Abstract
Kashin-Beck disease (KBD) is a serious degenerative chronic joint disease. However, there are few quantitative syntheses of KBD prevalence studies. In this study, an initial systematic review and meta-analysis were performed to study the prevalence of KBD in China. Five databases (PubMed, Web of Science, Chinese National Knowledge Infrastructure (CNKI), WanFang Data, and the China Science-Technology Journal Database (VIP)) were searched by performing an overall search method to identify studies of KBD prevalence in China that were published from the inception of the database to May 30, 2022. The risk of bias was assessed with the standardized risk of bias tool. Heterogeneity was assessed with the I2 statistic. A random-effect meta-analysis was performed to study the prevalence of KBD through an analysis of published studies. A total of 34 studies involving 24,820 patients with KBD were included in this meta-analysis. These studies were geographically divided into 3 endemic areas. The pooled overall prevalence rate for KBD was 0.06% (95% CI, 0.04–0.08%). The pooled prevalence estimates were 0.05% (95% CI, 0.01–0.12%) for northeast endemic areas, 0.06% (95% CI, 0.03–0.09%) for northwest endemic areas, and 0.04% (95% CI, 0–0.14%) for southwest endemic areas. There was a negative correlation between KBD prevalence and the publication year. No potential risk of publication bias was found by Begg’s test and Egger’s test. The publication year and quality score were significantly associated with the detected heterogeneity. Our study indicates that the occurrence and development of KBD have been effectively controlled in recent decades. More effective strategies are needed to prevent and treat KBD.
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Abbreviations
- KBD:
-
Kashin-Beck disease
- PRISMA:
-
Preferred Reporting Items for Systematic Reviews and Meta-analysis
- CNKI:
-
Chinese National Knowledge Infrastructure
- CI:
-
Confidence interval
References
Guo X (2001) Diagnostic, clinical and radiological characteristics of Kashin-Beck disease in Shaanxi Province, PR China. Int Orthop 25:147–150
Wang X, Zhang P, Ning Y, Yang L, Yu F, Guo X (2017) Serum and hair zinc levels in patients with endemic osteochondropathy in China: a meta-analysis. Biol Trace Elem Res 181:227–233
Guo X, Ma WJ, Zhang F, Ren FL, Qu CJ, Lammi MJ (2014) Recent advances in the research of an endemic osteochondropathy in China: Kashin-Beck disease. Osteoarthr Cartil 22:1774–1783
National Health and Family Planning Commission of China (2020) The prevention and control status of Kaschin-Beck disease in 2019 10-5-2.
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hrobjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, Stewart LA, Thomas J, Tricco AC, Welch VA, Whiting P, Moher D (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372:n71
Hoy D, Brooks P, Woolf A, Blyth F, March L, Bain C, Baker P, Smith E, Buchbinder R (2012) Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement. J Clin Epidemiol 65:934–939
Barendregt JJ, Doi SA, Lee YY, Norman RE, Vos T (2013) Meta-analysis of prevalence. J Epidemiol Community Health 67:974–978
Schwarzer G, Chemaitelly H, Abu-Raddad LJ, Rucker G (2019) Seriously misleading results using inverse of Freeman-Tukey double arcsine transformation in meta-analysis of single proportions. Res Synth Methods 10:476–483
Borenstein M, Hedges LV, Higgins JP, Rothstein HR (2010) A basic introduction to fixed-effect and random-effects models for meta-analysis. Res Synth Methods 1:97–111
Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327:557–560
Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315:629–634
Su H, Qiao H, Lu Y (2012) Analysis of survey of Kashin-Beck disease between 2009 to 2011 in Songyuan. Chin J Ctrl Endem Dis 27:142–143
Ding LY, Wang YG, Chen L (2012) Investigation on the results of Kashin Beck disease in Dunhua City of 2007–2010. Chin J Ctrl Endem Dis 27:374–375
Xu LH, Wang Q, Yu YF, Cui JY (2009) Analysis of 17-year monitoring results of Kashin -Beck disease in Wushenqi of Inner. Inner Mongolia Med J 41:211–213
Zhou JC, Zhang MQ, Li C (2013) Study on the evaluation model for eliminating Kashin-Beck disease in Huairou District, Beijing. Chin J Ctrl Endem Dis 28:287–289
Wang HJ (2011) 32 year surveillance report of Kashin Beck disease in Beijing. Medical J Chin People Health 23:1481–1482
Cao AP (2007) Kashin-Beck disease surveillance report in Yushe County from 1991 to 1999. Edu Econ Res 23:24–26
Yu YH, Cui CL, Yue YT (2011) Prevalence of Kashin-Beck disease in Henan Province. Henan J Prev Med 22:95–96
Yang WZ, Wang DS, Wang YC, Wu XJ, Bai JC, Zhang JM (1994) Surveillance and analysis of Kashin-Beck disease in Shanxian County of Henan Province. Henan J Preventive Med 5:95–96
He XQ, Zhong M (2010) Surveillance and analysis of prevention and treatment of Kashin-Beck disease in Nanzheng County of Shaanxi Province in the past 20 years. J Preventive Med Anhui Province 16:180–181
Xie L, Chen W, Jin L, Yang G, Yao PJ (2010) Monitoring report of Kashin-Beck disease and selenium in 2007 in 2007 and 2008. Mod Preve Med 37:924–925
Xie L, Chen W, Jin L, Yang G (2008) Report of Kashin-Beck disease prevalence and selenium salt monitoring in Xi’an city from 2006 to 2007. Chin J Ctrl Endem Dis 23:307–310
Lv XY, Xu GY, Chen P (2009) Report on monitoring of Kashin-Beck Disease in Shaanxi Province in 2007. Chin J Ctrl Endem Dis 24:309–310
Xu G, Cao XG, Lv XY (2004) Report of Kaschin-Beck disease prevalence and selenium salt monitoring in Shaanxi Province from 2001 to 2003. Chin J End Dis 23:556–557
Cao XG, Zhang BD, Qin ZR, Lv XY, Xu GY, Liu HL, Deng JX (2004) The monitoring report of Kashin-Beck disease prevalence rate in Yuyang County of Shaanxi Province from 2001 to 2003. Chin J End Dis 23:369–370
Su YF (2005) Review on prevention and control of Kashin-Beck disease in Liquan County Shaanxi Province. Chin J Endemiology 24:696
Yang G, Chen W, Xie L, Jin L (2005) Kashin-Beck disease in Jinjing Village, Zhouzhi County, Xi’an, from 2001 to 2003. Chin J End Dis 24:704
Chen W, Yang G, Jing L, Yao PJ, Xie L (2004) Analysis on monitoring results of Kashin-Beck disease flow monitoring points in Xi’an from 2001 to 2002. Occup Health 20:79–80
Xu GY, Lv XY, Cao XG (2009) Anaiysis on monitoring data of Kashin-Beck disease in Shannxi Province during 19 years. Chin J End Dis 24:442–446
Xie L, Chen W, Jing L, Yang G, Yao PJ (2011) Analysis on monitoring results of Kashin-Beck disease in LanTian County of Xi’an city from 2001 to 2008. Mod Preve Med 38:2382–2384
Lv XY, Xu GY, Liang ST, Zhang BD, Ma CA, Zhu CS, Liu HL, Deng JX (2002) Comprehensive prevention and control of Kashin-Beck disease in Binxian County of Shaanxi Province. End Dis Bulletin 17:62–63
Zhang BD, Ma CA, Lv XY, Xu GY, Duan G (2001) Analysis and investigation of Kashin-Beck disease prevalence rate in Yuyang County of Shaanxi Province. Chin J Endemiology 21:371–373
Yuan DC (2002) Epidemiological survey of Kashin-Beck disease in Ningqiang County. J Shaanxi College Trad Chin Med 25:79–80
Ge PF, Bo SY, Xu JM, Wang WL, Jia JX, Ren YG (2008) Analysis of surveillance results of Kashin-Beck disease in Gansu Province in 2003 and 2004. End Dis Bulletin 23:43–45
Liu FS, Ma MZ, Lei CY, Wang HW, Zheng WZ, Yang YM, Zhao WB, Jie DG, Yang LL, Xiong LQ (2007) Investigation report on Kashin-Beck disease in Tianshui City, Gansu Province, 2002–2003. End Dis Bulletin 22:47–49
Zhang YQ, Liang CZ, Yin XJ, Lai XQ, Zhao YH, Su XY (2014) Analysis of surveillance of Kashin-Beck Disease in Dingxi City of Gansu Province. Bull Dis Control Prev 29:28–29
Li Q, Zhao ZJ, Wen H, Yang P (2004) Observation of KBD prevalence state in two national monitoring points from 1999 to 2003. Chin J Infection Control 19:352–354
Ding SR, Wen H, Li Q, Wan DZX, Ren ZZX, Liu CZ, Mao JS (2001) Analysis on the state of Kashin-Beck disease from 1989 to 2000 in Xinghai County Qinghai Province. Chin J Infection Control 20:372–374
Ding SR (2003) Analysis on the state of Kashin-Beck disease from 1992 to 2001 in Guide County Qinghai Province. Chin J Infection Control 22:148–149
Li Q, Zhao ZJ (2006) Prevalence state of Kashin-Beck disease in Qinghai Province: a retrospective analysis. Chin J Endemiol 25:675–677
Bao JQ, Wan DZX, Zhuo MJ (1998) Analysis of Kashin-Beck disease in Xinghai County of Qinghai Province from 1995 to 1997. End Dis Bulletin 13:50–55
Zhao SC (2011) Surveillance and Analysis of Kashin-Beck Disease in Xietongmen County, Xigaze, Tibet, China from 2009 to2010. J Med Pest Control 27:485
Xu C, Tian H, Tian J, Zeng R, Yang K, Wu T, Liao Y (2013) A systematic review regarding the effects of different kinds of selenium supplementations on Kaschin-Beck disease. Chin J Endemiol 34:288–290
Huang H, Li FZ, Deng JY, Li JS, Yuan P (2010) Investigation results of Kashin-Beck disease in Sichuan Province, 2005–2009. J Preve Med Infor 26:966–968
Deng JY, Li DY, Cai W, Zhu L, Liang DH, GuY MGJ, Xu QL, Wang YG, Ze H, Chang L (1999) Analysis on the data of surveillance for KBD and hair selenium level. Chin J Endemiol 18:442–444
Yu FF, Liu H, Guo X (2016) Integrative multivariate logistic regression analysis of risk factors for Kashin-Beck disease. Biol Trace Elem Res 174:274–279
Ning YJ, Wang X, Guo X, Zhang P, Qu PF, Zhang F, Wang S, Lei YX, Lammi M (2018) Nutrients other than selenium are important for promoting children’s health in Kashin-Beck disease areas. Biol Trace Elem Res 183:233–244
Ning YJ, Wang X, Zhang P, Anatoly SV, Prakash NT, Li C, Zhou R, Lammi M, Zhang F, Guo X (2018) Imbalance of dietary nutrients and the associated differentially expressed genes and pathways may play important roles in juvenile Kashin-Beck disease. J Trace Elem Med Bio 50:441–460
Sun LY, Meng FG, Li Q, Zhao ZJ, He CZ, Wang SP, Sa RL, Man WW, Wang LH (2014) Effects of the consumption of rice from non-KBD areas and selenium supplementation on the prevention and treatment of paediatric Kaschin-Beck disease: an epidemiological intervention trial in the Qinghai Province. Osteoarthr Cartil 22:2033–2040
Wang KW, Yu J, Liu H, Liu YQ, Liu N, Cao YH, Zhang XF, Sun DJ (2020) Endemic Kashin-Beck disease: a food-sourced osteoarthropathy. Semin Arthritis Rheu 50:366–372
Zhang Y, Wei X, Cao C, Yu F, Li W, Zhao G, Wei H, Zhang F, Meng P, Sun S, Lammi MJ, Guo X (2021) Identifying discriminative features for diagnosis of Kashin-Beck disease among adolescents. BMC Musculoskelet Disord 22:801
Dang J, Li H, Niu K, Xu Z, Lin J, He Z (2021) Kashin-Beck disease diagnosis based on deep learning from hand X-ray images. Comput Methods Programs Biomed 200:105919
Wu S, Yi Z, Ling M, Liu S, Sun Z, Guo X (2021) DR4-associated death receptor signal promotes cartilage damage in patients with Kashin-Beck disease. Cartilage 13:789S-796S
Zhang D, Zhang D, Wang C, Zhang R, Li Q, Xiong Y (2021) Mechanism of DNA methylation-mediated downregulation of O6-Methylguanine-DNA methyltransferase in cartilage injury of Kashin-Beck disease. Rheumatology (Oxford) 61(8):3471–13480
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JKX, JHW, and HMZ designed the study. JKX performed the analysis and interpretation of the data. JHW, JHW, and HMZ analyzed the results and drafted the manuscript. All authors critically reviewed and amended the manuscript, and all authors read and approved the final manuscript.
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Xu, J., Wang, J. & Zhao, H. The Prevalence of Kashin-Beck Disease in China: a Systematic Review and Meta-analysis. Biol Trace Elem Res 201, 3175–3184 (2023). https://doi.org/10.1007/s12011-022-03417-x
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DOI: https://doi.org/10.1007/s12011-022-03417-x