Immunology Research Center, Department of Community Medicine, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
Ann Rheum Dis. 2020 Jun;79(6):819-828. doi: 10.1136/annrheumdis-2019-216515. Epub 2020 May 12.
To report the level and trends of prevalence, incidence and years lived with disability (YLDs) for osteoarthritis (OA) in 195 countries and territories from 1990 to 2017 by age, sex and Socio-demographic index (SDI; a composite of sociodemographic factors).
Publicly available modelled data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 were used. The burden of OA was estimated for 195 countries and territories from 1990 to 2017, through a systematic analysis of prevalence and incidence modelled data using the methods reported in the GBD 2017 Study. All estimates were presented as counts and age-standardised rates per 100 000 population, with uncertainty intervals (UIs).
Globally, the age-standardised point prevalence and annual incidence rate of OA in 2017 were 3754.2 (95% UI 3389.4 to 4187.6) and 181.2 (95% UI 162.6 to 202.4) per 100 000, an increase of 9.3% (95% UI 8% to 10.7%) and 8.2% (95% UI 7.1% to 9.4%) from 1990, respectively. In addition, global age-standardised YLD rate in 2017 was 118.8 (95% UI 59.5 to 236.2), an increase of 9.6% (95% UI 8.3% to 11.1%) from 1990. The global prevalence was higher in women and increased with age, peaking at the >95 age group among women and men in 2017. Generally, a positive association was found between the age-standardised YLD rate and SDI at the regional and national levels. Age-standardised prevalence of OA in 2017 ranged from 2090.3 to 6128.1 cases per 100 000 population. United States (6128.1 (95% UI 5729.3 to 6582.9)), American Samoa (5281 (95% UI 4688 to 5965.9)) and Kuwait (5234.6 (95% UI 4643.2 to 5953.6)) had the three highest levels of age-standardised prevalence. Oman (29.6% (95% UI 24.8% to 34.9%)), Equatorial Guinea (28.6% (95% UI 24.4% to 33.7%)) and the United States 23.2% (95% UI 16.4% to 30.5%)) showed the highest increase in the age-standardised prevalence during 1990-2017.
OA is a major public health challenge. While there is remarkable international variation in the prevalence, incidence and YLDs due to OA, the burden is increasing in most countries. It is expected to continue with increased life expectancy and ageing of the global population. Improving population and policy maker awareness of risk factors, including overweight and injury, and the importance and benefits of management of OA, together with providing health services for an increasing number of people living with OA, are recommended for management of the future burden of this condition.
报告 1990 年至 2017 年全球 195 个国家和地区按年龄、性别和社会人口指数（SDI；社会人口因素的综合指标）划分的骨关节炎（OA）流行率、发病率和伤残调整寿命年（YLDs）的水平和趋势。
使用来自全球疾病、伤害和风险因素研究（GBD）2017 的公开可用模型数据。通过使用 GBD 2017 研究中报告的方法对流行率和发病率模型数据进行系统分析，估算了 1990 年至 2017 年全球 195 个国家和地区的 OA 负担。所有估计数均以每 10 万人的人数和年龄标准化率表示，同时给出不确定性区间（UI）。
全球范围内，2017 年 OA 的年龄标准化点流行率和年发病率分别为 3754.2（95%UI 3389.4 至 4187.6）和 181.2（95%UI 162.6 至 202.4）每 100000 人，分别比 1990 年增长了 9.3%（95%UI 8%至 10.7%）和 8.2%（95%UI 7.1%至 9.4%）。此外，2017 年全球年龄标准化 YLD 率为 118.8（95%UI 59.5 至 236.2），比 1990 年增长了 9.6%（95%UI 8.3%至 11.1%）。全球患病率在女性中较高，并随着年龄的增长而增加，在 2017 年，女性和男性中>95 岁年龄组的患病率达到峰值。一般来说，在区域和国家层面上，年龄标准化 YLD 率与 SDI 之间存在正相关关系。2017 年全球 OA 的年龄标准化患病率范围为每 100000 人 2090.3 至 6128.1 例。美国（6128.1（95%UI 5729.3 至 6582.9））、美属萨摩亚（5281（95%UI 4688 至 5965.9））和科威特（5234.6（95%UI 4643.2 至 5953.6））的年龄标准化患病率最高。阿曼（29.6%（95%UI 24.8%至 34.9%））、赤道几内亚（28.6%（95%UI 24.4%至 33.7%））和美国（23.2%（95%UI 16.4%至 30.5%））的年龄标准化患病率在 1990 年至 2017 年期间增长最快。
OA 是一个重大的公共卫生挑战。虽然由于 OA，各国之间的患病率、发病率和 YLDs 存在显著的国际差异，但在大多数国家，OA 的负担正在增加。随着全球人口预期寿命的延长和人口老龄化，预计这种情况的负担将继续增加。建议提高人口和决策者对超重和伤害等危险因素以及 OA 管理的重要性和益处的认识，同时为越来越多的 OA 患者提供医疗服务，以管理这种疾病的未来负担。
