Li Zhiqiang, Chen Yaxiang, Shen Zhao
Department of Orthopedics, Cangzhou People's Hospital, Cangzhou, Hebei, China.
Front Public Health. 2025 Apr 28;13:1518572. doi: 10.3389/fpubh.2025.1518572. eCollection 2025.
It remains unclear whether elevated Body Mass Index(BMI)has a similar impact on the disease burden of osteoarthritis subtypes in older adults. This study aims to compare the long-term trends of osteoarthritis subtypes caused by high BMI across different gender groups globally from 1990 to 2021.
We obtained cross-sectional data from the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2021 (https://vizhub.healthdata.org/gbd-results/). The disease burden of osteoarthritis subtypes in older adults attributable to high BMI was quantified using Years Lived with Disability (YLDs). Linear regression and the Age-Period-Cohort (APC) method were employed to calculate the trends in Age-standardized Years lived with disability rate (ASYR), adjusting for age, period, and cohort effects.
The ASYR of osteoarthritis attributable to high BMI in older adults globally has shown a continuous upward trend over the past 32 years, with an Estimated Average Percentage Change (EAPC) of 0.96 (95% CI: 0.94 to 0.99). Specifically, the EAPC for hip osteoarthritis was 0.73 (95% CI: 0.70 to 0.76), while for knee osteoarthritis, it was 0.99 (95% CI: 0.96 to 1.02). China recorded the highest number of osteoarthritis YLDs globally, reaching 0.59 million (95% UI: -0.05 to 1.71). The United States had one of the highest ASYR rates for osteoarthritis at 410.85 per 100,000 (95% UI: -44.47 to 1,083.52), while India exhibited the highest EAPC for osteoarthritis worldwide at 2.74 (95% CI: 2.70 to 2.79), with hip osteoarthritis at 3.36 (95% CI: 3.25 to 3.48) and knee osteoarthritis at 2.70 (95% CI: 2.65 to 2.75). The local drift curves indicated a slow upward trend in the annual percentage change of YLDs for both hip and knee osteoarthritis attributable to high BMI across all age groups. In terms of gender, males exhibited a higher rate and risk of YLDs associated with high BMI.
Our findings provide strong evidence that the ASYR associated with high BMI globally have continuously increased over the past 32 years, with consistent patterns of change observed across different osteoarthritis subtypes. This highlights the critical role of BMI control in effectively alleviating the burden of osteoarthritis in older adults.
目前尚不清楚体重指数（BMI）升高对老年人骨关节炎亚型的疾病负担是否有类似影响。本研究旨在比较1990年至2021年全球不同性别群体中高BMI导致的骨关节炎亚型的长期趋势。
我们从《2021年全球疾病、伤害及风险因素负担研究》（GBD 2021）（https://vizhub.healthdata.org/gbd-results/）中获取了横断面数据。使用伤残调整生命年（YLDs）对高BMI导致的老年人骨关节炎亚型的疾病负担进行量化。采用线性回归和年龄-时期-队列（APC）方法计算年龄标准化伤残调整生命年率（ASYR）的趋势，并对年龄、时期和队列效应进行调整。
在过去32年中，全球老年人中高BMI导致的骨关节炎的ASYR呈持续上升趋势，估计平均百分比变化（EAPC）为0.96（95%CI：0.94至0.99）。具体而言，髋骨关节炎的EAPC为0.73（95%CI：0.70至0.76），而膝骨关节炎的EAPC为0.99（95%CI：0.96至1.02）。中国的骨关节炎YLDs全球数量最多，达到59万（95%UI：-0.05至1.71）。美国骨关节炎的ASYR率是最高的国家之一，为每10万人410.85（95%UI：-44.47至1,083.52），而印度在全球范围内骨关节炎的EAPC最高，为2.74（95%CI：2.70至2.79），其中髋骨关节炎为3.36（95%CI：3.25至3.48），膝骨关节炎为2.70（95%CI：2.65至2.75）。局部漂移曲线表明，所有年龄组中高BMI导致的髋和膝骨关节炎的YLDs年百分比变化呈缓慢上升趋势。在性别方面，男性与高BMI相关的YLDs发生率和风险更高。
我们的研究结果提供了有力证据，表明在过去32年中，全球与高BMI相关的ASYR持续增加，不同骨关节炎亚型的变化模式一致。这突出了控制BMI在有效减轻老年人骨关节炎负担方面的关键作用。
