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. 2023 Apr 3;6(4):e239501.
doi: 10.1001/jamanetworkopen.2023.9501.

Trends in Prevalence of Gout Among US Asian Adults, 2011-2018

Chio Yokose  1   2 , Natalie McCormick  1   2   3 , Na Lu  3   4 , Sruthi Tanikella  1   2 , Kehuan Lin  1   2 , Amit D Joshi  4   5 , Laura M Raffield  6 , Erica Warner  2   7   8 , Tony Merriman  9   10 , John Hsu  2   11 , Kenneth Saag  9 , Yuqing Zhang  1   2 , Hyon K Choi  1   2   3
Affiliations

Trends in Prevalence of Gout Among US Asian Adults, 2011-2018

Chio Yokose et al. JAMA Netw Open. .

Abstract

Importance: Gout disparities among Black individuals in the US have recently been explained by socioclinical factors; however, no information is available among Asian individuals living in Western countries, despite their disproportionately worsening metabolic health.

Objective: To determine the prevalence of gout and serum urate concentrations according to race and ethnicity and to explore the association of social determinants of health and clinical factors.

Design, setting, and participants: This is a population-based, cross-sectional analysis. Data from a nationally representative sample of US adults were obtained from the National Health and Nutrition Examination Survey (NHANES) (2011-2018) in which Asian race data were collected (primary). Data from the UK Biobank (2006-2021) were used for replication of the Asian vs White differences. Data analysis was performed from December 2021 to September 2022.

Main outcomes and measures: Race-specific gout prevalence and serum urate levels.

Results: A total of 22 621 participants from NHANES (2011-2018) were included in the analysis (mean [SD] age, 49.8 [17.8] years; 10 948 male participants [48.4%]). In 2017 to 2018, gout affected 12.1 million US individuals, with its crude prevalence increasing from 3.6% (95% CI, 2.8%-4.5%) in 2011 to 2012 to 5.1% (95% CI, 4.2%-5.9%) in 2017 to 2018 (P for trend = .03); this trend was no longer significant after age adjustment (P for trend = .06) or excluding Asian individuals (P for trend = .11). During the same period, age- and sex-adjusted prevalence among Asian Americans doubled from 3.3% (95% CI, 2.1%-4.5%) to 6.6% (95% CI, 4.4%-8.8%) (P for trend = .007) to numerically exceed all other racial and ethnic groups in 2017 to 2018, with age- and sex-adjusted odds ratio (ORs) of 1.61 (95% CI, 1.03-2.51) and a socioclinical factor-adjusted multivariable OR of 2.62 (95% CI, 1.59-4.33) for Asian vs White individuals. The latest age- and sex-adjusted gout prevalence among US individuals aged 65 years and older was 10.0% among White individuals and 14.8% among Asian individuals (including 23.6% of Asian men). Serum urate concentrations also increased between 2011 and 2018 among US Asian individuals (P for trend = .009). The Asian vs White disparity was also present in the UK Biobank.

Conclusions and relevance: The findings of this study suggest that the prevalence of gout among Asian individuals numerically surpassed that for all other racial and ethnic groups in 2017 to 2018. This Asian vs White disparity did not appear to be associated with socioclinical factors.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Hsu reported receiving grants from the National Institutes of Health during the conduct of the study and performing consulting for Cambridge Health Alliance, NFP, and Altamed outside the submitted work. Dr Saag reported receiving grants from Allena, Amgen, Arthrosi, DYVE, Horizon, LG Chem, Radius, SOBI, Shanton, Takeda, and Ultragenex and personal fees from AbbVie, Amgen, Arthrosi, Atom Bioscience, Bayer, CSL Behring, Daiichi Sankyo, Gilead, Horizon, Inflazome, LG Pharma, Mallinkrodt, Radius, Roche/Genentech, SOBI, and Takeda outside the submitted work. Dr Choi reported receiving research support from Ironwood and Horizon; consulting fees from Ironwood, Selecta, Horizon, Takeda, Kowa, and Vaxart; and personal fees from LG Chem, Protalix, and ANI outside the submitted work. No other disclosures were reported.

Figures

Figure.
Figure.. Trends in Gout Prevalence by Race and Ethnicity, 2011-2018
Graph shows age- and sex-standardized prevalence of gout among different US racial and ethnic groups. Data are presented incorporating sample weights and adjusted for clusters and strata of the complex sample design of National Health and Nutrition Examination Survey, 2011 to 2018.
See this image and copyright information in PMC

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