# 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

## TL;DR

This study finds that social and metabolic factors significantly increase the risk of developing secondary shoulder joint osteoarthritis, suggesting early intervention could help prevent the condition.

## Contribution

The study introduces a novel SLM score combining social, lifestyle, and metabolic factors to assess risk for secondary glenohumeral joint osteoarthritis.

## Key findings

- Participants with higher SLM scores had a 3.75-fold increased risk of developing secondary GJO.
- Social and metabolic factors showed significant associations with increased GJO risk.
- Subgroup analyses revealed stronger associations in women, men, and individuals under 60 years old.

## Abstract

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.

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.

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.

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.