Gout: global epidemiology, risk factors, comorbidities and complications: a narrative review

Abstract

Background: Gout is one of the oldest known diseases and the most common form of inflammatory arthritis. The established risk factors for gout include hyperuricemia, chronic renal disease, genetic, alcohol consumption, dietary factors, diuretic use, hypertension, obesity, and metabolic syndrome. Patients with gout have an increased risk of all-cause mortality, particularly from cardiovascular disease, cancer, and infectious diseases. Gout is also associated with several complications, such as nephrolithiasis. This literature review describes the global epidemiology and trends associated with gout, before providing an overview of its risk factors and complications.

Methods: This research used the narrative review method. Thorough searches were performed in PubMed and Google scholar, up to June 15, 2024, for articles that evaluated the risk factors, comorbidities or complications associated with gout. Moreover, we also included studies that reported the epidemiological characteristics or burden of gout at the global, regional, or national level.

Results: Gout is more prevalent in developed countries, than in developing countries, although its prevalence is increasing globally. In addition, gout is much more prevalent among males than among females. Hyperuricemia has the largest role in the development of gout, although many risk factors contribute to the increasing prevalence of gout, including genes, several medications, and diet. Gout is associated with several comorbidities and complications, which need to be taken into consideration when managing gout. In recent years, gout has been found to be associated with several new comorbidities.

Conclusions: Our findings provide a comprehensive and informative overview that can be useful for the prevention, diagnosis, and management of gout.

Keywords: Epidemiology; Global Burden of Disease; Gout; History; Hyperuricemia; Risk factor.

Fig. 1

Age-standardised point prevalence (A), incidence rate (B), and years lived with disability (YLDs) rate (C) of gout per 100,000 population in 2019, by country. (Generated from data available from http://ghdx.healthdata.org/gbd-results-tool)

Fig. 2

Global number of prevalent cases and point prevalence (A), incident cases and incidence rate (B) and years lived with disability (YLDs) and YLD rate (C) of gout per 100,000 population, by age and sex in 2019; Dotted and dashed lines indicate 95% upper and lower uncertainty intervals, respectively. (Generated from data available from http://ghdx.healthdata.org/gbd-results-tool)

Fig. 3

Age-standardised years lived with disability (YLDs) and the rate of gout for the 21 GBD regions, by SDI in 2019; Expected values based on the Socio-demographic Index and disease rates in all locations are shown as the black line. Each point shows the observed age-standardised YLD rate for each country in 2019. (Generated from data available from http://ghdx.healthdata.org/gbd-results-tool)