Trends in the manifestations of gout in Taiwan

To elucidate the recent changes in the clinical manifestations, risk factors and disorders associated with gout.

All gouty cases in Ho-Ping Gout Database were divided into two groups according to the date of first visit to our clinic: 1983-1991 (earlier group) and 1992-1999 (later group). Study variables were compared between these two groups.

In the later group, the age at onset of gout was lower by 2.7 yr (P < 0.0001) and the percentages of female gout and familial gout were higher (P = 0.0046 and P < 0.0001, respectively). Joint counts and the percentage of frequency of attacks > or =6 times/yr were lower in the later group (P < 0.0001), while the percentage of tophaceous gout was higher by 0.8% in the later group (P = 0.0004). The percentage of first attack at ankle was higher (P < 0.0001), while those at Achilles tendon, knee and upper extremity were lower in the later group (P < 0.0001). The percentages of diuretic use and alcohol consumption were lower in the later group (P < 0.0001). The percentages of obesity, hypertriglyceridaemia and nephrolithiasis were higher (P < 0.0001), while the percentages of hypertension and hypercholesterolaemia were lower in the later group (P < 0.0001 and P = 0.0003, respectively). The percentages of type 2 diabetes mellitus and renal insufficiency were not significantly different in multivariate analyses.

The age of onset, clinical manifestations, risk factors and disorders associated with gout have recently changed in Taiwan.