[Current status and temporal trends in osteoarthritis burden in China: an age-period-cohort analysis with projection]

Objective: To analyze the trends and driving factors of the disease burden of osteoarthritis (OA) in China from 1990 to 2021 and predict the incidence from 2022 to 2051. Methods: Based on data from the Global Burden of Disease Study 1990-2021, Joinpoint regression and decomposition analysis were used to evaluate the trends and driving factors of OA burden in China. An age-period-cohort model was constructed with data from 1992 to 2021 to assess age, period, and cohort effects. A Bayesian age-period-cohort model was applied to predict the incidence trend from 2022 to 2051. Results: In 2021, the age-standardized incidence, prevalence, and disability adjusted of life years rates of OA in China were 554.61/100 000, 7 030.66/100 000, and 244.79/100 000, increased by 13.86%, 14.34%, and 16.23% respectively compared with 1990. Both burden and growth rate were higher than global average. The fastest growth was during 2000-2005 (annual percent change=2.01%). The incidence risk of OA in female was 1.49 times than that in male, with significant differences in knee and hand OA; the incidence risk of hip OA in male was higher. The overall incidence risk peaked at 52.5 years, earliest for knee (47.5 years). Aging was the main driving factor; hand and hip OA risk increased faster. Projections showed hand OA rising sharply from 2022 to 2051, knee OA declining, hip and other subtypes increasing steadily. Conclusion: The burden of OA in China continues to rise. Targeted prevention and control by subtype is required, with emphasis on strengthening interventions for hand and hip OA and consolidating the effectiveness of knee OA control.