Miao Zhuang, Li Songlin, Luo Yange, Li Shihao, Chu Ziyue, Zheng Weibo, Li Xuezhou, Lu Qunshan, Liu Peilai
Key Laboratory of Ultra-Weak Magnetic Field Measurement Technology, Ministry of Education, School of Instrumentation and Optoelectronic Engineering, Beihang University, Beijing, 100191, People's Republic of China.
Department of Orthopaedics, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, People's Republic of China.
J Orthop Translat. 2025 Apr 24;52:209-219. doi: 10.1016/j.jot.2025.03.022. eCollection 2025 May.
High body-mass-index (BMI) has been shown to be a risk factor for knee osteoarthritis (KOA). Previous studies have examined the global or regional burden of osteoarthritis in multiple joints, including the hip, knee, and hand. However, there is no comprehensive analysis and prediction of the global burden of KOA attributed to high BMI.
Disease burden of KOA attributable to high BMI, from 1990 to 2021, were extracted from the Global Burden of Disease (GBD) 2021. Trends were analyzed at the global, regional, and national levels, with subgroup analyses. Joinpoint regression, age-period-cohort model, decomposition analysis, cross-country inequalities were used to analyze the trend of disease burden from multiple dimensions. Autoregressive integrated moving average (ARIMA) model, a time-series based forecasting algorithms, was applied to predict the burden for the next 20 years.
From 1990 to 2021, the risk factor attribution of high BMI in KOA increased from 25.44 % (95 % CI: -2.38 %-48.66 %) to 33.52 % (95 % CI: -3.38 %-61.92 %). Globally, regionally, and nationally, the burden of KOA attributed to high BMI showed a sharp increase. Except for the decline observed in high sociodemographic index (SDI) regions from 2000 to 2005, the burden exhibited an upward trend across all other time periods and regions. Age, cohort, and period had significant impacts on disease burden. Both population growth and epidemiological changes contributed positively to the increase in the burden. Economic and social development led to increasing disparities, with lower-SDI countries showing better health outcomes. ARIMA model showed that a continued rise in the burden of KOA due to high BMI globally through 2041.
KOA attributable to high BMI has imposed a substantial burden globally, regionally, and nationally over the past 30 years, with a marked increase. The projections indicate a further increase in the global burden over the next 20 years. Measures need to be taken for targeted preventive intervention.
High BMI is an important risk factor for KOA. The disease burden of KOA attributable to high BMI has increased significantly over the past 30 years. This burden is concentrated in economically developed areas, although the growth rate in less developed regions surpasses that of developed regions. This study suggested that targeted interventions addressing disease patterns across socioeconomic contexts are crucial to mitigating the burden of KOA attributable to high BMI. In addition, it is necessary to pay more attention to the disease burden of female.
高体重指数（BMI）已被证明是膝关节骨关节炎（KOA）的一个风险因素。以往的研究探讨了包括髋、膝和手在内的多个关节骨关节炎的全球或区域负担。然而，目前尚无对高BMI所致KOA全球负担的全面分析和预测。
从《2021年全球疾病负担》（GBD 2021）中提取1990年至2021年高BMI所致KOA的疾病负担。在全球、区域和国家层面分析趋势，并进行亚组分析。采用Joinpoint回归、年龄-时期-队列模型、分解分析、跨国不平等分析等方法从多个维度分析疾病负担趋势。应用自回归积分移动平均（ARIMA）模型这一基于时间序列的预测算法来预测未来20年的负担。
1990年至2021年，KOA中高BMI的风险因素归因从25.44%（95%CI：-2.38%-48.66%）增至33.52%（95%CI：-3.38%-61.92%）。在全球、区域和国家层面，高BMI所致KOA的负担均呈急剧上升。除了在2000年至2005年高社会人口指数（SDI）地区观察到负担有所下降外，在所有其他时间段和地区，负担均呈上升趋势。年龄、队列和时期对疾病负担有显著影响。人口增长和流行病学变化均对负担增加有正向贡献。经济和社会发展导致差距加大，SDI较低的国家健康状况更好。ARIMA模型显示，到2041年全球高BMI所致KOA负担将持续上升。
在过去30年里，高BMI所致KOA在全球、区域和国家层面均造成了巨大负担，且负担显著增加。预测表明，未来20年全球负担将进一步增加。需要采取措施进行有针对性的预防干预。
高BMI是KOA的一个重要风险因素。在过去30年里，高BMI所致KOA的疾病负担显著增加。这种负担集中在经济发达地区，尽管欠发达地区的增长率超过了发达地区。本研究表明，针对不同社会经济背景下的疾病模式进行有针对性的干预对于减轻高BMI所致KOA的负担至关重要。此外，有必要更加关注女性的疾病负担。
