Burden of osteoarthritis in China, 1990–2017: findings from the Global Burden of Disease Study 2017

Summary Background China has seen a remarkable epidemiological and demographic transition during the past three decades. We aimed to describe the prevalence of osteoarthritis as well as years lived with disability (YLDs) due to osteoarthritis in China, according to age, sex, and geographical location, from 1990 to 2017. Methods Data were obtained from systematic reviews of symptomatic osteoarthritis of the knee and hip in the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017). Three categories of sequelae (mild, moderate, and severe) of osteoarthritis were defined to indicate the degrees of severity and functional loss associated with the condition. A Bayesian meta-regression tool was applied to estimate the prevalence of osteoarthritis and the distribution of its severity. YLDs were calculated by multiplying the prevalence of osteoarthritis sequelae by their corresponding disability weights. All data were analysed by age–sex–province–year groups in China. Findings Around 26·1 million individuals in China had osteoarthritis in 1990, and this number rose to 61·2 million in 2017. The age-standardised prevalence of osteoarthritis increased from 2·9% (95% uncertainty interval 2·5–3·3) in 1990 to 3·1% (2·7–3·4) in 2017. The total YLDs due to osteoarthritis increased from 0·84 million (0·42–1·69) in 1990 to 1·97 million (0·98–3·94) in 2017, while the age-standardised YLD rate increased from 92·5 (45·7–185·6) per 100 000 people to 98·8 (49·4–197·6) per 100 000. Osteoarthritis prevalence and YLDs were higher in females than in males, and YLD rate increased with age. Osteoarthritis was the 24th most common cause of YLDs in China in 2017, accounting for 1·08% (0·64–2·02) of all YLDs. Interpretation Osteoarthritis is prevalent in China. Between 1990 and 2017, disease burden increased and varied greatly according to geographical location. Appropriate prevention and treatment strategies, predominantly those targeted at women, older people, and underdeveloped areas, must be developed to reduce the burden of the disease. Funding National Natural Science Foundation of China, China National Key Research and Development Programme.