Cui Aiyong, Li Huizi, Wang Dawei, Zhong Junlong, Chen Yufeng, Lu Huading
Department of Orthopaedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai 519000, Guangdong, China.
EClinicalMedicine. 2020 Nov 26;29-30:100587. doi: 10.1016/j.eclinm.2020.100587. eCollection 2020 Dec.
BACKGROUND: Knee osteoarthritis (OA) is a major cause of disability in the elderly, however, there are few studies to estimate the global prevalence, incidence, and risk factors of knee OA. METHODS: For this study, we searched PUBMED, EMBASE and SCOPUS from inception to April 4, 2020, without language restriction. We identified eligible studies with information on the prevalence or incidence of knee OA in population-based observational studies and extracted data from published reports. We did random-effects meta-analysis to generate estimates. This study was registered with PROSPERO (CRD42020181035). FINDINGS: Out of 9570 records identified, 88 studies with 10,081,952 participants were eligible for this study. The pooled global prevalence of knee OA was 16⋅0% (95% CI, 14⋅3%-17⋅8%) in individuals aged 15 and over and was 22⋅9% (95% CI, 19⋅8%-26⋅1%) in individuals aged 40 and over. Correspondingly, there are around 654⋅1 (95% CI, 565⋅6-745⋅6) million individuals (40 years and older) with knee OA in 2020 worldwide. The pooled global incidence of knee OA was 203 per 10,000 person-years (95% CI, 106-331) in individuals aged 20 and over. Correspondingly, there are around annual 86⋅7 (95% CI, 45⋅3-141⋅3) million individuals (20 years and older) with incident knee OA in 2020 worldwide. The prevalence and incidence varied substantially between individual countries and increased with age. The ratios of prevalence and incidence in females and males were 1⋅69 (95% CI, 1⋅59-1⋅80, <0⋅00) and 1⋅39 (95% CI, 1⋅24-1⋅56, <0⋅00), respectively. INTERPRETATION: Our study provides the global prevalence (16⋅0% [95% CI, 14⋅3%-17⋅8%]) and incidence (203 per 10,000 person-years [95% CI, 106-331]) of knee OA. These findings can be used to better assess the global health burden of knee OA. Further prospective cohort studies are warranted to identify modifiable risk factors for providing effectively preventive strategies in the early stages of the disease. FUNDING: This work was supported by grants from the National Natural Science Foundation of China (nos. 81772384 and 81572174).
背景：膝关节骨关节炎（OA）是老年人残疾的主要原因，然而，很少有研究来估计全球膝关节OA的患病率、发病率和危险因素。 方法：在本研究中，我们检索了从数据库建立至2020年4月4日的PubMed、Embase和Scopus数据库，无语言限制。我们在基于人群的观察性研究中确定了有关膝关节OA患病率或发病率信息的合格研究，并从已发表的报告中提取数据。我们进行随机效应荟萃分析以生成估计值。本研究已在国际前瞻性系统评价注册库（PROSPERO，注册号：CRD42020181035）登记。 结果：在确定的9570条记录中，88项研究共10081952名参与者符合本研究条件。15岁及以上人群中膝关节OA的合并全球患病率为16.0%（95%置信区间，14.3%-17.8%），40岁及以上人群中为22.9%（95%置信区间，19.8%-26.1%）。相应地，2020年全球约有6.541亿（95%置信区间，5.656-7.456亿）40岁及以上的人患有膝关节OA。20岁及以上人群中膝关节OA的合并全球发病率为每10000人年203例（95%置信区间，106-331）。相应地，2020年全球每年约有8670万（95%置信区间，4530-14130万）20岁及以上的人新发膝关节OA。各国之间的患病率和发病率差异很大，且随年龄增长而增加。女性与男性的患病率和发病率之比分别为1.69（95%置信区间，1.59-1.80，P<0.00）和1.39（95%置信区间，1.24-1.56，P<0.00）。 解读：我们的研究提供了膝关节OA的全球患病率（16.0%[95%置信区间，14.3%-17.8%]）和发病率（每10000人年203例[95%置信区间，106-331]）。这些发现可用于更好地评估膝关节OA的全球健康负担。有必要进一步开展前瞻性队列研究，以确定可改变的危险因素，从而在疾病早期提供有效的预防策略。 资助：本研究得到中国国家自然科学基金（编号：81772384和81572174）的资助。
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