TT/E2 ratio was inversely associated with OA risk, with a stronger and more consistent effect observed in females. These findings suggest the TT/E2 ratio as a potential biomarker for OA risk stratification, particularly in postmenopausal females. Future longitudinal studies are warranted to clarify the causal role of the TT/E2 ratio in OA.

    Keywords: Osteoarthritis, Testosterone, Estradiol, Risk factors, Hormones

    Received: 13 Jun 2024; Accepted: 29 Nov 2024.

    Copyright: © 2024 Tian and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Bocheng Zhang, Second Affiliated Hospital of Dalian Medical University, Dalian, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.