Decreased Risk of Knee Osteoarthritis with Taller Height in an East Asian Population: A Nationwide Cohort Study

Background: Numerous studies have explored factors impacting osteoarthritis (OA), but its relationship with height remains uncertain. This study investigates the relationship between height and osteoarthritis risk in South Korea. Methods: Participants aged 50 or older who underwent health screenings in 2009 were selected from the National Health Insurance System database. A total of 1,138,904 subjects were divided into height quartiles (Q1–Q4) based on age and gender. Cox proportional hazard models were used to assess knee osteoarthritis incidence risk, with the shortest quartile (Q1) as the reference. Results: After adjusting for age, sex, income, smoking, drinking, exercise, hypertension, diabetes mellitus, dyslipidemia, and body mass index (BMI), no significant difference in OA incidence risk based on height was observed. However, when adjusted for weight instead of BMI, we observed a gradual decrease in hazard ratio with increasing height. The hazard ratio for the tallest group was 0.787 (95% CI, 0.781~0.795). Similar results were obtained in all subgroups. Conclusions: Compared to previous studies, our findings present a clear distinction. Therefore, there may be racial differences in the association between height and knee OA risk, and our study provides evidence that, in East Asian populations, taller individuals have a reduced risk of knee OA.