The Rising Incidence of Gout and the Increasing Burden of Comorbidities: A Population-based Study over 20 Years

J Rheumatol. 2018 Apr;45(4):574-579. doi: 10.3899/jrheum.170806. Epub 2017 Dec 15.

Abstract

Objective: To examine the incidence of gout over the last 20 years and to evaluate possible changes in associated comorbid conditions.

Methods: The medical records were reviewed of all adults with a diagnosis of incident gout in Olmsted County, Minnesota, USA, during 2 time periods (January 1, 1989-December 31, 1992, and January 1, 2009-December 31, 2010). Incident cases had to fulfill at least 1 of 3 criteria: the American Rheumatism Association 1977 preliminary criteria for gout, the Rome criteria, or the New York criteria.

Results: A total of 158 patients with new-onset gout were identified during 1989-1992 and 271 patients during 2009-2010, yielding age- and sex-adjusted incidence rates of 66.6/100,000 (95% CI 55.9-77.4) in 1989-1992 and 136.7/100,000 (95% CI 120.4-153.1) in 2009-2010. The incidence rate ratio was 2.62 (95% CI 1.80-3.83). At the time of their first gout flare, patients diagnosed with gout in 2009-2010 had higher prevalence of comorbid conditions compared with 1989-1992, including hypertension (69% vs 54%), diabetes mellitus (25% vs 6%), renal disease (28% vs 11%), hyperlipidemia (61% vs 21%), and morbid obesity (body mass index ≥ 35 kg/m2; 29% vs 10%).

Conclusion: The incidence of gout has more than doubled over the recent 20 years. This increase together with the more frequent occurrence of comorbid conditions and cardiovascular risk factors represents a significant public health challenge.

Keywords: COMORBIDITY; EPIDEMIOLOGY; GOUT; INCIDENCE.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Chi-Square Distribution
  • Comorbidity / trends
  • Diabetes Mellitus / epidemiology*
  • Female
  • Gout / epidemiology*
  • Humans
  • Hyperlipidemias / epidemiology*
  • Hypertension / epidemiology*
  • Incidence
  • Kidney Diseases / epidemiology*
  • Male
  • Middle Aged
  • Minnesota / epidemiology
  • Obesity, Morbid / epidemiology*
  • Poisson Distribution
  • Prevalence
  • Retrospective Studies
  • Statistics, Nonparametric