Global Burden of Hip and Knee Osteoarthritis Attributable to Metabolic Risks in Women of Reproductive Age, 1990–2021: A Systematic Analysis from the Global Burden of Disease Study 2021

Abstract

Background This study assessed hip osteoarthritis (HOA) and knee osteoarthritis (KOA) burden attributable to the aggregate GBD category “Metabolic risks” among women of reproductive age, using GBD 2021 estimates from 1990 to 2021. Methods We analyzed disability-adjusted life-years (DALYs) and years lived with disability (YLDs) for HOA and KOA in women aged 15–49 years across 204 countries and territories, with stratification by age, Socio-demographic Index (SDI), and GBD region. We calculated absolute numbers, age-standardized rates (ASRs), and estimated annual percentage changes (EAPCs); performed decomposition analyses; and used ARIMA and damped Holt exponential-smoothing models to describe possible burden trajectories from 2022 to 2050. Results From 1990 to 2021, global KOA DALYs attributable to metabolic risks increased from 118,483.85 to 342,005.11, an increase of approximately 188.7%, while the KOA ASR increased from 10.95 to 16.54 per 100,000, an increase of approximately 50.9% (EAPC 1.57%). HOA DALYs increased from 10,426.34 to 28,184.59, an increase of approximately 170.3%, while the HOA ASR increased from 0.93 to 1.37 per 100,000, an increase of approximately 47.0% (EAPC 1.32%). Both forecasting approaches suggested further increases through 2050, although the magnitude of the projected changes was model-dependent. Interpretation The burden of HOA and KOA attributable to metabolic risks increased substantially among women of reproductive age, with marked geographic and SDI-related heterogeneity. These findings support consideration of metabolic risk management within existing women’s health and noncommunicable disease (NCD) services.