Zhang Xinge, Huang Chuiguo, Hu Zhaolan, Tan Yejun, Wang Pengfei, Zhu Lemei, Kang Jin
Department of Rheumatology and Immunology, The Second Xiangya Hospital of Central South University, Changsha, 410011, China.
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China.
Glob Health Res Policy. 2025 Jul 22;10(1):29. doi: 10.1186/s41256-025-00419-9.
Osteoarthritis (OA) is a leading cause of disability worldwide, yet global estimates of lifetime risk remain limited. This study aims to provide comprehensive global, regional, and national lifetime risk estimates for OA, including knee, hand, and hip subtypes, from 1990 to 2021.
Using data from the Global Burden of Disease (GBD) Study 2021, we estimated the lifetime risk of developing OA from age 20 onwards, stratified by sex, location, and Socio-demographic Index (SDI). Average annual percentage change (AAPC) was also calculated. Spatial heterogeneity in 2021 lifetime risks and their AAPCs was evaluated using the Factor Detector of the Geographic Detector method, with q-statistics quantifying the explanatory power of demographic, socioeconomic, health system and OA-related risk factors.
In 2021, the global lifetime risk of OA was 14.21% (95% confidence interval: 14.21%, 14.22%), with knee OA at 9.31% (95% CI: 9.31%, 9.32%), hand OA at 3.45% (95% CI: 3.45%, 3.46%), and hip OA at 0.71% (95% CI: 0.71%, 0.71%). Lifetime risk increased with higher socio-demographic Index (SDI), from 11.62% in low-SDI regions to 16.10% in high-SDI regions. The highest risk was observed in the High-income Asia Pacific region (18.10%), led by the Republic of Korea (21.20%). Between 1990 and 2021, global lifetime OA risk increased with an AAPC of 0.30% (95% CI: 0.30%, 0.30%), with the most notable increases in East Asia (AAPC: 0.53%). Spatial heterogeneity analysis revealed that the historical proportions employed in agriculture and with upper secondary education had the strongest associations with 2021 lifetime risks and their trends (q-statistics up to 0.84), followed by life expectancy, SDI, and health-system indicators.
In 2021, 1 in 7 individuals globally were projected to develop OA, with the highest risks in high-SDI regions. The steady rise in OA risk, especially in East Asia, highlights the need for targeted public health strategies that focus on prevention, early diagnosis, and ensuring equitable access to treatment to mitigate the increasing OA burden.
骨关节炎（OA）是全球残疾的主要原因之一，但全球对终生风险的估计仍然有限。本研究旨在提供1990年至2021年期间全球、区域和国家层面OA（包括膝关节、手部和髋关节亚型）的全面终生风险估计。
利用《2021年全球疾病负担（GBD）研究》的数据，我们估计了20岁及以后患OA的终生风险，按性别、地理位置和社会人口指数（SDI）进行分层。还计算了年均变化率（AAPC）。使用地理探测器方法中的因子探测器评估2021年终生风险及其AAPC的空间异质性，q统计量量化人口、社会经济、卫生系统和OA相关风险因素的解释力。
2021年，全球OA的终生风险为14.21%（95%置信区间：14.21%，14.22%），其中膝关节OA为9.31%（95%CI：9.31%，9.32%），手部OA为3.45%（95%CI：3.45%，3.46%），髋关节OA为0.71%（95%CI：0.71%，0.71%）。终生风险随着社会人口指数（SDI）的升高而增加，从低SDI地区的11.62%增至高SDI地区的16.10%。风险最高的是高收入亚太地区（18.10%），以韩国（21.20%）为首。1990年至2021年期间，全球OA终生风险以年均0.30%（95%CI：0.30%，0.30%）的速度上升，东亚地区上升最为显著（AAPC：0.53%）。空间异质性分析显示，从事农业的历史比例和接受高中教育的比例与2021年终生风险及其趋势的关联最强（q统计量高达0.84），其次是预期寿命、SDI和卫生系统指标。
预计2021年全球每7个人中就有1人会患OA，高SDI地区风险最高。OA风险的稳步上升，尤其是在东亚地区，凸显了制定有针对性的公共卫生策略的必要性，这些策略应侧重于预防、早期诊断，并确保公平获得治疗，以减轻不断增加的OA负担。
