Burden Of Gout Research Articles

The changing burden of gout in adults aged 70 and above based on the global burden of disease 2019

IntroductionGout is a significant global health issue, particularly among adults aged 70 and above. Understanding its epidemiological evolution and associated factors is crucial for guiding interventions and improving management.MethodsThis study analyzed data from the Global Burden of Disease study to assess the prevalence and trends of gout among adults aged 70 and above from 1990 to 2019. We evaluated temporal trends and regional disparities by calculating the estimated annual percentage change (EAPCs).ResultsGlobally, the number of older adults individuals affected by gout increased from 5,316,210 cases in 1990 to 15,666,063 cases in 2019. It is noteworthy that the global burden of gout among the older adults continued to rise from 1990 to 2019, with an EAPC of 1.17 (95% CI: 1.02 to 1.32). In 2019, the prevalence rates among individuals aged 70–74, 75–79, 80–84, and 85 and above were 3,121.31 per 100,000, 3,437.17 per 100,000, 3,592.38 per 100,000, and 3,726.91 per 100,000, respectively. The regions with the highest prevalence rates of gout in 2019 were Australasia, High-income North America, and Southern Latin America, with rates of 8,500.73, 8,351.33, and 4,666.87 per 100,000, respectively. At the national level, some developed countries such as New Zealand, the United States of America, and Australia had the highest prevalence rates, reaching 8,893.74, 8,508.06, and 8,427.94 per 100,000, respectively. It is noteworthy that regions with higher levels of Socio-Demographic Index tended to have relatively higher burden of gout among the older adults, and the prevalence rates varied across different regions and age groups.ConclusionThe study underscores the persistent burden of gout among the older adults, emphasizing the need for targeted interventions to address this issue and improve public health outcomes in this demographic.

A comprehensive analysis of trends in the burden of gout in China and globally from 1990 to 2021

Gout is a prevalent metabolic disorder characterized by urate crystal accumulation in joints, leading to acute arthritis and tophi formation. Despite advancements in management, the incidence and prevalence of gout have been increasing globally, particularly in China. This study analyzed data from the Global Burden of Disease Injuries and Risk Factors Study (GBD) to evaluate trends in gout from 1990 to 2021. Statistical analyses were conducted using R and Joinpoint software, while the ARIMA model was employed for forecasting future trends. Our findings revealed a global increase in gout incidence from 93.097 per 100,000 in 1990 to 109.075 per 100,000 in 2021, with cases rising from 3,983,109 to 9,401,585. In China, incidence increased from 122.522 to 151.612 per 100,000, with cases growing from 1,182,498 to 3,079,836. Similarly, global prevalence rose from 536.545 to 653.816 per 100,000, while in China, it increased from 640.679 to 810.359 per 100,000. Disability metrics, including YLDs and DALYs, also demonstrated significant increases both globally and in China. Our analysis indicated that middle-aged and elderly populations, particularly males, are at higher risk for gout. These findings underscore the urgent need for enhanced prevention and management strategies, specifically targeting high-risk populations. Effective public health policies and interventions are crucial to mitigate the escalating burden of gout and improve the quality of life for affected individuals. This study relied on secondary data from the GBD, which may be subject to biases in data collection and reporting. Additionally, variations in diagnostic practices and healthcare access across regions could influence the accuracy of reported trends. Future research should address these limitations by incorporating primary data and exploring region-specific factors contributing to gout prevalence and incidence.

Global, regional, and national burden of gout in elderly 1990–2021: an analysis for the global burden of disease study 2021

BackgroundGout, an inflammatory arthritis, disproportionately affects the elderly due to hyperuricemia, leading to significant health-related quality of life impairments and escalating healthcare costs. However, a comprehensive global analysis focusing on the elderly population is needed to inform effective interventions.MethodsUtilizing data from the Global Burden of Disease Study 2021, this study assessed the prevalence, incidence, and Years Lived with Disability (YLDs) of gout among individuals aged ≥ 55 years in 204 countries from 1990 to 2021. We also evaluated the impact of high body mass index (BMI) and kidney dysfunction as key risk factors.ResultsThe study identified 37,230,366 cases of gout globally among the elderly, with an age-standardized prevalence rate of 2505.4 per 100,000 population. There was a notable increase in prevalence with an Estimated Annual Percentage Change (EAPC) of 1.08. Similarly, the age-standardized incidence and YLD rates increased, with EAPCs of 0.83 and 1.06, respectively. High-income regions, particularly Australasia and High-income North America, exhibited the highest rates, while Central Latin America and the Caribbean reported the lowest. Males had a higher burden of gout than females. High BMI and kidney dysfunction were significant contributors to YLDs, with their impact more pronounced in regions with higher Socio-Demographic Index (SDI).ConclusionThe study found a growing gout burden among the elderly, with substantial regional and gender disparities. It underscores the urgent need for targeted public health interventions, particularly in high SDI regions, to address modifiable risk factors like high BMI and kidney dysfunction and to curb the rising trend of gout prevalence and disability.

Gout Flare Burden in the United States: A Multiyear Cross-Sectional Survey Study.

The objective of this study was to assess the burden of gout flares and examine associated patient characteristics and outcomes in a sample of US adults. Data were collected via an online survey of US adults ≥18 years using a random stratified sampling framework. Participants with gout completed questions about treatments, serum urate (SU) levels, severity, satisfaction with control, and gout flares. All participants completed the Veterans RAND 12-Item Health Survey, the Generalized Anxiety Disorder 7-Item Scale, and the Patient Health Questionnaire 9-Item Scale. Data were summarized using descriptive statistics. Multivariable-adjusted logistic regression analyses examined factors predictive of reporting gout flares to a physician. A total of 933 participants met the study criteria for having gout. Those with gout tended to be older (58.3 [SD 13.3] years vs 45.4 [SD 16.1] years; P < 0.001), male (76.3% vs 46.9%; P < 0.001), White (80.5% vs 76.8%; P = 0.01), and married or living with their partner (58.9% vs 52.8%; P < 0.001) compared with those without gout (n = 30,146). The total gout flare burden for those with gout was 6.6 gout flares per year. Nearly 72% of gout flares were either not reported to physicians or pretreated or prevented. Characteristics of those who were less likely to report gout flares included being younger, being less educated, having a lower Charlson Comorbidity Index score, not being diagnosed with gout by their doctor, and not taking a urate-lowering therapy. This study confirmed that gout flares are common in US adults with gout and found that gout flares are underreported. Reliance on clinical documentation of physician-reported gout flares is insufficient to assess the true patient burden of gout.

Burden of gout among different WHO regions, 1990–2019: estimates from the global burden of disease study

The global incidence of gout has increased rapidly, likely secondary to the increase in the prevalence of conditions that predispose to gout, such as obesity. Depending on the population studied, the prevalence of gout ranges from less than 1 to 6.8%. Thus, gout can be a significant burden on healthcare systems. The objective of this study is to observe the trends in the incidence, prevalence, and disability-adjusted life years (DALYs) of gout between 1990 and 2019 globally and in the European Union (EU) 15+ nations. We extracted data from the Global Burden of Disease Study database based on the International Classification of Diseases (ICD) versions 10 and 9. Incidence, prevalence, and disability-adjusted life years (DALYs) were extracted for individual EU15+ countries and globally in males and females between 1990 and 2019. Joinpoint regression analysis was used to describe trends. Between 1990 and 2019, gout prevalence, incidence, and DALYs increased in both males (+ 21.42%, + 16.87%, + 21.49%, respectively) and females (+ 21.06%, + 18.75%, + 20.66%, respectively) globally. The United States of America had the highest increase in prevalence (males: + 90.6%; females + 47.1%), incidence (males: + 63.73%; females: + 39.11%) and DALYs (males: + 90.43%; females: + 42.75%). Incidence, prevalence, and DALYs from gout are increasing worldwide and in most of the EU15+ countries for males and females. Studies have reported the association of gout with comorbidities such as metabolic syndrome, diabetes mellitus, and cardiovascular disease. Health policies and resource allocation are required to increase awareness and modify risk factors globally.

Global, regional, and national burden of gout, 1990–2020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021

Gout is an inflammatory arthritis manifesting as acute episodes of severe joint pain and swelling, which can progress to chronic tophaceous or chronic erosive gout, or both. Here, we present the most up-to-date global, regional, and national estimates for prevalence and years lived with disability (YLDs) due to gout by sex, age, and location from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, as well as forecasted prevalence to 2050. Gout prevalence and YLDs from 1990 to 2020 were estimated by drawing on population-based data from 35 countries and claims data from the USA and Taiwan (province of China). Nested Bayesian meta-regression models were used to estimate prevalence and YLDs due to gout by age, sex, and location. Prevalence was forecast to 2050 with a mixed-effects model. In 2020, 55·8 million (95% uncertainty interval 44·4-69·8) people globally had gout, with an age-standardised prevalence of 659·3 (525·4-822·3) per 100 000, an increase of 22·5% (20·9-24·2) since 1990. Globally, the prevalence of gout in 2020 was 3·26 (3·11-3·39) times higher in males than in females and increased with age. The total number of prevalent cases of gout is estimated to reach 95·8 million (81·1-116) in 2050, with population growth being the largest contributor to this increase and only a very small contribution from the forecasted change in gout prevalence. Age-standardised gout prevalence in 2050 is forecast to be 667 (531-830) per 100 000 population. The global age-standardised YLD rate of gout was 20·5 (14·4-28·2) per 100 000 population in 2020. High BMI accounted for 34·3% (27·7-40·6) of YLDs due to gout and kidney dysfunction accounted for 11·8% (9·3-14·2). Our forecasting model estimates that the number of individuals with gout will increase by more than 70% from 2020 to 2050, primarily due to population growth and ageing. With the association between gout disability and high BMI, dietary and lifestyle modifications focusing on bodyweight reduction are needed at the population level to reduce the burden of gout along with access to interventions to prevent and control flares. Despite the rigour of the standardised GBD methodology and modelling, in many countries, particularly low-income and middle-income countries, estimates are based on modelled rather than primary data and are also lacking severity and disability estimates. We strongly encourage the collection of these data to be included in future GBD iterations. Bill & Melinda Gates Foundation and the Global Alliance for Musculoskeletal Health.

Projected Health and Economic Burden of Comorbid Gout and Chronic Kidney Disease in a Virtual US Population: A Microsimulation Study.

Gout, a common comorbidity of chronic kidney disease (CKD), is associated with high morbidity and healthcare utilization. However, a large proportion of gout remains undermanaged or untreated which may lead to worse patient outcomes and greater healthcare costs. This study estimates the present and future health and economic burden of controlled and uncontrolled gout in a virtual United States (US) CKD population. A validated microsimulation model was used to project the burden of gout in patients with CKD in the USA through 2035. Databases were utilized to build a virtual CKD population of "individuals" with controlled or uncontrolled gout. Modelling assumptions were made on the basis of the literature, which was sparse in some cases. Health and economic outcomes with the current care (baseline) scenario were evaluated, along with potential benefits of urate-lowering intervention scenarios. The prevalence of comorbid gout and CKD in the USA was projected to increase by 29%, from 7.9 million in 2023 to 9.6 million in 2035 in the baseline scenario. Gout flares, tophi, and comorbidity development were also projected to increase markedly through 2035, with the economic burden of gout in the CKD population subsequently increasing from $38.9 billion in 2023 to $47.3 billion in 2035. An increased use of oral urate-lowering therapies in undermanaged patients, and pegloticase use in patients refractory to oral urate-lowering therapies were also project to result in 744,000 and 353,000 fewer uncontrolled gout cases, respectively, by 2035. Marked reductions in complications and costs ensued. This study projected a substantial increase in comorbid gout and CKD. However, improved use of urate-lowering interventions could mitigate this growth and reduce the health and economic burdens of gout.

Global pattern, trend, and cross-country inequality of early musculoskeletal disorders from 1990 to 2019, with projection from 2020 to 2050

This study aims to estimate the burden, trends, forecasts, and disparities of early musculoskeletal (MSK) disorders among individuals ages 15 to 39 years. The global prevalence, years lived with disabilities (YLDs), disability-adjusted life years (DALYs), projection, and inequality were estimated for early MSK diseases, including rheumatoid arthritis (RA), osteoarthritis (OA), low back pain (LBP), neck pain (NP), gout, and other MSK diseases (OMSKDs). More adolescents and young adults were expected to develop MSK disorders by 2050. Across five age groups, the rates of prevalence, YLDs, and DALYs for RA, NP, LBP, gout, and OMSKDs sharply increased from ages 15-19 to 35-39; however, these were negligible for OA before age 30 but increased notably at ages 30-34, rising at least 6-fold by 35-39. The disease burden of gout, LBP, and OA attributable to high BMI and gout attributable to kidney dysfunction increased, while the contribution of smoking to LBP and RA and occupational ergonomic factors to LBP decreased. Between 1990 and 2019, the slope index of inequality increased for six MSK disorders, and the relative concentration index increased for gout, NP, OA, and OMSKDs but decreased for LBP and RA. Multilevel interventions should be initiated to prevent disease burden related to RA, NP, LBP, gout, and OMSKDs among individuals ages 15-19 and to OA among individuals ages 30-34 to tightly control high BMI and kidney dysfunction. The Global Burden of Disease study is funded by the Bill and Melinda Gates Foundation. The project is funded by the Scientific Research Fund of Sichuan Academy of Medical Sciences& Sichuan Provincial People's Hospital (2022QN38).

The Effects of Pharmacological Urate-Lowering Therapy on Cardiovascular Disease in Older Adults with Gout.

Cardiovascular disease is an important cause of mortality in older patients. In addition to the traditional risk factors for cardiovascular disease, hyperuricemia has been increasingly associated with an elevated risk of cardiovascular disease. Uric acid itself has several unfavorable effects on the cardiovascular system, and hyperuricemia can lead to the development of gout. Gout is the most prevalent inflammatory rheumatic disease. Older patients with gout have an increased risk of cardiovascular morbidity and mortality due toan increased prevalence of traditional risk factors, as well as the inflammatory burden of gout activity. As the prevalence of traditional risk factors and the prevalence of both hyperuricemia and gout are increasing in older adults, cardiovascular risk management in these patients is very important. This risk management consists of, on the one hand, treatment of individual traditional risk factors and, on the other hand, of urate lowering, thereby decreasing inflammatory burden of gout. However, there is insufficient evidence to conclude that urate-lowering therapy reduces the risk of cardiovascular events. Moreover, from a cardiovascular point of view, there is no preference for one urate lowering drug over another in patients with gout, nor is there enough evidence to support a preference in patients with gout with increased cardiovascular risk. Personalized treatment in older patients with gout should be aimed at optimizing serum uric acid levels, as well as targeting traditional cardiovascular risk factors. Further prospective randomized trials are needed to support the hypothesis that urate lowering reduces cardiovascular risk in older patients with gout.

Global burden and epidemic trends of gout attributable to high body mass index from 1990 to 2019.

Gout is an inflammatory and metabolic disease characterized by arthritis and elevation of the serum uric acid (SUA) level. More and more studies have shown that high body mass index (BMI) has become one of the most important risk factors for gout. We used the data of gout burden attributed to high body mass index (BMI) from global burden of disease (GBD) study 2019 to provide insights for reducing the global burden of gout. From 1990 to 2019, the prevalence and DALYs of gout caused by high BMI worldwide has been increasing. The burden of gout caused by high BMI is heavier in the elderly male group and regions with high SDI worldwide. Our findings provide evidence for the burden of gout caused by high BMI. Developing a weight management plan and lifestyle habits for groups severely affected by gout will effectively reduce the global disease and economic burden.

Epidemiology of gout - Global burden of disease research from 1990 to 2019 and future trend predictions.

Understanding the global burden of gout in the past and future can provide important references for optimizing prevention and control strategies in healthcare systems. This study aimed to report variations in the global disease burden and risk factors of gout in 204 countries and territories from 1990 to 2019. We conducted a retrospective analysis of gout based on the latest Global Burden of Disease (GBD) 2019 database. We collected data on the prevalence, incidence, and disability-adjusted life years (DALYs) of gout from 1990 to 2019. The data were then stratified by age, sex, and economic development level. Decomposition analysis, frontier analysis, and prediction models were used to analyze the changes and influencing factors influencing each indicator. Globally, there were 53,871,846.4 [95% uncertainty interval (UI): 43,383,204.6-66,342,327.3] prevalent cases, 92,228,86.8 (95% UI: 7419,132.1-11,521,165) incident cases, and 1673,973.4 (95% UI: 1,068,061.1-2,393,469.2) cases of DALYs of gout in 2019, more than double those in 1990. Moreover, the pace of increase in the age-standardized prevalence rate (ASPR), age-standardized incidence rate (ASIR), and age-standardized DALY rate (ASDR) accelerated during 1990-2019, with estimated annual percentage changes (EAPC) of 0.94 [95% confidence interval (CI): 0.85-1.03], 0.77 (95% CI: 0.69-0.84), and 0.93 (95% CI: 0.84-1.02), respectively, especially among men. The disease burden of gout has increased in all the other 20 GBD regions in the past 30 years, except Western Sub-Saharan Africa. The highest risk of high body mass index (BMI) and kidney dysfunction was in high-income countries such as North America and East Asia. The global prevalence rate, incidence rate, and DALYs rate of gout in 2030 will reach 599.86, 102.96 per 100,000 population, and 20.26 per 100,000 population, respectively, roughly the same as in 2019. With the development of society, the disease burden of gout will become increasingly severe. It is very important to study the accurate epidemiological data on gout for clinical diagnosis and treatment and health policy.

The association between gout flares and monosodium urate burden assessed using musculoskeletal ultrasound in patients with gout.

Ultrasound (US) has a high sensitivity in detecting monosodium urate (MSU) deposition in gout patients. However, the value of US in predicting gout flares has been reported only in a few monocentric studies. To investigate the association between gout flares in the previous year and US-detected MSU burden using two different US scores. A retrospective study. Patients with gout were consecutively recruited to undergo musculoskeletal US examinations of their knees, ankles, and feet. The score derived from Outcome Measure in Rheumatology (hereinafter referred to as MSU score) and musculoskeletal US features-based (hereinafter referred to as MSKF score) were used to quantify the MSU burden of gout. Odds ratios for frequent gout flares were calculated. We enrolled 1894 patients with gout (mean age: 45 years; gout duration: 5 years; males: 96.1%), experiencing a median of three flares over the past year. Of these, 428 (22.6%) patients reported frequent (⩾7) gout flares. The MSU and MSKF median scores were 6 and 9, respectively. For each five-point increase in MSU and MSKF score, the odds ratio of frequent gout flares increased 1.13-fold and 1.24-fold, respectively. The area under the curve (AUC) for the MSU and MSKF score was 0.635 [95% confidence interval (CI): 0.604-0.665] and 0.688 (95% CI: 0.659-0.718), respectively, (AUC difference 0.054, p value for AUC difference < 0.001). The MSU and MSKF scores were significantly associated with the number of gout flares in the previous year. The MSKF score outperformed the MSU score in terms of frequent gout flare discrimination.

Association between the triglyceride/high-density lipoprotein (TG/HDL) ratio and incidence of gout: A nationwide cohort study.

The global burden of gout, a severe and painful arthralgia, is of note and is expected to increase in the future. We aimed to investigate the association between the triglyceride/high-density lipoprotein (TG/HDL) ratio, a simple and validated biomarker for insulin resistance, and the incidence of gout in a longitudinal setting in the general population. Our study was conducted using the National Health Insurance Service-Health Screening Cohort database of Republic of Korea (2002-2019). We included 300,107 participants who had no previous history of gout and had data for more than three repeated measurements of the triglyceride-glucose (TyG) index. The incidence of gout was determined using at least two or more claims of the ICD-10 code M10. During a median 9.62 years (interquartile range 8.72-10.53), 14,116 individuals (4.72%) had a reported incidence of gout. In a fully adjusted multivariable time-dependent Cox proportional hazards model with repeated measures of the TyG index, a unit increase in the index significantly increased the risk of gout in the entire cohort (hazard ratio (HR) = 1.150, 95% confidence interval (CI) 1.116-1.184). In a multivariable Cox proportional model of average TyG index quartiles, comparison of the lowest (Q1) and highest quartiles (Q4) indicated a significant positive association with the incidence of gout (HR: 1.326, 95% CI: 1.260-1.397). This association was non-linear (J-shape) when assessing the entire cohort and the diabetes and non-diabetes cohorts. Our study demonstrated that increased TyG index was associated with an incidence risk of gout in the general population. Additionally, this association was non-linear (J-shape) not only in the entire cohort, but also in diabetes mellitus and non-diabetes mellitus cohorts. The TyG index may be an important predictor of gout.

Comparative Study to Assess the Safety and Effectiveness of Allopurinol &amp; Febuxostat in Patients Diagnosed with Gout

Introduction: Gout is placed under the umbrella term ‘arthritis’ - a wide variety of joint illness and joint pain. Some types of arthritis cause inflammation in the joints, while others do not. It is the most prevalent form of inflammatory arthritis which arises due to the elevated levels of Serum Uric acid (SUA), leading to the deposition of Mono Sodium Urate (MSU) crystals in and around joints. burden of gout has risen in recent decades with a prevalence rate of &lt;1% to 6.8% and the patients with gout may have significant medical comorbidity load asociated with pain, disability and activity limitation which inturn affects the patients’ Health-related quality of life (HRQOL). Several drugs are used to treat acute attacks of gout which includes Colchicine, Non steroidal anti inflammatory drugs (NSAIDs), and Corticosteroids. Long term management of gout focuses on lowering SUA level to normal (&lt;0.36mmol/L). There are two major classes of drugs used to reduce SUA levels, Urate-lowering therapy (ULT), specifically Uricosuric drugs and Xanthine oxidase inhibitors (XOIs). Hence, it is necessary to compare the safety and effectiveness of Allopurinol and Febuxostat used in the management of gout and there is a growing need to research the impact of gout on patients’ HRQOL inorder to improve productivity and QOL of patients. Objectives: The goal of the study was to compare the safety and effectiveness of Allopurinol and Febuxostat in patients diagnosed with Gout. The study also aimed to assess the effect of these on renal profile and the study further assessed the Health-related quality of life of the patients. Methodology: This was an observational study conducted in the selected Orthopedic clinics in T. Dasarahalli, Bengaluru District for a period of 6 months by enrolling 50 subjects, based on various inclusion and exclusion criteria. The subject’s demographic details, laboratory data and responses were collected with the help of a self-designed questionnaire. ...........

1295-P: The Association between Risk of Gout Flares and Monosodium-Urate Burden Assessed Using Musculoskeletal Ultrasound in Patients with Gout

Objective: We aimed to investigate the association between the risk of gout flares and ultrasound (US)-detected monosodium urate (MSU) burden using two different US score. Methods: Patients with gout were consecutively recruited to undergo musculoskeletal ultrasound examinations of their knees, ankles, and feet. The Outcome Measure in Rheumatology (OMERACT) and musculoskeletal ultrasound features-based (MSUS) score were used to quantify the MSU burden of gout. Odds ratios for the risk of frequent gout attacks were calculated. Results: We enrolled 1253 patients with gout (median age, 46 years; gout duration, 5 years; males, 95.9%) and a median of 3 flares over the past year. Of these, 275 (21.9%) patients had frequent (≥7) gout attacks. The OMERACT and MSUS median scores were 6 and 9, respectively. For each 5-point OMERACT and MSUS score increase, the risk of frequent gout attack increased 1.13-fold and 1.27-fold, respectively. The area under the curve (AUC) for the OMERACT and MSUS score was 0.654 (95% confidence interval [CI] 0.617-0.691) and 0.699 (95% CI: 0.663-0.735), respectively, (AUC difference 0.046, P-value for AUC difference, 0.013). Conclusions: The OMERACT and MSUS score were significantly associated with the risk of frequent gout attacks. The MSUS score outperformed the OMERACT in terms of frequent gout attack discrimination. Disclosure S.Yang: None. X.Lin: None. Y.Gao: None. N.Liang: None. Y.Han: None. H.Sun: None. S.Qu: None. H.Chen: None. Funding Key Technologies Research and Development Program of China (2019YFA0904500); National Natural Science Foundation of China (81870606, 82170904); Three-Year Action Plan (2022-2024) to Promote Clinical Skills and Innovation in Municipal Hospitals of Shanghai

Global, Regional, and National Prevalence of Gout From 1990 to 2019: Age-Period-Cohort Analysis With Future Burden Prediction.

Gout is a common and debilitating condition that is associated with significant morbidity and mortality. Despite advances in medical treatment, the global burden of gout continues to increase, particularly in high-sociodemographic index (SDI) regions. To address the aforementioned issue, we used age-period-cohort (APC) modeling to analyze global trends in gout incidence and prevalence from 1990 to 2019. Data were extracted from the Global Burden of Disease Study 2019 to assess all-age prevalence and age-standardized prevalence rates, as well as years lived with disability rates, for 204 countries and territories. APC effects were also examined in relation to gout prevalence. Future burden prediction was carried out using the Nordpred APC prediction of future incidence cases and the Bayesian APC model. The global gout incidence has increased by 63.44% over the past 2 decades, with a corresponding increase of 51.12% in global years lived with disability. The sex ratio remained consistent at 3:1 (male to female), but the global gout incidence increased in both sexes over time. Notably, the prevalence and incidence of gout were the highest in high-SDI regions (95% uncertainty interval 14.19-20.62), with a growth rate of 94.3%. Gout prevalence increases steadily with age, and the prevalence increases rapidly in high-SDI quantiles for the period effect. Finally, the cohort effect showed that gout prevalence increases steadily, with the risk of morbidity increasing in younger birth cohorts. The prediction model suggests that the gout incidence rate will continue to increase globally. Our study provides important insights into the global burden of gout and highlights the need for effective management and prophylaxis of this condition. The APC model used in our analysis provides a novel approach to understanding the complex trends in gout prevalence and incidence, and our findings can inform the development of targeted interventions to address this growing health issue.

Global, regional and national burdens of gout in the young population from 1990 to 2019: a population-based study

ObjectiveTo use data from the Global Burden of Disease (GBD) Study 2019 to report the global, regional and national rates and trends of annual incidence, point prevalence and years lived...

Global burden of gout in 1990-2019: A systematic analysis of the Global Burden of Disease study 2019.

Although gout is one of the most common rheumatic diseases, world data are lacking because most studies have focused on industrialized countries. Therefore, we aimed to investigate the global burden of gout and its associations with the year of diagnosis, age, geographical region, sociodemographic status and various further risk factors. Retrospective data from the Global Burden of Disease (GBD) were used, initially collected between 1990 and 2019. Raw numbers and age-standardized rates (per 100,000 persons) of prevalence, incidence and years lived with disability (YLDs) of gout were extracted from GBD 2019 for 204 countries and territories and stratified by sex, age, year, sociodemographic index and geographic region. Correlations between gout and other chronic diseases were identified, and the burden attributable to high body mass index (BMI) and kidney dysfunction was described. The total number of patients and gout age-standardized prevalence rate increased between 1990 and 2019. Gout was most prevalent in Australasia and high-income North America, and a higher sociodemographic index (SDI) was associated with higher age-standardized prevalence, incidence and YLDs. High BMI and kidney dysfunction were risk factors for gout, while gout was correlated with other kidney diseases. The global prevalence of gout, as well as incidence, and YLDs increased worldwide from 1990 to 2019 and had a significant association with sex, age, geographic region, SDI and risk factors. Understanding the complex interplay of environmental, sociodemographic and geographic risk factors is essential in mitigating the ever-rising disease burden of gout.

The burden of gout in acne keloidalis nuchae-Insights from a population-based study.

The risk of gout amid patients with acne keloidalis nuchae (AKN) has not been investigated in the past. To assess the risk of developing gout among patients with AKN relative to control subjects. A population-based retrospective study followed patients with AKN (n=2677) and age-, sex-, and ethnicity-matched control subjects (n=13 190). The incidence of new-onset gout was compared between the two groups. Hazard ratio (HR) for the risk of gout was obtained using a multivariate Cox regression model. The incidence rate of gout was 1.12 (95% CI, 0.68-1.76) and 0.48 (95% CI, 0.34-0.66) per 1000 person-years among patients with AKN and controls, respectively. The crude risk of developing gout was significantly higher in patients with AKN (HR, 2.27; 95% CI, 1.26-4.10; p=0.007). After controlling for age, sex, and ethnicity, AKN emerged as an independent risk factor of gout (adjusted HR, 2.34; 95% CI, 1.29-4.22; p=0.005). When adjusting for other confounders such as body mass index, diabetes mellitus, hypertension, and dyslipidemia, the risk of gout in AKN fell out of significance (adjusted HR, 1.39; 95% CI, 0.73-2.65; p=0.311), CONCLUSION: Patients with AKN experience an increased risk of gout. The risk is not independent and is mainly mediated through the metabolic comorbidities typifying AKN. We recommend screening for gout in patients with suggestive complaints.

Trend dynamics of gout prevalence among the Chinese population, 1990-2019: A joinpoint and age-period-cohort analysis.

BackgroundThe burden of gout is increasing worldwide, which places a heavy burden on society and healthcare systems. This study investigates the independent effects of age, period, and cohort on the gout prevalence from 1990 to 2019 in China, compares these effects by gender and then predicts the future burden of gout over the next decade.MethodsThe data were obtained from the Global Burden of Disease (GBD) study in 2019. Joinpoint regression model was employed to calculate the annual percentage change (APC) in gout prevalence, and the age-period-cohort analysis was utilized to estimate the independent effects of age, period, and cohort. ARIMA model was extended to predict the gout epidemic in 2020–2029.ResultsIn 2019, there were 16.2 million cases of gout in China, with an age-standardized prevalence rate (ASPR) of 12.3‰ and 3.9‰ in men and women, respectively. During 1990–2019, the ASPR of gout was increasing significantly, with an average APC of 0.9%. The periods of 2014–2017 and 2001–2005 were “joinpoint” for men and women (APC: 6.3 and 5.6%). The age-period-cohort analyses revealed that the relative risk (RR) of developing gout increased with age, peaking at 70–74 years in men (RRage(70−74) = 162.9) and 75–79 years in women (RRage(75−79)=142.3). The period effect trended upward, with a more rapid increase in women (RRperiod(2019) = 2.31) than men (RRperiod(2019) = 2.23). The cohort effect generally peaked in the earlier cohort born in 1905–1909 for both sexes. Gout prevalence showed a strong positive correlation with the consumption of meat and aquatic products (rmeat = 0.966, raquaticproducts = 0.953). Within 2029, the ASPR of gout was projected to be 11.7‰ and 4.0‰ in men and women, respectively.ConclusionThe prevalence of gout is increasing at an alarming rate in China; thus, it is necessary to provide targeted health education, regular screening, and accessible urate-lowering therapy healthcare to prevent and protect against gout in China, particularly in older women.