TOPLINE

Consumption of alcohol was associated with an increased risk for incident osteoarthritis, with the risk increasing with the level of alcohol intake compared with no drinking. The association persisted even among people with normal liver function or normal weight, and it appeared more pronounced in women than in men.

METHODOLOGY

• Investigators conducted a retrospective cohort study, based on South Korean National Health Insurance Service data (2009-2023), to assess the link between alcohol intake and incident osteoarthritis.
• The primary cohort included 1,233,179 adults aged 40 years or older without a prior diagnosis of osteoarthritis and whose daily alcohol intake could be estimated. They were drawn from a larger pool of 2,197,872 participants who reported drinking frequency.
• The analysis included 870,404 men and 362,775 women.
• Participants self-reported their drinking frequency per week and the amount of alcohol consumed per occasion, from which their daily intake was estimated. They were categorized as nondrinkers, light drinkers (< 10 g/d for both sexes), moderate drinkers (10 to < 30 g/d for men; 10 to < 20 g/d for women), or heavy drinkers (≥ 30 g/d for men; ≥ 20 g/d for women).
• Incident osteoarthritis was ascertained via diagnostic codes; prespecified subgroup analyses examined 858,703 participants with normal liver function and 820,281 with normal weight.

TAKEAWAY

• A total of 571,077 participants developed osteoarthritis over a mean follow-up duration of 9.9 years. Compared with nondrinkers, light drinkers (adjusted hazard ratio [aHR], 1.037; 95% CI, 1.030-1.045), moderate drinkers (aHR, 1.081; 95% CI, 1.072-1.091), and heavy drinkers (aHR, 1.186; 95% CI, 1.174-1.197) had an increased risk for incident osteoarthritis, with a dose-response pattern (P for trend < .001).
• A sex-stratified analysis found that light drinking was associated with an increased risk for osteoarthritis in women (aHR, 1.063; 95% CI, 1.053-1.073).
• The association between heavy alcohol consumption and incident osteoarthritis persisted in the normal-weight cohort, with the heavy-drinking group showing an increased risk for osteoarthritis (aHR, 1.182; 95% CI, 1.168-1.197). A similar association was seen for the heavy-drinking group in the normal-liver-function cohort.
• Participants who quit drinking after baseline retained an elevated risk for osteoarthritis relative to stable nondrinkers (aHR, 1.110; 95% CI, 1.085-1.136), similar to persistent drinkers (aHR, 1.096; 95% CI, 1.081-1.112).

IN PRACTICE

"The consistent association between alcohol consumption and OA [osteoarthritis] observed in both liver disease-free and normal weight cohorts suggests that this association is not fully explained by hepatic dysfunction or obesity, raising the possibility of effects of alcohol on joint tissues that operate through pathways independent of these factors," the authors wrote.

"[T]he temporal sequence of the cohort design, the graded exposure-response relationship, and the consistency across restriction and sensitivity analyses support that alcohol may be a potentially modifiable risk factor for OA," they added.

SOURCE

The study was led by Seoyeon Cho, Ewha Womans University College of Medicine, Seoul, South Korea. It was published online on September 15 in Osteoarthritis and Cartilage.

LIMITATIONS

Self-reported alcohol intake may have led to underreporting, especially among heavy drinkers. Residual confounding from unmeasured factors such as diet, genetics, and occupational strain could not be excluded. Patterns of alcohol consumption may have changed over time, and the findings may not be generalizable to populations with different drinking cultures and genetic backgrounds.

DISCLOSURES

The study received support from Brain Korea 21 FOUR, the National Research Foundation of Korea grant funded by the Ministry of Science and ICT, and the Korea Health Industry Development Institute. The authors reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.