Abstract
•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.
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.
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 onset≤30 years old was defined as early-onset and>30 years as late-onset. Clinical features and risk factors were compared between the groups.
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.
The manifestations of gout in China have changed over the last decade, associated with a trend towards younger onset.