Prevalence, Incidence, and Years Lived With Disability Due to Gout and Its Attributable Risk Factors for 195 Countries and Territories 1990–2017: A Systematic Analysis of the Global Burden of Disease Study 2017

Abstract

Objective To describe the levels and trends of point prevalence, annual incidence, and years lived with disability (YLD) for gout and its attributable risk factors in 195 countries and territories from 1990 to 2017 according to age, sex, and Sociodemographic Index (SDI; a composite of sociodemographic factors). Methods Data were extracted from the Global Burden of Disease (GBD) 2017 study. A comprehensive systematic review of databases and the disease‐modeled analysis were performed by the GBD team at the Institute for Health Metrics and Evaluation, in collaboration with researchers and experts worldwide, to provide estimates at global, regional, and national levels during 1990 and 2017. Counts and age‐standardized rates per 100,000 population, along with 95% uncertainty intervals (95% UIs), were reported for point prevalence, annual incidence, and YLD. Results Globally, there were ~41.2 million (95% UI 36.7 million, 46.1 million) prevalent cases of gout, with 7.4 million incident cases per year (95% UI 6.6 million, 8.5 million) and almost 1.3 million YLD (95% UI 0.87 million, 1.8 million) in 2017. The global age‐standardized point prevalence estimates and annual incidence rates in 2017 were 510.6 (95% UI 455.6, 570.3) and 91.8 (95% UI 81.3, 104.1) cases per 100,000 population, respectively, an increase of 7.2% (95% UI 6.4%, 8.1%) and 5.5% (95% UI 4.8%, 6.3%) from 1990. The corresponding age‐standardized YLD rate was 15.9 (95% UI 10.7, 21.8) cases per 100,000 persons, a 7.2% increase (95% UI 5.9%, 8.6%) from 1990. In 2017, the global point prevalence estimates for gout were higher in males, and higher prevalence was seen in older age groups and increased with age for both males and females. The burden of gout was generally highest in developed regions and countries. The 3 countries with the highest age‐standardized point prevalence estimates of gout in 2017 were New Zealand (1,394.0 cases [95% UI 1,290.1, 1,500.9]), Australia (1,171.4 cases [95% UI 1,038.1, 1,322.9]), and the US (996.0 cases [95% UI 923.1, 1,076.8]). The countries with the highest increases in age‐standardized point prevalence estimates of gout from 1990 to 2017 were the US (34.7% [95% UI 27.7%, 43.1%]), Canada (28.5% [95% UI 21.9%, 35.4%]), and Oman (28.0% [95% UI 21.5%, 34.8%]). Globally, high body mass index and impaired kidney function accounted for 32.4% (95% UI 18.7%, 49.2%) and 15.3% (95% UI 13.5%, 17.1%), respectively, of YLD due to gout in the 2017 estimates. The YLD attributable to these risk factors were higher in males. Conclusion The burden of gout increased across the world from 1990 to 2017, with variations in point prevalence, annual incidence, and YLD between countries and territories. Besides improving the clinical management of disease, prevention and health promotion in communities to provide basic knowledge of the disease, risk factors, consequences, and effective treatment options (tailoring to high‐risk groups such as the middle‐aged male population) are crucial to avoid disease onset and hence to decrease the global diseas...

A Randomized Pilot Study of DASH Patterned Groceries on Serum Urate in Individuals with Gout

“…The disease burden of gout has been increasing worldwide, a trend thought to be driven by concurrent epidemics in obesity and Western lifestyle [1][2][3][4]. Interventions that can effectively reduce serum urate (SU) while simultaneously improving cardiovascular risk factors are critically needed to prevent and treat gout comprehensively.…”

Gout, Hyperuricaemia and Crystal-Associated Disease Network (G-CAN) common language definition of gout

“…Gout is a common disease with increasing incidence and prevalence, particularly in Western or westernising countries, paralleling the obesity epidemic over recent decades. [8][9][10][11] There are currently an estimated 41 million people worldwide with gout. 10 It is the most common form of inflammatory arthritis, 12 estimated to affect about 4% of the population in the USA, 13 2%-3% in the 14 UK and 0.9%-2.5% in Europe.…”

“…[8][9][10][11] There are currently an estimated 41 million people worldwide with gout. 10 It is the most common form of inflammatory arthritis, 12 estimated to affect about 4% of the population in the USA, 13 2%-3% in the 14 UK and 0.9%-2.5% in Europe. 15 It is more common in men, with a prevalence of 5.2% in men and 2.7% in women.…”

“…[64][65][66] A recent Global Burden of Disease analyses of 195 countries and territories between 1990 and 2017 found that high body mass index accounted for 53.4% and 48.6% of the years lived with disability for gout in high-income North America and Australasia. 10 Early adult obesity in women was associated with a 2.8-fold increased risk of gout compared with nonobese women in a study using data from the Atherosclerosis Risk in Communities (ARIC) study. 67 Higher meat intake (particularly red meat), seafood intake and alcohol consumption are associated with an increased risk of hyperuricaemia, [68][69][70] incident gout 71 72 and recurrent gout flares 73 74 partly because their high purine content raises urate levels, as demonstrated by short-term metabolic experiments of purine loading in animals and humans.…”

Urate Crystals; Beyond Joints

“…The burden of gout is substantial, and epidemiological data suggest that the prevalence of gout may be increasing, with a global prevalence estimated at ∼3% (1,2). The United States has seen more than 7% increase in prevalence of gout over the past two decades (3). Some of the medical societies recommend that it should be treated with urate-lowering therapies only for the cases with acute form of disease (4).…”