Prevalence and Associations of Osteoarthritis, Rheumatoid Arthritis, and Psoriatic Arthritis in US Adults with MAFLD

Background/Aims: This study examined the weighted prevalence and associations of three major arthritis subtypes—osteoarthritis (OA), rheumatoid arthritis (RA), and psoriatic arthritis (PsA)—among US adults with metabolic dysfunction–associated fatty liver disease (MAFLD).

Materials and Methods: The authors analyzed cross-sectional data from the NHANES 2017-March 2020 pre-pandemic sample, including 2074 adults, of whom 1296 had MAFLD and 778 were non-MAFLD controls. Arthritis subtypes were self-reported. They estimated weighted descriptive prevalence and used propensity score weighting combined with survey-weighted logistic regression to evaluate associations between MAFLD and arthritis subtypes. No formal trend, joinpoint, or annual percentage change (APC) analysis was performed.

Results: In the MAFLD group, RA had the highest weighted prevalence (17.9%), followed by OA (9.2%) and PsA (1.0%). Weighted prevalence varied across demographic subgroups, with higher OA and RA prevalence observed among older adults. After weighting and multivariable adjustment, MAFLD was associated with higher odds of OA and RA. Estimates for PsA should be interpreted cautiously because of the low number of cases and limited precision. After adjustment, MAFLD was independently associated with higher odds of osteoarthritis (OR 1.94, 95% CI 1.05-3.77, P = .043) and rheumatoid arthritis (OR 1.65, 95% CI 1.03-2.63, P = .036). Psoriatic arthritis showed a strong but imprecise association (OR 13.87, 95% CI 1.58-121.93, P = .019), although the wide confidence interval indicates substantial uncertainty in the estimate.

Conclusion: This study suggests that MAFLD may be associated with higher odds of OA and RA; however, these findings should be interpreted with caution, and the model should be considered as a supportive analytical tool rather than a stand-alone diagnostic method. Further studies are needed before clinical application can be recommended.

Cite this article as: Huang D, Wang H, Wang S, Yu T, Zhou L. Prevalence and associations of osteoarthritis,rheumatoid arthritis, and psoriatic arthritis in US adults with MAFLD. ArchRheumatol. Published online July 3, 2026. 10.5152/ ArchRheumatol.2026.25239.