U.S. Gout Prevalence Swells

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According to a new study the U.S. has seen a swell in the prevalence of gout over the last twenty years. Prior research found that gout incidence in the U.S. more than doubled from the 1960s to 1990s. It has almost doubled again, swelling from 2.6% (NHANES III 1988-1994) to 4% in this new study.

The study, conducted by Dr. Hyon Choi, Professor of Medicine in the Section of Rheumatology and the Clinical Epidemiology Unit at Boston University School of Medicine in Massachusetts, has been published online in Arthritis & Rheumatism, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology (ACR).

Gout is an inflammatory arthritis triggered by crystallization of uric acid within the joints. Acute gout will typically manifest itself as an acutely red, hot, and swollen joint with excruciating pain.

The deposition of uric acid crystals is caused by an overproduction or under excretion of uric acid. Certain common medications, alcohol, and dietary foods are known to be contributory factors.

There is also medical evidence suggesting gout is strongly associated with metabolic syndrome—a group of health conditions characterized by central obesity, insulin resistance, high blood pressure and blood lipid issues—and may lead to heart attack, diabetes and premature death.

Choi, states, "Our study aim was to determine if the prevalence of gout and hyperuricemia among U.S. adults has continued to climb in the new millennium."

To this end, the researchers analyzed data from the latest U.S. National Health and Nutrition Examination Survey (NHANES) which was conducted in 2007 and 2008, comparing the data with those from previous NHANES III survey (1988-1994).

There were 5,707 participants who completed the most recent NHANES survey which included questions regarding history of gout diagnosed by a healthcare professional. Researchers defined hyperuricemia as serum urate level greater than 7.0 mg/dL in men and 5.7 mg/dL in women.

Of the 5,707 participants, slightly fewer than half were men, more than two-thirds were white, and the mean age was 47.

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The prevalence of hyperuricemia was 21.4% for the entire population, which added up to 43.3 million adults having high urate levels.

The prevalence of hyperuricemia among participants ages 20 to 29 was 18.6% (95% CI 14 to 23.1), increasing to 36.8% (95% CI 29 to 44.7) among those 80 and older.

The prevalence of gout (participants self-reporting having been told by a physician or other health professional that they have gout) was found to be 3.9% (8.3 million) among U.S. adults (5.9% among men and 2.0% among women).

This prevalence of gout was found to increase with age. For people in their 20s, the prevalence was 0.4%, rising to 12.6% among those in their 80s.

Results from the nationally-representative sample of adult Americans suggest gout and hyperuricemia remain prevalent in the U.S. and compared to earlier NHANES data was 1% and 3% higher, respectively. After adjusting for obesity or hypertension, the differences in prevalence rates were substantially lessened. Further analysis revealed that gout prevalence was higher in men (6%) compared to women (2%); hyperuricemia occurred in 21.2% of men and 21.6% of women.

Dr. Choi concluded, "We found that the prevalences of gout and hyperuricemia continue to be substantial in the U.S. adult population. Improvements in managing modifiable risk factors, such as obesity and hypertension, could help prevent further escalation of gout and hyperuricemia among Americans."

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The above story is reprinted (with editorial adaptations by Ramona Bates, MD) from materials provided by Wiley-Blackwell, via EurekAlert!, a service of AAAS and the below sources.

Source:
"Prevalence of Gout and Hyperuricemia in the US General Population." Yanyan Zhu, Bhavik J Pandya, Hyon K Choi." Arthritis & Rheumatism; Published Online: July 28, 2011 (DOI: 10.1002/art.30520). http://doi.wiley.com/10.1002/art.30520.

Centers for Disease Control and Prevention: Gout

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