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Osteoarthritis
Global burden of early-onset osteoarthritis, 1990–2019: results from the Global Burden of Disease Study 2019
  1. Qianlin Weng1,
  2. Qiu Chen1,
  3. Ting Jiang1,2,3,4,
  4. Yuqing Zhang5,6,
  5. Weiya Zhang7,8,
  6. Michael Doherty7,8,
  7. Junqing Xie9,
  8. Ke Liu1,
  9. Jiatian Li1,
  10. Tuo Yang10,
  11. Jie Wei1,2,3,11,
  12. Guanghua Lei1,2,3,12,
  13. Chao Zeng1,2,3,11,12
  1. 1 Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China
  2. 2 Key Laboratory of Aging-related Bone and Joint Diseases Prevention and Treatment, Ministry of Education, Xiangya Hospital, Central South University, Changsha, China
  3. 3 Hunan Key Laboratory of Joint Degeneration and Injury, Xiangya Hospital, Central South University, Changsha, China
  4. 4 Department of Ultrasonography, Xiangya Hospital, Central South University, Changsha, China
  5. 5 Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
  6. 6 The Mongan Institute, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
  7. 7 Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK
  8. 8 Pain Centre Versus Arthritis UK, Nottingham, UK
  9. 9 Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
  10. 10 Health Management Center, Xiangya Hospital, Central South University, Changsha, China
  11. 11 Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
  12. 12 National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
  1. Correspondence to Professor Guanghua Lei, Department of Orthopaedics, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, China; lei_guanghua{at}csu.edu.cn; Professor Jie Wei, Department of Epidemiology and Health Statistics, Xiangya school of Public Health, Central South University, Changsha, Hunan, China; weij1988{at}csu.edu.cn; Professor Chao Zeng, Department of Orthopaedics, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, China; zengchao{at}csu.edu.cn

Abstract

Objectives Early-onset osteoarthritis (OA) is an emerging health issue amidst the escalating prevalence of overweight and obesity. However, there are scant data on its disease, economic burden and attributable burden due to high body mass index (BMI).

Methods Using data from the Global Burden of Diseases Study 2019, we examined the numbers of incident cases, prevalent cases, years lived with disability (YLDs) and corresponding age-standardised rates for early-onset OA (diagnosis before age 55) from 1990 to 2019. The case definition was symptomatic and radiographically confirmed OA in any joint. The average annual percentage changes (AAPCs) of the age-standardised rates were calculated to quantify changes. We estimated the economic burden of early-onset OA and attributable burden to high BMI.

Results From 1990 to 2019, the global incident cases, prevalent cases and YLDs of early-onset OA were doubled. 52.31% of incident OA cases in 2019 were under 55 years. The age-standardised rates of incidence, prevalence and YLDs increased globally and for countries in all Sociodemographic Index (SDI) quintiles (all AAPCs>0, p<0.05), with the fastest increases in low-middle SDI countries. 98.04% of countries exhibited increasing trends in all age-standardised rates. Early-onset OA accounts for US$46.17 billion in healthcare expenditure and US$60.70 billion in productivity loss cost in 2019. The attributable proportion of high BMI for early-onset OA increased globally from 9.41% (1990) to 15.29% (2019).

Conclusions Early-onset OA is a developing global health problem, causing substantial economic costs in most countries. Targeted implementation of cost-effective policies and preventive intervention is required to address the growing health challenge.

  • Epidemiology
  • Health services research
  • Osteoarthritis

Data availability statement

Data are available in a public, open access repository.

https://doi.org/10.1136/ard-2023-225324

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    Data availability statement

    Data are available in a public, open access repository.

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    Footnotes

    • JW, GL and CZ are joint senior authors.

    • Handling editor Josef S Smolen

    • QW, QC and TJ contributed equally.

    • Contributors CZ, GL and JW have full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. CZ, GL, JW, JX, YZ, WZ and MD conceived and designed the study. All authors have read, provided critical feedback on intellectual content and approved the final manuscript. QW and QC primary responsibility for seeking, cataloging, extracting or cleaning data. QW, QC and TJ designing or coding figures and tables. QW, QC and TJ analysed the data. QW, QC and TJ drafted the manuscript. GL is responsible for the overall content as the guarantor.

    • Funding This work was supported by the National Key Research and Development Plan (2022YFC3601900, 2022YFC3601901 and 2022YFC2505500), the National Natural Science Foundation of China (81930071, 82072502, 82372474 and U21A20352), Project Program of National Clinical Research Center for Geriatric Disorders (Xiangya Hospital, 2020LNJJ03, 2021LNJJ06), the Key Research and Development Program of Hunan Province (2021SK2017), the Natural Science Foundation of Hunan Province (2022JJ20100, 2023JJ30893), and the Central South University Innovation-Driven Research Programme (2023CXQD031).

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    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.

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