Background:The relationship between hand osteoarthritis (HOA) and systemic metabolic factors is unclear.The aim of this study was to investigate the prevalence of systemic metabolic factors including obesity,hypertension,diabetes mellitus,and atherosclerosis in symptomatic patients with HOA and the association between these systemic metabolic factors and symptomatic HOA in the Chinese Hann population aged 40 years and above.Methods:A cross-sectional survey was conducted on Chinese Han population aged 40 years and above in six centers in China.The sociodemographic features,lifestyle of the participants,and medical history of hypertension,diabetes mellitus,and atherosclerosis were collected.The cases with hand symptoms underwent anteroposterior radiographic examination of both hands to obtain a diagnosis.The correlations between systemic metabolic factors and symptomatic HOA were analyzed using Logistic regression analysis.Results:Overweight (39.3％ vs.30.5％,P ＜ 0.001),hypertension (34.7％ vs.18.6％,P ＜ 0.001),diabetes mellitus (11.2％ vs.3.3％,P ＜ 0.001),and atherosclerosis (19.8％ vs.8.3％,P ＜ 0.001) were more prevalent in symptomatic patients with HOA than those in the population without HOA.Overweight (odds ratio [OR] =1.35,95％ confidence interval [CI]:1.10-1.65,P =0.005),hypertension (OR =1.47,95％ CI:1.18-1.83,P ＜ 0.001),and diabetes mellitus (OR =2.45,95％ CI:1.74-3.45,P ＜ 0.001) were associated with a higher prevalence of symptomatic HOA and the OR of symptomatic HOA significantly increased with the accumulated number of the three metabolic factors.Symptomatic HOA was associated with a higher prevalence of atherosclerosis (OR =1.39,95％ CI:1.05-1.85,P =0.023).Conclusions:Overweight,hypertension,and diabetes mellitus were associated with a higher prevalence of HOA,showing cumulative effects.Atherosclerosis risk should be assessed in patients with HOA.