The association between endogenous sex hormones and knee osteoarthritis in women: A population-based cohort study
Authors' conclusion
In middle-aged and older women, the risk of KOA is inversely associated with endogenous testosterone but not with SHBG or estradiol.
Study context
- Population
- Women from the UK Biobank (mean 56.0 years) with data on sex hormone-binding globulin (SHBG), testosterone or estradiol at baseline
- Participants
- 178,280 women
- Exposure
- Higher vs lower endogenous sex hormone levels
- Outcome
- Prevalence of knee OA at baseline and incident knee OA during follow-up
Methodological detailslogistic regression, accelerated failure time models
- Logistic regression
- Accelerated failure time models
Main finding
As reported in the abstract
Prevalent knee OA at baseline
OR per 1 SD increase in testosterone
0.91
95% CI 0.87–0.96
Observational data: associations, not effects.
Further findings
Time to incident knee OA (women without knee OA at baseline) · median follow-up 13.6 years
- Time ratio per 1 SD increase in testosterone
- 1.04 (95% CI 1.01-1.06)
Nonlinear associations of sex hormones with prevalence and occurrence of knee OA
- No evidence of nonlinear associations after adjustment for multiple comparisons
Original publication
The association between endogenous sex hormones and knee osteoarthritis in women: A population-based cohort study. Osteoarthritis Cartilage. Published 7 March 2025. doi:10.
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