Funding Information: Open access funding provided by FCT|FCCN (b-on). Publisher Copyright: © The Author(s) 2025.; To investigate the association between cardiometabolic factors, obesity, radiographic severity, and symptomatic hand osteoarthritis (HOA), as the role of these factors in HOA remains unclear. A cross-sectional analysis in the EPIPorto cohort included participants with HOA (≥ 1 joint with Kellgren-La...