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Association Between Alcohol Consumption and Hand Osteoarthritis in a Nationally Representative Cohort of 90,764 Adults
Shujaa Khan, MD, Ignacio Pasqualini, MD, Samantha Panich, MD; Youssra Marjoua, MD
Cleveland Clinic, Cleveland, OH
Introduction: Alcohol consumption is a widely studied behavioral factor with known associations to chronic diseases, yet its relationship with musculoskeletal conditions such as osteoarthritis (OA) remains uncertain. While existing literature has explored this association in hip and knee OA, limited, conflicting evidence exists for hand OA. This study aimed to examine the association between alcohol consumption frequency and the risk of hand OA using data from the nationally representative All of Us Research Program.
Methods: We conducted a retrospective case-control study using the All of Us Research Program Controlled Tier Dataset v8 (February 2024 release). Adults aged ?18 years were included if they had complete data on alcohol use, hand OA status, and relevant covariates. Hand OA cases were defined via EHR-documented SNOMED-coded diagnoses, with controls lacking any OA diagnosis. Using a 1:4 age- and sex-matched design, the final cohort included 90,764 participants (18,292 cases and 72,472 controls). Alcohol use frequency was categorized into five levels. Multivariable logistic regression assessed the association between alcohol use and hand OA, adjusting for age, BMI, gender, race, ethnicity, diabetes, hypertension, and hyperlipidemia.
Results: Among 90,764 participants, 70% were female and 49% identified as White. Alcohol use patterns differed significantly between groups (P < 0.001), with higher frequencies observed among those with hand OA. However, after multivariable adjustment, alcohol consumption frequency was not significantly associated with hand OA. Compared to never users, adjusted odds ratios (ORs) ranged from 0.89 (95% CI: 0.69-1.15) for low-frequency to 0.91 (95% CI: 0.59-1.40) for high-frequency use (all P > 0.05). Notably, increasing age was independently associated with lower odds of hand OA (OR: 0.87, 95% CI: 0.86-0.89, P < 0.001), while male sex conferred greater odds (OR: 2.21, 95% CI: 1.72-2.85, P < 0.001).
Conclusion: This study represents the largest and most diverse analysis to date examining the association between alcohol consumption and hand osteoarthritis. Alcohol consumption frequency was not associated with increased or decreased odds of hand osteoarthritis. These findings suggest that alcohol use may not play a significant role in hand OA development, highlighting the need for further research into biological and environmental contributors.
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