ArticleFrontiers in endocrinology2026
Development and validation of a uric acid-inflammation-metabolism score for predicting osteoarthritis risk: evidence from NHANES 2007-2018 and an external Chinese cohort.
Article in Frontiers in endocrinology, 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
Objective: To develop and validate a novel Uric acid-Inflammation-Metabolism (UIM) score for assessing the association with osteoarthritis(OA) prevalence and to explore joint effect mechanisms among three biological dimensions: uric acid metabolism, inflammatory status, and metabolic disturbance. Methods: This retrospective cross-sectional study included a discovery cohort from NHANES 2007-2018 (n=3288) and an external validation cohort from Anhui Provincial Hospital (n=859). LASSO logistic regression selected optimal predictors from 14 candidate variables, and the UIM score was constructed via weighted multivariable logistic regression. Discrimination, calibration, and clinical utility were evaluated, with restricted cubic splines (RCS) assessing dose-response relationships and additive interactions analyzed. Results: Seven variables (UA, eGFR, serum creatinine, hs-CRP, WC, HDL-C, BMI) were retained. In the fully adjusted model, participants in the highest UIM score quartile (Q4) had a 2.63-fold higher OA risk than those in the lowest quartile (Q1) (OR = 2.63, 95% CI: 1.47-4.72), with a significant J-shaped nonlinear relationship. The UIM score (AUC = 0.707) outperformed individual biomarkers and the traditional model, with satisfactory calibration and clinical utility. The uric acid dimension contributed most (70.50%), followed by metabolic (26.92%) and inflammatory (2.58%) dimensions. A significant additive antagonistic interaction was observed between high inflammation and high metabolic disturbance. External validation and sensitivity analyses confirmed the score's robustness and generalizability. Conclusions: The UIM score integrating uric acid metabolism, inflammation, and metabolic disturbance outperforms individual biomarkers in OA risk prediction with good cross-cohort generalizability. Antagonistic interactions among the three dimensions reflect the complexity of OA pathogenesis, and the UIM score is a practical tool for OA prevalence stratification and clinical assessment.
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