1990—2021年中国膝关节骨关节炎疾病负担变化及趋势分析-现代医学

1990—2021年中国膝关节骨关节炎疾病负担变化及趋势分析

单位：重庆医科大学附属永川医院骨科, 重庆 402160

分类号：R684.3

出版年·卷·期（页码）：2026·54·第一期（75-84）

摘要：

目的：分析1990—2021年中国膝关节骨关节炎(KOA)疾病负担变化趋势，并预测2022至2035年KOA发病率，为制定防控策略提供科学依据。方法：基于2021年全球疾病负担(GBD 2021) 数据库中的公开建模数据，采用Joinpoint回归模型分析KOA趋势变化；运用年龄-时期-队列模型分析年龄、时期及队列因素对KOA发病率和伤残调整寿命年(DALYs)率的影响；贝叶斯年龄-时期-队列模型预测2022—2035年KOA发病率。结果：2021年，中国KOA患病人数约为1.10亿，发病人数约为851.24万。发病率在50~54岁年龄组最高，患病率和DALYs率在80~84岁年龄组最高。1990—2021年，中国KOA的年龄标准化发病率、年龄标准化患病率及年龄标准化DALYs率均呈逐年上升趋势，且在所有年龄段中女性均高于男性。年龄-时期-队列分析显示，1992—2021年中国KOA发病率呈现双峰分布特征；年龄效应分析显示，KOA发病率在50~54岁年龄组达到峰值，随后随年龄渐趋下降，而DALYs率随年龄增长而上升；在时期效应方面，KOA发病率与DALYs率RR值呈逐年递增趋势；队列效应分析显示，1975—1979年出生人群的发病率及DALYs率风险最高。贝叶斯年龄-时期-队列模型预测结果显示，至2035年，女性KOA发病率将呈下降趋势，而男性发病率变化不显著，趋于平稳，但女性KOA发病率仍要高于男性。结论：1990—2021年中国30岁以上人群KOA疾病负担持续加重，亟需制定基于科学证据、多维度干预的综合防治方案。

Objective: To analyze the changing trend of disease burden of knee osteoarthritis(KOA) in China from 1990 to 2021, predict the incidence of KOA from 2022 to 2035, and provide scientific evidence for formulating targeted prevention and control strategies. Methods: Based on the public modeling data from the Global Burden of Disease Study 2021(GBD 2021), the Joinpoint regression model was used to analyze the temporal trend of KOA disease burden. The age-period-cohort model was applied to quantify the independent effects of age, period, and cohort factors on the incidence rate and disability-adjusted life years(DALYs) rate of KOA. The Bayesian age-period-cohort model was used to predict the changing trend of KOA incidence in China from 2022 to 2035. Results: In 2021, the number of KOA patients in China was approximately 110 million, and the number of incident cases was about 8.512 4 million. Epidemiological characteristics showed that the KOA incidence was the highest in the 50-54 years age group, while the prevalence and DALYs rate were the highest in the 80-84 years age group. From 1990 to 2021, the age-standardized incidence rate, age-standardized prevalence rate, and age-standardized DALYs rate KOA in China all showed a continuous upward trend, and these indicators were consistently higher in females than in males across all age groups. The age-period-cohort analysis revealed a bimodal distribution pattern in the incidence of KOA in China from 1992 to 2021. The age effect results showed that the incidence of KOA peaked in the 50-54 age group and plateaued thereafter, while the DALYs rate exhibited a continuous, age-dependent inrease. In terms of period effects, the relative risk (RR) values of KOA incidence rate and DALYs rate increased year by year. Cohort effect analysis indicated that the population born between 1975 and 1979 had the highest risk of KOA incidence and DALYs rate. The prediction results of the Bayesian age-period-cohort model showed that by 2035, the incidence rate of KOA in females would present a downward trend, whereas the incidence rate in males would remain stable with no significant change; however, the incidence rate in females would still be higher than that in males. Conclusion: The disease burden of KOA in people over 30 years old in China has been continuously increasing from 1990 to 2021. Based on the epidemiological characteristic analysis and prediction results of this study, it is urgent to formulate a comprehensive prevention and control plan supported by scientific evidence and centered on multi-dimensional intervention.

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