Prevalence of knee osteoarthritis in the middle-aged and elderly in China: 
a Meta-analysis

doi:10.3969/j.issn.2095-4344.0105

Abstract

Abstract:

BACKGROUND: Investigation on epidemiologic features of knee osteoarthritis in many areas of China has been much reported. However, multicenter studies with large samples have been rarely reported. The published papers cannot give a good description about the epidemiologic features of knee osteoarthritis.
OBJECTIVE: To evaluate the epidemiologic features of knee osteoarthritis in the patients aged over 40 years in China.
METHODS: Meta-analysis was used to evaluate the data extracted from papers published 2001-2016 on the epidemiology of knee osteoarthritis in the middle-aged and elderly in China. The prevalence rate of knee osteoarthritis in the patients over 40 years of age was summarized, with every 10 years as group, and then analyzed on Stata 12.0 software.
RESULTS AND CONCLUSION: Twenty-six articles were included, involving 42 199 people aged more than 40 years old. The total prevalence rate of knee osteoarthritis at the age above 40 years old in China was 17.0% (95%CI: 16.7%-17.4%), the prevalence rate was 12.3% in male and 22.2% in female (P < 0.05). Noticeably, the prevalence rate increased with age. The total prevalence rate in northern China was 16.1% (95%CI: 15.6%-16.6%), 12.2% in male and 21.4% in female; the total prevalence in southern China was 18.0% (95%CI: 17.5%-18.5%), 12.3% in male and 23.1% in female. There was no significant difference in the prevalence rate between northern and southern China (P > 0.05). The total prevalence rate in rural China was 23.6% (95%CI: 16.7%-30.4%), with 15.4% in male and 28.1% in female; and the total prevalence in urban China was 20.0% (95%CI: 16.2%-23.9%), with 13.7% in male and 24.3% in female. There was no significant difference in the prevalence rate between rural and urban China (P > 0.05). These results suggest that knee osteoarthritis in China is a common disease, characterized by increased prevalence with age, relatively significant difference between male and female, but no difference between northern and southern China as well as between rural and urban China. It is of great significance to timely propagate and perform interventional strategies for prevention and treatment of knee osteoarthritis in China.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words: China, Knee Joint, Osteoarthritis, Meta-Analysis, Tissue Engineering

CLC Number:

R318

Tie Xiao-jia1, Zheng Ru-geng1, Zhao Meng1, Han Ya-jun2, Guo Hong-liang3, Wang Zhi-zhou4, Ma Guo-ju1. Prevalence of knee osteoarthritis in the middle-aged and elderly in China:
a Meta-analysis[J]. Chinese Journal of Tissue Engineering Research, 2018, 22(4): 650-656.

Figures/Tables 4

2.1 文献检索结果共检索到6 835篇文献，经筛选后共纳入26篇[4-29]，提取40岁以上人群样本总量42 199人，其中提取男性16 531人，提取女性18 657人。文献涵盖了中国11个省、2个直辖市的中老年人。文献基本特征见表1。 2.2 男、女性患病率的变化不同性别、年龄段测定结果见表2。40岁以上人群膝关节骨关节炎总体患病率为17.0%(95%CI：16.7%-17.4%)，其中男性12.3%(95% CI：11.8%-12.8%)，女性22.2%(95%CI：21.6%-22.8%)，男女之间比较差异有显著性意义(P < 0.05)，见图1-3。从性别对比观察可见中老年男、女性5个年龄组膝关节骨关节炎患病率均表现为女性高于男性。从不同年龄组对比观察可见，男性及女性膝关节骨关节炎患病率均随年龄增加而增高，男女性均呈现70岁以后年龄段患病率增长明显加快。男性40-69岁年龄段患病率增长相对平缓；女性从40-49岁年龄段至50-59岁年龄段患病率增长较快，50-59岁年龄段至60-69岁年龄段患病率增长相对平缓。 2.3 南、北方膝关节骨关节炎患病率的变化根据中国地理分界，以秦岭-淮河一线划分南北方地域时，男性及女性膝关节骨关节炎患病率在南、北方的患病情况见表3及图4，5。 40岁以上人群膝关节骨关节炎总体患病率在北方地区为16.1%(95%CI：15.6%-16.6%)，其中男性患病率为12.2%(95%CI：11.5%-12.9%)，女性为21.4%(95%CI： 20.6%-22.2%)。南方地区总体患病率为18.0%(95%CI：17.5%-18.5%)，其中男性患病率为12.3%(95%CI：11.6%- 13.0%)，女性为23.1%(95%CI：22.2%-23.9%)。在男性人群、女性人群及总体人群中均呈现南北方之间患病率比较差异无显著性意义(P > 0.05)。 2.4 农村、城市患病率的变化农村及城市间膝关节骨关节炎患病率情况见表4及图6。 40岁以上人群膝关节骨关节炎总体患病率在农村地区为23.6%(95%CI：16.7%-30.4%)，其中男性患病率为15.4%(95%CI：9.0%-21.7%)，女性为28.1%(95%CI：16.1%-40.1%)。城市地区总体患病率为20.0%(95%CI：16.2%-23.9%)，其中男性患病率为13.7%(95%CI：9.9%-"

References

[1] Fautrel B, Hilliquin P, Rozenberg S，et al.Impact of osteoarthritis: results of a nationwide survey of 10 000 patients consulting for OA. Joint Bone Spine. 2005;72(3):235-240.

[2] Arden N, Nevitt MC.Osteoarthritis: epidemiology. Best Pract Res Clin Rheumatol. 2006;20(1):3-25.

[3] 王波,詹思延.如何撰写高质量的流行病学研究论文第一讲观察性流行病学研究报告规范--STROBE介绍[J]. 中华流行病学杂志,2006, 27(6):547-549.

[4] 苏阳,朱志刚,蔡裕兴,等. 广州地区中老年人症状性膝关节骨关节炎流行病学的调查研究[J]. 中华关节外科杂志(电子版), 2010, 4(4):438-444.

[5] 张建新,王和鸣,吴超英,等.泉州市中老年人退行性膝骨关节炎的流行病学调查[J].中国中医骨伤科杂志, 2007, 15(2):4-5.

[6] [王伟,王坤正,党小谦,等.中老年人人群骨关节炎的流行病学研究[J].中国老年学杂志, 2007, 27(6):566-568.

[7] 刘爱武,王秋萍,张玮,等.北京市农村中老年女性膝骨关节炎的流行病学调查[J].中外健康文摘, 2010, 7(20):20-21.

[8] 唐江龙.迪庆高原民族地区农村中老年人膝骨性关节炎的流行病学调查[J].中国当代医药, 2013, 20(17):159-160.

[9] 林培顺, 叶汉良,刘彩婵,等.广州花都区新华街骨性关节炎流行现况报告[J].按摩与康复医学, 2013,29(12):17-19.

[10] 张国良.河南省方城县中老年人膝关节骨性关节炎患病率调查[J]. 中国社区医师:医学专业, 2011, 13(11):283-284.

[11] 荣杰生,姜丽英,陶树清,等.黑龙江省城市和农村地区中老年人骨关节炎患病状况调查[J].中华流行病学杂志, 2010, 31(6):655-658.

[12] 刘德龙.湖南省湘北地区中老年膝骨关节炎的流行病学调查研究[D]. 中南大学, 2014.

[13] 宰庆书,蒋长伟,岳耀升,等.鲁西南邹城市膝骨性关节炎的流行病学调查及早期阶梯性治疗[J]. 中国组织工程研究, 2015,19(29): 4609-4613.

[14] 向珍蛹,茅建春,曲环汝,等.浦东上钢社区中老年人群膝骨关节炎危险因素的流行病学研究[J].上海交通大学学报(医学版), 2013, 33(3):318-322.

[15] 宋志红,王永斌,阮玉琦,等.上海市奉贤区农村中老年人骨关节炎患病率及分布现况[J].中国慢性病预防与控制, 2007, 15(1):60-61.

[16] 顾斌,朱秀龙,张美花,等.上海市郊区老年人膝关节骨关节炎现患调查[J].中国全科医学, 2011,14(29):3374-3376.

[17] 范琰,龚伶伶,娄灵芝,等.上海市中心社区老年膝骨关节炎流行病学调查[J].中国中医药咨讯, 2010, 2(31):317-318.

[18] 孙红,田文,廖伟华,等. 社区居民膝关节骨性关节炎流行病学调查分析[J].海南医学, 2013, 24(7):312-313.

[19] 项晓伟,罗明,苗峻,等.深圳市罗湖区50岁以上老年人膝关节骨性关节炎流行病学调查及生存质量评价[J]. 现代医药卫生, 2014, 30(18):2771-2773.

[20] 臧长海,曾庆馀,李小峰,等. 太原地区骨关节炎流行病学研究[J]. 山西医药杂志, 2006, 35(9):767-770.

[21] 宋素艳,于素静,刘建春,等.唐山地区中老年膝骨性关节炎流行病学及相关因素调查[J].医学信息, 2013,(11):250-251.

[22] 宋雄英, 李雪峰, 刘春阳,等. 长辛店地区60岁及以上人群膝原发性骨关节炎患病率调查及影响因素分析[J].中华老年医学杂志, 2011, 30(2):172-174.

[23] 杨静,孙官军,裴福兴,等.四川省部分地区汉族中老年人骨关节炎的流行病学研究[J].中国骨与关节损伤杂志, 2010, 25(8):693-696.

[24] 薛庆云,王坤正,裴福兴,等.中国40岁以上人群原发性骨关节炎患病状况调查[J].中华骨科杂志, 2015, 35(12):1206-1212.

[25] 顾明士,张申岳,王萍,等. 中老年人膝骨关节炎患病趋势十年前后对照分析[J]. 上海医药, 2013,35(4):57-59.

[26] Zhang Y, Xu L, Nevitt MC, et al. Comparison of the prevalence of knee osteoarthritis between the elderly Chinese population in Beijing and whites in the United States: The Beijing Osteoarthritis Study. Arthritis Rheum. 2001;44(9):2065-2071.

[27] 曾勤,蔡立民,朱玉霞,等.东莞市社区居民症状性膝关节骨性关节炎患病情况调查[J].新中医, 2011,43(8):70-71.

[28] 曾敏川,李康华. 湖南省郴州地区膝关节骨性关节炎流行病学调查[J]. 实用预防医学, 2014, 21(10):1157-1160.

[29] 李伟,赵育红,武长江,等.冀北地区中老年膝关节骨性关节炎发病及相关危险因素调查[J].河北医学,2015,21(6):1044-1046.

[30] Issa SN, Sharma L. Epidemiology of osteoarthritis: An update. Curr Opin Rheumatol. 2006;18(2):147-156.

[31] Roman-Blas JA, Castañeda S, Largo R, et al. Osteoarthritis associated with estrogen deficiency. Arthritis Res Ther. 2009; 11(5):311-312.

[32] Prietoalhambra D, Judge A, Javaid MK, et al.Incidence and risk factors for clinically diagnosed knee, hip and hand osteoarthritis: influences of age, gender and osteoarthritis affecting other joints. Ann Rheum Dis. 2014;73(9):1659-1664.

[33] Sluka KA, Berkley KJ, O’Connor MI, et al. Neural and psychosocial contributions to sex differences in knee osteoarthritic pain. Biol Sex Differ. 2012;3(1):1-12.

[34] Nicolella DP, O’Connor MI, Enoka RM, et al. Mechanical contributors to sex differences in idiopathic knee osteoarthritis. Biol Sex Differ.2012;3(1):1-11.

[35] 邱贵兴.骨关节炎流行病学和病因学新进展[J]. 继续医学教育, 2005, 19(7):68-69.