Younger age of onset of gout in Taiwan

To study the clinical features of gout in the community and in medical centres, and to describe the recent changes in gout in Chinese patients.

We analysed retrospectively the clinical features of 1079 Chinese gout patients seen by a rheumatologist between 1993 and 2000. These included 558 patients from a private clinic and 521 patients from a medical centre. The data were compared with those in previous reports of large Caucasian and non-Caucasian series.

The mean age of onset was 41.6 yr and the mean disease duration before first visit was 4.2 yr. For medical centre patients, the mean age of onset was 43.0 yr and mean disease duration before the first visit was 4.8 yr. For private clinic patients, the mean age of onset was 40.2 yr and mean disease duration before the first visit was 3.6 yr. Young patients with gout, with onset before age 30, constituted 23.3 and 26.7% of the medical centre and private clinic patients respectively. Female patients constituted 10.6 and 5.6% respectively, the family history was positive in 27.1 and 28.7%, and urolithiasis occurred in 11.5 and 10.9%. Tophi were found in 21.1% of medical centre and 12.7% of private clinic patients. The mean time from first gouty attack to visible tophi was 6.6 yr in those who developed tophi.

The age at onset of gout was much earlier than in previous reports. Twenty-five per cent of patients had their first gouty attack before age 30. The first attack frequently occurred between the third and fifth decades (68.2%) rather than between the fourth and sixth decades, as reported in previous papers. The incidence of gout in females had increased (8.0% of the patients were female) and the incidence of tophi was high (16.8%). Besides, our patients had more frequent gouty attacks and the interval from the first attack to visible tophi was shorter than in previous reports of the disease in Caucasians.