Worldwide trends in hyperuricaemia from 2000 to 2023: a systematic review and modelling analysis

Hyperuricaemia is not currently included in major global health surveillance frameworks, including the Global Burden of Diseases, Injuries, and Risk Factors Study, despite its well established clinical associations with non-communicable diseases. The absence of harmonised, comparable sex-specific prevalence estimates of hyperuricaemia across countries has limited its visibility in public health planning and prevention strategies. We aimed to provide the first standardised, sex-specific, global, regional, and national estimates of hyperuricaemia prevalence and cases from 2000 to 2023.

For this systematic review and modelling analysis, we searched PubMed, EMBASE, and Global Index Medicus for population-based studies reporting hyperuricaemia prevalence in adults between Jan 1, 2000, and April 8, 2025, without any language restrictions. Accounting for age, sex, hyperuricaemia diagnostic thresholds, urbanisation, and national income, prevalence estimates were generated with Bayesian hierarchical metaregression for 200 countries and territories from 2000 to 2023, with uncertainty expressed as 95% credible intervals (CrIs). No individuals with lived experience of hyperuricaemia were involved in the design or conduct of the study. The protocol was registered with PROSPERO (CRD420251145761).

We included 402 reports (420 studies) comprising 709 prevalence data points from 7 488 451 adults in 34 countries. Globally, the prevalence of hyperuricaemia increased from 6·7% (95% CrI 5·0-9·5) to 11·2% (8·2-15·2) in women and from 12·3% (9·8-17·0) to 18·6% (14·6-25·1) in men between 2000 and 2023. Prevalent cases of hyperuricaemia rose from 126 million (95% CrI 93-178) to 305 million (222-414) in women and from 226 million (180-312) to 500 million (392-676) in men, with population growth and ageing explaining roughly half the increase. Prevalence was consistently higher in high-income and urban settings, and increased with age in both men and women, with sex differences narrowing in older age groups. Prevalence rose in all regions, with the largest absolute increases in Polynesia and Micronesia among women (9·2 [95% CrI 2·9-10·9] percentage points) and in East Asia among men (10·8 [10·7-10·9] percentage points). In 2023, regional prevalence in women ranged from 4·0% (95% CrI 2·8-5·9) in North Africa and the Middle East to 42·6% (17·3-61·9) in Polynesia and Micronesia, and in men it ranged from 7·5% (4·9-11·2) in central Asia to 36·5% (12·0-66·8) in Polynesia and Micronesia. South Asia had the highest number of prevalent cases in 2023 (102 million [95% CrI 33-196] women and 120 million [37-266] men). At the country level, between 2000 and 2023, prevalence increased in 199 countries and territories among women and in 195 countries and territories among men. In 2023, country-level prevalence ranged from 1·4% (95% CrI 1·0-2·1) in Yemen to 55·8% (22·6-75·8) in the Cook Islands among women, and from 3·7% (2·3-5·9) to 46·5% (14·2-78·6) in the same countries among men.

The global prevalence and prevalent cases of hyperuricaemia have risen markedly over the past two decades in both men and women, driven by population growth, ageing, and increasing age-specific rates. Although substantial heterogeneity exists across regions and countries, prevalence is consistently higher in high-income and urban settings and increases with age. These findings highlight the need to integrate hyperuricaemia into non-communicable disease surveillance systems and to implement targeted prevention and early management strategies to mitigate the associated metabolic and cardiovascular complications.

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