ArticleClinical rheumatology2026
Cartilage metabolism mediates the association between serum vitamin D levels and the risk of osteoarthritis: a prospective cohort study from the UK Biobank.
Article in Clinical rheumatology, 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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Abstract
objectivesTo explore the association between serum vitamin D levels and the risk of knee and hip osteoarthritis (KOA and HOA).
methodsThis study included 295,557 participants (mean 56 years, 53% female) from the UK Biobank who had data on serum vitamin D levels and did not have KOA or HOA at baseline. The associations between serum vitamin D levels and the incidences of KOA and HOA were evaluated using Cox regression models. Mediating effects of serum biomarkers of inflammation (IL-1a, IL-1b, IL-6, and TNF) and cartilage metabolism (COMP, CRTAC1, and COL9A1) were explored.
resultsDuring a median follow-up of 13.1 years, 12,266 (4.2%) and 8931 (3.0%) participants developed KOA and HOA, respectively. Serum vitamin D levels were positively associated with osteoarthritis risk (KOA-hazard ratio [HR] = 1.14, 95% confidence interval [CI] 1.12-1.17; HOA-HR = 1.09, 95% CI 1.06-1.12). Compared to participants with severe vitamin D deficiency (< 25 nmol/L), those with sufficient vitamin D levels (≥ 75 nmol/L) had a 55% and 30% higher risk of developing KOA and HOA, respectively. Cartilage metabolism markers, but not inflammation markers, mediated 5.6%-12.6% of the associations between serum vitamin D levels and KOA risk.
conclusionHigh serum vitamin D levels are associated with an increased risk of OA in middle-aged and older adults. While serum vitamin D has recognized benefits for bone and cardiovascular health, these findings highlight a potential association with osteoarthritis risk without suggesting a causal effect. Key Points • High vitamin D levels increase osteoarthritis risk. • Cartilage metabolism partially mediates this association. • Inflammatory markers show no mediating effect.
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