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

• Published in: Journal of rheumatology Vol. 45; no. 4; p. 574
• Main Authors: Elfishawi, Mohanad M, Zleik, Nour, Kvrgic, Zoran, Michet, Jr, Clement J, Crowson, Cynthia S, Matteson, Eric L, Bongartz, Tim
• Format: Journal Article
• Language: English
• Published: Canada 01.04.2018
• Subjects: 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; Minnesota; INCIDENCE; GOUT; EPIDEMIOLOGY; COMORBIDITY
• ISSN: 0315-162X
• DOI: 10.3899/jrheum.170806

To examine the incidence of gout over the last 20 years and to evaluate possible changes in associated comorbid conditions. 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. 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/m ; 29% vs 10%). 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.