Two-decade trajectories of gout: a multi-center cohort study of 10,658 Chinese patients with gout

Abstract Objective To examine changes of age of onset and disease characteristics of gout between 2003 and 2022 in multiple centers in mainland China. Methods A cross-sectional cohort study was conducted among people with gout from two geographically separate centers in China. Baseline gout clinic data were collected through electronic medical records review. The onset age trends and disease characteristics of patients who developed gout between 2003–2012 (1st decade) and 2013–2022 (2nd 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 2003–38.9 years in 2022. The proportion of patients with an onset age ≤19 and 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 1st decade, patients who developed gout in the 2nd 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 2nd decade had higher rates of subcutaneous tophi, frequent gout flares, nephrolithiasis, hypertension and diabetes, though lower rates of dyslipidaemia (p< 0.05). Conclusions Over the past two decades in mainland China, there has been a noticeable trend toward younger onset of gout, alongside an increase in disease severity and metabolic comorbidities.