Gout Disease Burden Rose from 1990 to 2019 But Will Stay Similar to 2019 Rate by 2030

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The global prevalence rate, incidence rate, and disability-adjusted life years (DALYs) rate of gout doubled from 1990 to 2019, a new retrospective analysis found.¹

“Gout is a highly common disease, accounting for a substantial proportion of the global disease burden,” investigators wrote. “The increasing burden of gout needs global attention.”

Another study exploring the same topic found from 1990 – 2019 the global prevalence rose from 22 million to 53 million. The growth rate of gout incidence was 63.44%.² Not only does gout cause a lot of joint pain, but a gout attack can increase the risk of cardiovascular events, and gout is independently linked to an increased risk of death from kidney disease.¹

Like the 2023 study, the new study also found a significant increase in worldwide gout prevalence from 1990 – 2019. Led by Tingfen Han, from the department of traditional Chinese medicine at Taizhou Hospital of Zhejiang Province affiliated with Wenzhou Medical University in China, the team sought to understand the global burden of gout in the past and future, as well as predict the gout burden in 2030.

To assess variations in the global burden and risk factors of gout in 204 countries and territories from 1990 – 2019, the team leveraged data on the Global Burden of Disease 2019 database. They collected data on prevalence, incidence, and DALYs of gout, and then stratified that data by age, sex, and economic development level. The team assessed the data through a decomposition analysis, frontier analysis, and prediction models.

The team saw more than double cases of gout in 2019 than 1990 worldwide with 53,871,846.4 prevalent cases (95% uncertainty interval [UI] 3,383,204.6 – 66,342,327.3), 92,228,86.8 incident cases (95% UI, 7419,132.1 – 11,521,165), and 1673,973.4 cases of DALYs of gout (95% UI, 1,068,061.1 – 2,393,469.2). Overall, gout prevalence, incidence, and DALYs increased by 22.4%, 18%, and 22.2%, respectively.

Likewise, the pace of the increase of the age-standardized prevalence rate, age-standardized incidence rate, and age-standardized DALY rate rose from the years 1990 to 2019. The annual percentage of pace changes were estimated to be 0.94 (95% confidence interval [CI], 0.85 – 1.03), 0.77 (95% CI, 0.69 – 0.84), and 0.93 (95% CI, 0.84 – 1.02), respectively.

Investigators found DALYs increased with age in 2019 except for those in the 75 – 84 age group. Females aged 65 – 69 years and males aged 60 – 64 years had a greater prevalence, incidence, and DALYs of gout—and men had 2.5 – 3.5 greater rates than women did. However, females ≥ 95 years old had a greater rate of gout.

“The incidence and prevalence rates of gout among young and middle-aged women are lower than those in men,” investigators wrote. “However, this advantage in women disappears after menopause. In addition to estrogen, diet may play a role by regulating inflammatory pathways.”

The team observed the disease burden of gout increased in 20 GBD regions, excluding Western Sub-Saharan Africa. In 2019, the United States had the greatest gout prevalence (1752 (95% UI: 1507.1–2016.7), incidence 216.9 (95% UI: 181.5–259.9), and DALYs (95% UI: 35–73.6) per 100,000 populations. The US also had the greatest increase in prevalence (85.8%), incidence (61%), and DALYs (84.5%), of gout burden from 1990 - 2019 compared to other countries; Australia followed with 44.7%, 30.3%, and 44.5%, respectively.

Countries with the greatest risk of high body mass index (BMI) and kidney dysfunction were in high-income countries including North America and East Asia.

Overall, investigators found the global prevalence rate, incidence rate, and DALYs rate of gout in 2030 will reach 599.86, 102.96, and 20.26 per 100,000 population, respectively, which is around the same as in 2019.

Limitations the investigators pointed out include the estimations potentially being underestimated in low- and middle-income areas due to the lack of medical resources, not considering comorbidities that could affect the burden of gout such as gouty nephropathy, and the relationship between DALYs and the sociodemographic index cannot be considered a causal relationship.

“Health management institutions need relevant epidemiological data for supervision within their jurisdiction to mitigate the pandemic of gout,” investigators concluded. “This study provides an epidemiological data reference for health management institutions.”

^References

1. ^{Han T, Chen W, Qiu X, Wang W. Epidemiology of gout - Global burden of disease research from 1990 to 2019 and future trend predictions. Ther Adv Endocrinol Metab. 2024;15:20420188241227295. Published 2024 Mar 4. doi:10.1177/20420188241227295}
2. ^{He Q, Mok TN, Sin TH, et al. Global, Regional, and National Prevalence of Gout From 1990 to 2019: Age-Period-Cohort Analysis With Future Burden Prediction. JMIR Public Health Surveill. 2023;9:e45943. Published 2023 Jun 7. doi:10.2196/45943}