1990至2019年中国不同部位骨关节炎疾病负担的年龄-时期-队列分析

Age-period-cohort analysis of disease burden of osteoarthritis at different sites in China from 1990 to 2019

目的系统分析1990至2019年中国不同部位骨关节炎的疾病负担情况及其变化趋势,为制订有针对性的预防和治疗措施提供依据。方法基于2019全球疾病负担研究(global burden of disease study 2019,GBD 2019),分析1990至2019年中国不同部位骨关节炎的发病情况和伤残调整寿命年(disability adjusted life year,DALY)情况,以及利用年龄-时期-队列(age-period-corhort,APC)模型分析不同部位骨关节炎的年龄、时期和出生队列效应。结果1990至2019年中国不同部位骨关节炎发病人数呈现上升趋势,其中膝关节的发病人数上升趋势最为明显,且发病人数在骨关节炎中居首位。1990至2019年中国不同部位骨关节炎的DALY呈现上升趋势,标化DALY率在膝关节、手关节、髋关节和其它部位平均每年上升趋势分别为1.1%、0.5%、0.2%和0.2%。发病率的APC模型结果显示,手关节骨关节炎的标化发病率在55~59岁达到高峰。髋关节骨关节炎的标化发病率在30~64岁呈现逐年上升的趋势,在65以上年龄组呈现逐年下降的趋势。膝关节骨关节炎标化发病率在50~54岁达到高峰。其它部位骨关节炎标化发病率在30~59岁呈显著上升趋势。髋关节、膝关节和其它部位骨关节炎的时期和队列RR值随时间推移逐渐增加。2019年我国有11.83%的骨关节炎DALY是由高体质量指数(body mass index,BMI)导致的,与1990年相比,2019年归因DALY增长了4.62%,归因DALY率增长了3.68%。结论根据我国不同部位骨关节炎的发病特点,制订有针对性的措施,以期降低我国骨关节炎造成的疾病负担。

Objective The disease burden of osteoarthritis(OA)in different parts of China from 1990 to 2019 was systematically analyzed to provide evidence for the prevention and treatment of OA.Methods Based on the data from the Global Burden of Disease Study 2019(GBD 2019),the incidence and disability adjusted life year(DALY)of osteoarthritis at different sites in China from 1990 to 2019 were analyzed,and the age-period-cohort model was used to analyze the age,period and birth cohort effects of osteoarthritis at different sites.Results From 1990 to 2019,the number of patients with osteoarthritis in different parts of China showed an upward trend,especially in the knee.The number of patients with osteoarthritis ranked frst.From 1990 to 2019,the DALY of osteoarthritis in different parts of China showed an upward trend.Standardized DALY rates in the knee,hand,hip,and other joints increased by an average of 1.1%,0.5%,0.2%and 0.2%per year,respectively.Age-period-cohort models of incidence showed that the standardized incidence of osteoarthritis of the hand peaked at the age of 55-59 years.The standardized incidence rate of osteoarthritis of the hip(OA)in the age group of 30-64 years was increasing year by year,and in the age group over 65 years was decreasing year by year.The standardized incidence of osteoarthritis of the knee peaked at the age of 50-54 years.The standardized incidence of osteoarthritis in other parts of the body increased signifcantly from 30 to 59 years of age.The duration and cohort RR of osteoarthritis of the hip,knee and other sites increased with time.In our country,11.83%of osteoarthritis DALY in 2019 was led by high body mass index,with a 4.62%increase in attributable DALY and a 3.68%increase in attributable DALY in 2019 compared with 1990.Conclusions According to the characteristics of osteoarthritis in different parts of China,we should take some measures to reduce the disease burden of osteoarthritis.