Analysis of disease burden of osteoarthritis in China from 1990 to 2021 and projections for 2022–2044
TL;DR
China's overall OA burden has risen substantially and will keep increasing over the next two decades and provide reliable epidemiological evidence for hierarchical OA prevention and national health policy formulation.
Abstract
Objective To analyze the secular trend of osteoarthritis (OA) disease burden in China from 1990 to 2021 and predict future burden changes spanning 2022–2044 to support targeted public health intervention. Methods Based on the Global Burden of Disease 2021 (supplemented with partial 2023 GBD data), crude incidence, age-standardized incidence rate (ASIR), disability-adjusted life years (DALYs) and OA prevalence data were retrieved. Joinpoint regression calculated average annual percentage change (AAPC) to assess secular trends; ARIMA and Brown time-series models were selected via AIC and residual diagnosis for future burden prediction, with 95% forecast uncertainty intervals calculated. Results National OA prevalent cases increased from 4.65 million in 1990 to 11.65 million in 2021, with the AAPC of ASIR and age-standardized DALY rate reaching 0.43% and 0.49% (all P < 0.001). China's ASIR surpassed the global average after 2003; females sustained higher OA burden than males, incidence peaked among people aged 55–59 years, and DALY loss predominantly clustered in the population ≥85 years. Knee OA dominated the burden across all anatomical subtypes. Forecasts indicate the national ASIR and standardized DALY rate will rise to 589.00/100,000 and 292.02/100,000 by 2044 with inherent predictive uncertainty. Conclusion China's overall OA burden has risen substantially and will keep increasing over the next two decades. Females, middle-aged and elderly residents, and patients with knee OA constitute core high-risk groups. These findings provide reliable epidemiological evidence for hierarchical OA prevention and national health policy formulation.