ORIGINAL RESEARCH article
Front. Public Health
Sec. Life-Course Epidemiology and Social Inequalities in Health
The association between social determinants, lifestyle and metabolic factors and the onset of secondary glenohumeral joint osteoarthritis: A cohort study of adults in the UK
Provisionally accepted
- 1The Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- 2Heilongjiang University of Chinese Medicine, Harbin, China
- 3Shandong University of Traditional Chinese Medicine Second Affiliated Hospital, Jinan, China
- 4Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing, China
- 5Shandong First Medical University, Jinan, China
- 6Shandong Provincial Hospital, Jinan, China
- 7Department of Radiology, Shandong Provincial Hospital, Shandong University, Ji'nan, China
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Objective: Secondary Glenohumeral Joint Osteoarthritis (GJO) is a degenerative condition of non-weight-bearing joints. While age and gender are known risk factors, the role of modifiable factors remains underexplored. This study aimed to assess the association of social determinants, lifestyle, and metabolic factors with the incidence of secondary GJO. Methods: We included 26,708 UK Biobank participants without OA at baseline and who reported secondary GJO only at follow-up. Median follow-up duration was 8.85 years. A Social Determinants, Lifestyle, and Metabolic (SLM) score was developed based on 17 variables: 4 social, 5 lifestyle, and 8 metabolic indicators. Each adverse factor contributed one point (range: 0–17). Cox proportional hazards models were used to evaluate the relationship between baseline SLM score and incident secondary GJO. Subgroup analyses were stratified by age and gender. Results: There was a significant linear trend between SLM score and secondary GJO risk (P < 0.001). Participants with higher SLM scores had a 3.75-fold increased risk of developing secondary GJO (AHR = 3.75, 95% CI: 1.87–7.51, P = 0.0002). Higher social determinant scores (AHR = 3.35, P = 6.8×10⁻⁶) and metabolic scores (AHR = 1.62, P = 0.045) were independently associated with increased risk, while lifestyle factors showed a nonsignificant trend. Subgroup analyses revealed stronger associations in women, men, and individuals under 60 years old. Conclusions: Modifiable social and metabolic factors significantly influence the risk of secondary GJO. Early identification and intervention targeting these factors may aid in the prevention of this condition.
Keywords: Incidence risk, lifestyle, metabolic, secondary glenohumeral joint osteoarthritis, social determinants
Received: 08 Oct 2025; Accepted: 01 Dec 2025.
Copyright: © 2025 Yan, Yuan, Mei, Zhang, Liu, Sun, Liu and He. 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: Qiang He
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