Burden of Osteoarthritis in China, 1990 to 2017: Findings from the Global Burden of Disease Study 2017

Background: China has experienced a remarkable epidemiological and demographic transition during the past three decades. We aimed to describe the prevalence and years lived with disability (YLDs) caused by osteoarthritis (OA) in China according to age, sex, and geographic location from 1990 to 2017. Methods: Data came from systematic reviews of symptomatic OA at the knee and hip in the Global Burden of Diseases Injuries, and Risk Factors Study 2017 (GBD 2017). Three sequelae (mild, moderate and severe) of OA were developed to indicate levels of OA severity and its associated functional loss. A Bayesian meta-regression tool was applied to estimate prevalence of OA and its distribution of severity. YLDs were calculated by multiplying the prevalence of OA sequelae with the corresponding disability weight (DW). All data was analyzed by age-sex-province-year groups in China. Findings: We estimated that 26·1 million individuals had OA in 1990, rising to 61·2 million in 2017. The age-standardized prevalence of OA increased from 2·9% (95% UI: 2·5%-3·3%) in 1990 to 3·1% (95% UI: 2·7%- 3·4%) in 2017. The YLDs of OA increased from 0.84 million (95% UI: 0·42- 1·69 million) in 1990 to 1·97 million (95% UI: 0·98-3·94 million) in 2017. The age-standardized YLDs rate (per 100,000 population) increased from 92·5 (95% UI: 45·7-185·6) in 1990 to 98·8 (95% UI: 49·4-197·6) in 2017. A female preponderance was observed for prevalence and YLDs due to OA. Interpretation: OA prevalence is high in China. Between 1990 and 2017 disease burden increased and varied greatly according to geographic location. We call for the development of appropriate prevention and treatment strategies that predominantly target women, the elderly, and underdeveloped areas in order to reduce the burden of OA. Funding Statement: National Natural Science Foundation of China. Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: Not required.