Epidemiological trends and characteristics of osteoarthritis in China during 1990-2021

Abstract

Background: This study aimed to comprehensively analyze the incidence, prevalence, and disability-adjusted life years (DALYs) of osteoarthritis (OA) in China from 1990 to 2021 by age, sex, joint sites, high body mass index (BMI) and sociodemographic index (SDI).

Methods: Data and methodologies from the Global Burden of Diseases (GBD) Study 2021 were obtained to evaluate the burden of OA in China. This assessment was conducted by estimating the number of incident cases, prevalent cases, DALYs, and corresponding age-standardized rates (ASRs). The estimated annual percentage change was employed to delineate the trends over time.

Results: In China, the number of OA incidence cases, prevalence cases, and DALYs increased to 11.65 million, 152.85 million and 5.33 million in 2021, respectively, exhibiting a consistent upward trend over the years. The ASRs of OA incidence, prevalence, and DALYs rose 13.86 %, 14.34 %, and 16.23 % from 1990 to 2021, respectively, with knee OA most affected. In 2021, OA incidence, prevalence, and DALYs were higher in women than in men, and increased with age for both sexes, peaking at ages 50-54 for incidence and 55-59 for prevalence and DALYs. DALYs of OA attributed to high BMI increased rapidly, and high BMI contributed to 21.64 % of the total age-standardized DALYs rate of OA in China. Positive correlations were observed between ASRs and China's SDI from 1990 to 2021.

Conclusion: OA constitutes a significant public health challenge in China, with a persistently high disease burden. There is a pressing need to enhance public understanding of the risk factors associated with OA and to promote preventive strategies to mitigate the future burden of this disorder.The translational potential of this article China has the largest elderly population and the highest prevalence of OA globally. Updating and analyzing epidemiological data of OA in China will offer the public, healthcare professionals, and policymakers the most current, comprehensive, and comparable information, which holds significant translational potential.

Keywords: China; Disability-adjusted life years; Incidence; Osteoarthritis; Prevalence.

Graphical abstract

Fig. 1

Incident cases and age-standardized incidence rate (per 100,000) of osteoarthritis (OA) according to different joint sites and genders by time and age group in China. (a) Number of OA incident cases by joint sites (the bar graph with left Y-axis) and age-standardized incidence rate by gender (the line graph with right Y-axis) from 1990 to 2021. The number of OA incident cases was increased to 11.65 million in 2021 from 4.65 million in 1990, with an age-standardized incidence rate (ASIR) of 554.61 per 100,000 people, and there was a moderate increase of 13.86 % from 1990 to 2021. (b) Number of OA incident cases by joint sites (the bar graph with left Y-axis) and age-standardized incidence rate by gender (the line graph with right Y-axis) in 1990 and 2021 according to different age groups. The number of incident case increased with age for both sexes and peaked at 2.33 million in the 50 to 54 age group, and then the decreasing trends were observed up to the oldest age group.

Fig. 2

Prevalent cases and age-standardized prevalence rate (per 100,000) of osteoarthritis (OA) according to different joint sites and genders by time and age group in China. (a) Number of OA prevalent cases by joint sites (the bar graph with left Y-axis) and age-standardized prevalence rate by gender (the line graph with right Y-axis) from 1990 to 2021. The number of OA prevalent cases was increased to 152.85 million in 2021 from 53.35 million in 1990, with an age-standardized prevalence rate (ASPR) of 7033.66 per 100,000 people, and there was a substantial increase of 14.34 % from 1990 to 2021. (b) Number of OA prevalent cases by joint sites (the bar graph with left Y-axis) and age-standardized prevalence rate by gender (the line graph with right Y-axis) in 1990 and 2021 according to different age groups. The number of prevalent cases increased with age for both sexes and peaked at 27.59 million in the 55 to 59 age group, and reached a secondary peak at 25.67 million in the 65 to 69 age group, and then the decreasing trends were observed up to the oldest age group.

Fig. 3

Disability-adjusted life years (DALYs) and age-standardized DALYs rate (per 100,000) of osteoarthritis (OA) according to different joint sites and genders by time and age group in China. (a) Number of OA DALYs by joint sites (the bar graph with left Y-axis) and age-standardized DALYs rate by gender (the line graph with right Y-axis) from 1990 to 2021. The number of OA DALYs was increased to 5.33 million in 2021 from 1.83 million in 1990, with an age-standardized DALYs rate (ASDR) of 244.79 per 100,000 people, and there was a noticeable increase of 16.23 % from 1990 to 2021. (b) Number of OA DALYs by joint sites (the bar graph with left Y-axis) and age-standardized DALYs rate by gender (the line graph with right Y-axis) in 1990 and 2021 according to different age groups. The number of DALYs increased with age for both sexes and peaked at 0.91 million in the 55 to 59 age group, and reached a secondary peak at 0.83 million in the 65 to 69 age group, and then the decreasing trends were observed up to the oldest age group.

Fig. 4

Proportions of age-standardized rate (ASR) of disability-adjusted life years (DALYs) for osteoarthritis (OA) attributable to a high body mass index (BMI) by gender and joint sites from 1990 to 2021 in China. ASDR attributable to high BMI accounted for 13.02 % of the total ASDR of total OA in 1990 and increased to 21.64 % in 2021. ASDR attributable to high BMI accounted for 17.41 % of the knee ASDR of total OA in 1990 and increased to 31.08 % in 2021. ASDR attributable to high BMI accounted for 16.79 % of the total ASDR of hip OA in 1990 and increased to 29.88 % in 2021.

Fig. 5

Correlation between age-standardized rate (ASR) of osteoarthritis (OA) and sociodemographic index (SDI) in China from 1990 to 2021. Correlation between (a) ASR of incidence and SDI, (b) ASR of prevalence and SDI, (c) ASR of disability-adjusted life years (DALYs) and SDI of OA in China from 1990 to 2021. (d) Correlation between ASR of DALYs and SDI of OA due to high body mass index (BMI) in China from 1990 to 2021. Circles represent the number of OA cases. The shaded part of the line represents the 95 % CI.