Temporal trends and future projections of hip/knee osteoarthritis burden attributable to metabolic risk in women of reproductive age (1990–2021): A multidimensional analysis across 204 countries and territories

Temporal trends and future projections of hip/knee osteoarthritis burden attributable to metabolic risk in women of reproductive age (1990–2021): A multidimensional analysis across 204 countries and territories | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Temporal trends and future projections of hip/knee osteoarthritis burden attributable to metabolic risk in women of reproductive age (1990–2021): A multidimensional analysis across 204 countries and territories Fumin Xue, Weiren Wang, Lanqing Shang, Guangzhi Zhou, Siwen Kang, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6740462/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background : Osteoarthritis (OA) is a leading cause of disability worldwide, with women of reproductive age being particularly vulnerable to hip/knee OA (HOA/KOA) due to metabolic risks (e.g., obesity, high BMI). Leveraging Global Burden of Disease (GBD 2021) data, this study systematically analyzed the metabolic risk-attributable burden of HOA/KOA among women aged 15–49 years across 204 countries and territories from 1990--2021, with projections to 2050. Methods : Data on disability-adjusted life years(DALYs), years livedwith disability (YLDs), and age-standardized rates (ASRs) for HOA/KOA in women of reproductive age were extracted from the GBD 2021. The analyses were stratified by the sociodemographic index(SDI). Time series models (ARIMA, exponential smoothing) were employed to forecast disease burden trends (2022–2050), and decomposition analysis quantified contributions from population growth, aging, and epidemiological changes. Results : Global trends : From 1990--2021, DALYs for HOA and KOA in women of reproductive age increased by 169% and 202%, respectively, with ASRs increasingby 24.5% and 41.2%, respectively. Regional disparities : Low-SDI countries exhibited the fastest case growth (HOA: +298%, KOA: +574%), whereas high-SDI regions had the highest absolute burden (HOA cases accounted for 16.5% of all HOA cases globally). Metabolic risk drivers : Population growth (HOA: 48.9%, KOA: 46.6%) and increasing incidence rates (HOA: 47.7%, KOA: 48.5%) were the primary contributors. Projections : By 2050, ARIMA models predicted HOA/KOA cases to surge by 58.7% and 80.3%, respectively, whereasexponential smoothing indicated slower but significant growth. Conclusions : Metabolic risk drivesa substantial increasein the HOA/KOA burden among women of reproductive age, with the fastest growth occurring in low- and middle-SDI countries. High-SDI regions should prioritize chronic disease management, whereas low-SDI areas require enhanced community screening and health education. Early OA screening should be integrated into prepregnancy care systems, supported by multisectoral collaboration under the UN Sustainable Development Goals. Future research must elucidate the molecular mechanisms of metabolic riskand refine community-based interventions to mitigate disease progression. Trial registration IHME [email protected] Global burden of disease Hip/knee osteoarthritis Metabolic risk factors Full Text Additional Declarations No competing interests reported. Tables 1 and 2 are available in the Supplementary Files section Supplementary Files table1Hip.xlsx table2Knee.xlsx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6740462","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":475844642,"identity":"777991e7-4182-4282-99fe-a2dcb0c1b05e","order_by":0,"name":"Fumin Xue","email":"","orcid":"","institution":"Liaoning University of Traditional Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"Fumin","middleName":"","lastName":"Xue","suffix":""},{"id":475844643,"identity":"387f1f7a-cc71-4d34-a622-b490549e9f23","order_by":1,"name":"Weiren Wang","email":"","orcid":"","institution":"Liaoning University of Traditional Chinese 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in women of reproductive age (1990–2021): A multidimensional analysis across 204 countries and territories","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Global burden of disease, Hip/knee osteoarthritis, Metabolic risk factors","lastPublishedDoi":"10.21203/rs.3.rs-6740462/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6740462/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: Osteoarthritis (OA) is a leading cause of disability worldwide, with women of reproductive age being particularly vulnerable to hip/knee OA (HOA/KOA) due to metabolic risks (e.g., obesity, high BMI). Leveraging Global Burden of Disease (GBD 2021) data, this study systematically analyzed the metabolic risk-attributable burden of HOA/KOA among women aged 15–49 years across 204 countries and territories from 1990--2021, with projections to 2050.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e: Data on disability-adjusted life years(DALYs), years livedwith disability (YLDs), and age-standardized rates (ASRs) for HOA/KOA in women of reproductive age were extracted from the GBD 2021. The analyses were stratified by the sociodemographic index(SDI). Time series models (ARIMA, exponential smoothing) were employed to forecast disease burden trends (2022–2050), and decomposition analysis quantified contributions from population growth, aging, and epidemiological changes.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: \u003cstrong\u003eGlobal trends\u003c/strong\u003e: From 1990--2021, DALYs for HOA and KOA in women of reproductive age increased by 169% and 202%, respectively, with ASRs increasingby 24.5% and 41.2%, respectively. \u003cstrong\u003eRegional disparities\u003c/strong\u003e: Low-SDI countries exhibited the fastest case growth (HOA: +298%, KOA: +574%), whereas high-SDI regions had the highest absolute burden (HOA cases accounted for 16.5% of all HOA cases globally). \u003cstrong\u003eMetabolic risk drivers\u003c/strong\u003e: Population growth (HOA: 48.9%, KOA: 46.6%) and increasing incidence rates (HOA: 47.7%, KOA: 48.5%) were the primary contributors. \u003cstrong\u003eProjections\u003c/strong\u003e: By 2050, ARIMA models predicted HOA/KOA cases to surge by 58.7% and 80.3%, respectively, whereasexponential smoothing indicated slower but significant growth.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e: Metabolic risk drivesa substantial increasein the HOA/KOA burden among women of reproductive age, with the fastest growth occurring in low- and middle-SDI countries. High-SDI regions should prioritize chronic disease management, whereas low-SDI areas require enhanced community screening and health education. Early OA screening should be integrated into prepregnancy care systems, supported by multisectoral collaboration under the UN Sustainable Development Goals. Future research must elucidate the molecular mechanisms of metabolic riskand refine community-based interventions to mitigate disease progression.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTrial registration \u003c/strong\u003eIHME [email protected]\u003c/p\u003e","manuscriptTitle":"Temporal trends and future projections of hip/knee osteoarthritis burden attributable to metabolic risk in women of reproductive age (1990–2021): A multidimensional analysis across 204 countries and territories","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-06-26 15:16:40","doi":"10.21203/rs.3.rs-6740462/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"8ec74c08-e9fa-4e2b-aabf-b7bd95ac85a0","owner":[],"postedDate":"June 26th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-09-18T09:54:52+00:00","versionOfRecord":[],"versionCreatedAt":"2025-06-26 15:16:40","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6740462","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6740462","identity":"rs-6740462","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}