Chinese Evidence-based Medicine Center and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, 610044, Sichuan, China.
Department of Orthopedics, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 611731, Sichuan, China.
BMC Public Health. 2020 Oct 1;20(1):1491. doi: 10.1186/s12889-020-09611-7.
Knee osteoarthritis (OA) is a common disease condition associated with aging and a frequent cause of primary care consultations. Few longitudinal studies have been conducted to investigate the incidence of symptomatic knee osteoarthritis (OA) and to identify its risk factors among the Chinese population.
The China Health and Retirement Longitudinal Study (CHARLS) is a nationwide longitudinal survey of persons aged ≥45 years. Symptomatic knee OA was diagnosed when both self-reported knee pain and self-reported physician-diagnosis arthritis existed. Using the national survey data collected from the CHARLS, we estimated the incidence of symptomatic knee OA, taking into account the complex survey design and response rate. We applied weighted logistic regression analysis to identify its risk factors.
In the 4-year follow-up, the cumulative incidence of symptomatic knee OA among middle-aged and older Chinese adults was 8.5%; the incidence was higher among females (11.2%) than males (5.6%). Female (odds ratio (OR) 1.98 [95% confidence interval (CI) 1.65-2.37]), rural area (OR 1.32 [95% CI 1.08-1.60]), and West region (OR 2.33 [95% CI 1.89-2.87]) were associated with a higher risk of incident symptomatic knee OA. Physical activities (OR 0.47 [95% CI 0.29-0.76]) and high education level (OR 0.60 [95% CI 0.41-0.88]) was associated with a lower risk of incident symptomatic knee OA, while histories of heart disease (OR 1.40 [95% CI 1.07-1.82]), kidney disease (OR 1.80 [95% CI 1.35-2.39]), and digestive disease (OR 1.54 [95% CI 1.30-1.82]) were associated with a higher risk of incident symptomatic knee OA.
The cumulative incidence of symptomatic knee OA over 4 years was relatively high, and varied by province and region. Lack of physical activities was confirmed to be risk factors of incident symptomatic knee OA. The presence of heart disease, kidney disease, and digestive disease may be associated with a higher risk of incident symptomatic knee OA, further research need to confirm these findings.
膝骨关节炎（OA）是一种常见的与年龄相关的疾病，也是基层医疗咨询的常见原因。很少有纵向研究调查中国人群中症状性膝骨关节炎（OA）的发病率，并确定其危险因素。
中国健康与养老追踪调查（CHARLS）是一项针对≥45 岁人群的全国性纵向调查。当自我报告的膝关节疼痛和自我报告的医生诊断的关节炎同时存在时，诊断为症状性膝 OA。利用 CHARLS 收集的全国调查数据，我们考虑到复杂的调查设计和应答率，估计了症状性膝 OA 的发病率。我们应用加权逻辑回归分析来确定其危险因素。
在 4 年的随访中，中国中老年人症状性膝 OA 的累积发病率为 8.5%；女性（11.2%）的发病率高于男性（5.6%）。女性（比值比（OR）1.98[95%置信区间（CI）1.65-2.37]）、农村地区（OR 1.32[95%CI 1.08-1.60]）和西部地区（OR 2.33[95%CI 1.89-2.87]）与症状性膝 OA 的发病风险增加相关。体力活动（OR 0.47[95%CI 0.29-0.76]）和高教育水平（OR 0.60[95%CI 0.41-0.88]）与症状性膝 OA 的发病风险降低相关，而心脏病史（OR 1.40[95%CI 1.07-1.82]）、肾病（OR 1.80[95%CI 1.35-2.39]）和消化系统疾病（OR 1.54[95%CI 1.30-1.82]）与症状性膝 OA 的发病风险增加相关。
4 年内症状性膝 OA 的累积发病率相对较高，且因省份和地区而异。缺乏体力活动被证实是症状性膝 OA 的发病危险因素。心脏病、肾病和消化系统疾病的存在可能与症状性膝 OA 的发病风险增加相关，需要进一步研究来证实这些发现。
