Association between abdominal obesity-related indices (ABSI, AIP, CMI) and osteoarthritis in U.S. adults: A cross-sectional study based on NHANES 2011-2016.

BackgroundObesity is an established independent risk factor for osteoarthritis (OA). BMI cannot reflect fat distribution, while abdominal obesity is more closely related to OA. ABSI, AIP, and CMI are novel abdominal obesity indices with good predictive performance, but their associations with OA remain unclear.ObjectiveTo explore the independent associations of ABSI, AIP, CMI with OA risk in U.S. adults, clarify dose-response relationships, and compare their predictive ability.MethodsThis cross-sectional study included 11,319 participants from NHANES 2011-2016. Weighted logistic regression, RCS, subgroup analysis, and ROC analysis were applied.ResultsAfter full adjustment, elevated AIP and CMI were independently associated with higher OA risk (AIP: OR = 1.36; CMI: OR = 1.55). AIP showed a linear positive association, and CMI had an inverted U-shaped association with OA. ABSI showed no significant association. The associations were stronger in adults ≤60 years and non-Hispanic white individuals. ABSI had the highest AUC (0.637).ConclusionElevated AIP and CMI are independently associated with OA, modified by age and ethnicity. AIP and CMI can be used for OA risk stratification in young and middle-aged adults with abdominal obesity and metabolic disorders.