Two-decade trajectories of gout: a multicentre cohort study of 10 658 Chinese patients with gout

Abstract Objective The objective of this study was to examine changes of age of onset and disease characteristics of gout between 2003 and 2022 in multiple centres in mainland China. Methods A cross-sectional cohort study was conducted among people with gout from two geographically separate centres in China. Baseline gout clinic data were collected through a electronic medical records review. The onset age trends and disease characteristics of patients who developed gout between 2003 and 2012 (first decade) and between 2013 and 2022 (second decade) were compared. Results A total of 10 658 patients were included. The age of gout onset declined over the two decades (Ptrend < 0.001), with the average onset age decreasing from 42.0 in 2003 to 38.9 years in 2022. The proportion of patients with an onset age of ≤19 and of 20–29 years increased annually by 5.8% and 9.6%, respectively (Ptrend < 0.05). Compared with age-, sex- and disease duration–matched patients in the first decade, patients who developed gout in the second decade were more likely to have a history of smoking and alcohol consumption, and less likely to engage in regular exercise (P < 0.001). Additionally, those with onset of gout in the second decade had higher rates of s.c. tophi, frequent gout flares, nephrolithiasis, hypertension and diabetes, though lower rates of dyslipidaemia (P < 0.05). Conclusion Over the past two decades in mainland China, there has been a noticeable trend towards younger onset of gout, alongside an increase in disease severity and metabolic comorbidities.