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Trends in the manifestations of 9754 gout patients in a Chinese clinical center: A 10-year observational study - 18/11/21

Doi : 10.1016/j.jbspin.2020.09.010 
Qianhui Gao a, 1, Xiaoyu Cheng a, 1, Tony R. Merriman b, c, d, Can Wang a, Lingling Cui a, Hui Zhang b, Wenyan Sun b, Jing Wang e, f, Feiyue Wang e, f, Changgui Li a, b, Jie Lu a, b,
a Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, Department of Endocrinology and Metabolism, the Affiliated Hospital of Qingdao University, 266003 Qingdao, China 
b Institute of Metabolic Diseases, Qingdao University, 266003 Qingdao, China 
c Department of Biochemistry, University of Otago, Dunedin, New Zealand 
d Division of Clinical Immunology and Rheumatology, University of Alabama Birmingham, Alabama, USA 
e Institute of Smart Healthcare Systems, Qingdao Academy of Intelligent Industries, 266109 Qingdao, China 
f The State Key Laboratory for Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, 100190 Beijing, China 

Corresponding author at: Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, 266003 Qingdao, China.Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao UniversityQingdao266003China

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Highlights

Remarkable changes have occurred in the manifestations of gout over the last decade in China.
We demonstrated these changes were attributed to the younger trend of gout.
Compared with late-onset gout patients, early-onset gout patients have their own unique characteristics, which should be effectively distinguished in clinical treatment.
To uncover the clinical features of gout will help us to diagnose and prevent gout and further control the rising prevalence of gout and hyperuricemia in the younger population.

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Abstract

Objective

The prevalence of gout is increasing but studies of its clinical features in large samples are lacking. This study aimed to clarify changes in the clinical manifestations of gout in China over the last decade and investigate the clinical features and risk factors of early-onset gout.

Methods

Clinical manifestations were compared between 9754 gout patients who first presented at our clinic with gout in 2008–2012 (earlier group) or 2013–2018 (later group). Gout onset30 years old was defined as early-onset and>30 years as late-onset. Clinical features and risk factors were compared between the groups.

Results

The gout-onset age was 4.14 years younger and the percentage of early-onset gout (3827 patients) was higher in the later 2013–2018 group (5979 patients). The disease duration was significantly shorter (5.72±0.09 vs. 6.01±0.11 years P < 0,05) and the ratio of patients with tophi was correspondingly lower in the later group (22.0% vs. 20.0%, P < 0,05). More patients were obese (32.6% vs. 37.7%, P<0.001) and serum urate levels (465.0±1.9μmol/L vs. 485.5±1.5μmol/L) were significantly higher in the later group. As the age of gout-onset became younger, we did the multivariate logistic regression and identified a positive family history, male sex, obesity, elevated serum urate, and sugar-sweetened soft drinks as independent predictors of early-onset gout.

Conclusion

The manifestations of gout in China have changed over the last decade, associated with a trend towards younger onset.

Il testo completo di questo articolo è disponibile in PDF.

Keywords : Gout, Early-onset, Risk factors


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