With elevated CRP, MetS increased individuals' risk of OA by up to 35% (HR = 1.35, 95% CI:1.3–1.4).Finally, the results of sensitivity analyses showed that MetS was significantly associated with an increased risk of OA (HR = 1.15, 95% CI:1.11–1.19) even after a 4-year lag in exposure (Supplementary 3). Here, CRP is linked to metabolic syndrome.