did not reach statistical significanceP = 0.0007
When the RAR was converted to a quartile variable, participants in the Q2 had a 1.18-fold increased risk of developing osteoarthritis compared to the Q1 (OR = 1.18, 95% CI: 0.89, 1.57, P = 0.2492), but did not reach statistical significance; participants in Q3 had a 1.65-fold increased risk (OR = 1.65, 95% CI: 1.24, 2.20, P = 0.0007), which was statistically significant; and participants in Q4 had a 1.97-fold increased risk (OR = 1.97, 95% CI: 1.42, 2.73, P < 0.0001).