Department of Clinical and Experimental Medicine and Pharmacology, University of Messina, Via Consolare Valeria Gazzi, 98125 Messina, Italy.
Ann Rheum Dis. 2013 May;72(5):694-700. doi: 10.1136/annrheumdis-2011-201254. Epub 2012 Jun 26.
To assess the epidemiology of gout and hyperuricaemia in the Italian general population during the years 2005-2009.
Using the Italian primary care database (Health Search/CSD Longitudinal Patient Database), the prevalence, incidence and recurrence rates of gout and/or hyperuricaemia (serum urate level >360 mmol/l (6 mg/dl)) in outpatients aged ≥18 years during the years 2005-2009 were estimated. Rates together with 95% CI were measured overall and stratified by age, gender and calendar year. The characteristics of patients with newly diagnosed gout and hyperuricaemia were investigated and compared with the general population.
The prevalence of gout increased from 6.7 per 1000 inhabitants in 2005 to 9.1 per 1000 inhabitants in 2009. It increased with advancing age and was fourfold higher in men. A similar trend was observed for asymptomatic hyperuricaemia (85.4 per 1000 inhabitants in 2005 vs 119.3 per 1000 inhabitants in 2009). The incidence of gout remained stable during the observation years (0.93 per 1000 person years in 2005 vs 0.95 in 2009). Recurrent episode rate was 19.1% during the first year following the first gout attack and 31.6% during the following 5 years. Advanced age, increased levels of uric acid, nephrolithiasis and concomitant use of ciclosporin were the main predictors of recurrence of gout attacks.
The prevalence of gout and hyperuricaemia increased in Italy from 2005 to 2009. A high recurrence rate for gout attack was observed during the first year following the first episode. Early management of hyperuricaemia in patients at higher risk of recurrent gout attack should be considered in primary care.
评估 2005-2009 年意大利普通人群中痛风和高尿酸血症的流行病学情况。
利用意大利初级保健数据库(Health Search/CSD 纵向患者数据库),估算了 2005-2009 年期间≥18 岁门诊患者痛风和/或高尿酸血症(血清尿酸水平>360mmol/l(6mg/dl))的患病率、发病率和复发率。总体和按年龄、性别和日历年份分层的发生率均采用率及 95%置信区间(CI)进行测量。调查了新诊断为痛风和高尿酸血症患者的特征,并与普通人群进行了比较。
痛风的患病率从 2005 年的每 1000 名居民 6.7 例增加到 2009 年的每 1000 名居民 9.1 例。其随年龄增长而增加,且男性发病率是女性的四倍。无症状高尿酸血症也呈现出类似的趋势(2005 年为每 1000 名居民 85.4 例,2009 年为每 1000 名居民 119.3 例)。在观察期间,痛风的发病率保持稳定(2005 年为每 1000 人年 0.93 例,2009 年为每 1000 人年 0.95 例)。首次痛风发作后第一年的复发率为 19.1%,随后 5 年的复发率为 31.6%。高龄、尿酸水平升高、肾结石和环孢素同时使用是痛风发作复发的主要预测因素。
2005-2009 年意大利痛风和高尿酸血症的患病率增加。首次发作后第一年痛风发作的复发率较高。在初级保健中,应考虑对有更高复发性痛风发作风险的患者进行高尿酸血症的早期管理。