Gout epidemiology and comorbidities
Jasvinder A Singh1, Angelo Gaffo2
1Medicine Service, Birmingham VA Medical Center, Birmingham, AL, United States; School of Medicine, Department of Medicine, Division of Rheumatology, University of Alabama at Birmingham, AL, United States; School of Public Health, Department of Epidemiology, University of Alabama at Birmingham, AL, United States.
Insights
Gout, the most common inflammatory arthritis, affects 1-4% globally, with higher rates in men, the elderly, and minorities. Common comorbidities like hypertension and kidney disease complicate gout management.
Area of Science:
- Rheumatology
- Epidemiology
- Internal Medicine
Background:
- Gout is the most prevalent inflammatory arthritis globally.
- It disproportionately affects men, the elderly, and racial/ethnic minorities.
- Associated comorbidities significantly increase disease burden and complicate management.
Purpose of the Study:
- To review the epidemiology of gout.
- To examine comorbidities associated with gout.
Main Methods:
- Systematic review of published studies on gout epidemiology and comorbidities.
Main Results:
- Global gout prevalence is 1-4%, with incidence at 0.1-0.3%.
- Gout is 3-10 times more common in men than women, increasing with age, particularly over 80.
- Higher prevalence is observed in U.S. racial minorities, Māori, Han Chinese, and Asian ethnic groups.
- Comorbidities are frequent, including hypertension (up to 75%), chronic kidney disease (stage 3+), metabolic syndrome, and diabetes.
- Associations with cardiovascular disease, stroke, and neurodegenerative disorders are under investigation.
Conclusions:
- Gout is the leading inflammatory arthritis worldwide.
- Disease burden is higher in men, the elderly, and minorities.
- Frequent comorbidities present significant management challenges.
Objective:
To review the epidemiology of gout and associated comorbidities.
Methods:
We review the key published studies of the epidemiology of gout and associated comorbidities.
Results:
The prevalence of gout ranged 1-4% worldwide and incidence ranged 0.1-0.3%. Gout is more common in men vs. women by 3:1 to 10:1. Gout incidence and prevalence increased by each decade of life, with prevalence increasing to 11-13% and incidence increasing to 0.4% in people older than 80 years. Racial minorities in the U.S., New Zealand Māori, Han Chinese and some ethnic groups in Asia have a higher prevalence of gout. Comorbidities are common in people with gout and complicate its management and disease outcomes. Hypertension is present in up to three-quarters of gout patients and could be in the causal pathway of its association with cardiovascular disease and stroke. Chronic kidney disease of stage 3 or greater severity is present in many patients with gout. Appropriate management can improve both gout and stabilize chronic kidney disease. Whether the association of gout with metabolic syndrome and diabetes is causal is still controversial. Given the biological anti-oxidant effect of serum urate, the association of gout with neurodegenerative disorders is being actively explored.
Conclusions:
Gout is the most common inflammatory arthritis in adults worldwide, with a disproportionate burden of disease in men, the elderly and racial/ethnic minorities. Comorbidities in gout are very common and add further to the disease morbidity and make its management challenging.
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