Pathmanathan K, Robinson Philip C, Hill C L, Keen H I
Department of Rheumatology, Fiona Stanley Hospital, Perth, Australia.
University of Queensland, Faculty of Medicine, Queensland, Australia.
Semin Arthritis Rheum. 2021 Feb;51(1):121-128. doi: 10.1016/j.semarthrit.2020.12.001. Epub 2020 Dec 18.
Gout continues to increase in prevalence in developed countries with Oceanic countries particularly affected. Both gout and hyperuricaemia are associated with the metabolic syndrome and its sequelae. Recently, the Australian Institute for Health and Welfare (AIHW) reported a prevalence rate of 0.8% which appeared incongruous with other published research. Thus, an updated systematic review was undertaken to review the literature on the prevalence of gout and hyperuricaemia in Australia from data published after 2011.
A comprehensive, systematic search was conducted in MEDLINE, Embase and Web of Science in addition to relevant websites to identify research reporting the prevalence of gout and/or hyperuricaemia in Australia from May 2011 until June 2020. Crude gout and hyperuricaemia prevalence data was obtained and presented alongside case ascertainment, time-period, age range and stratified by gender if available.
118 full text articles were screened. 12 articles were included for analysis of gout prevalence. 4 articles were identified for the hyperuricaemia analysis. Wide variation in prevalence figures exist largely due study design and sample age range. Studies using a case definition of self-reported diagnosis of gout reported prevalence rates between 4.5% and 6.8%. The remaining studies used either electronic coding data from general practitioners or wastewater estimation of allopurinol consumption and documented adult prevalence rates between 1.5% and 2.9%. Prevalence increases with age, male sex and over time in keeping with global data. Hyperuricaemia prevalence ranged between 10.5% and 16.6% in Caucasian or an Australian representative population. AIHW estimates applied a chronic condition status, defined as current and lasted or expected to last more than six months, to cases of gout in the Australian National Health Survey. This likely results in an under-estimation in reported Australian gout prevalence rates.
Gout is highly prevalent in Australia compared to global comparisons and continues to increase over time. Hyperuricaemia prevalence is also high although contemporary data is limited.
在发达国家，痛风的患病率持续上升，大洋洲国家尤其受到影响。痛风和高尿酸血症均与代谢综合征及其后遗症相关。最近，澳大利亚卫生与福利研究所（AIHW）报告的患病率为0.8%，这一数字似乎与其他已发表的研究结果不一致。因此，开展了一项更新的系统评价，以根据2011年后发表的数据回顾澳大利亚痛风和高尿酸血症患病率的相关文献。
除了相关网站外，还在MEDLINE、Embase和科学网进行了全面、系统的检索，以识别2011年5月至2020年6月期间报告澳大利亚痛风和/或高尿酸血症患病率的研究。获取了痛风和高尿酸血症的粗患病率数据，并与病例确诊情况、时间段、年龄范围一并呈现，如有可用数据，还按性别进行了分层。
筛选了118篇全文文章。纳入12篇文章分析痛风患病率。确定4篇文章用于高尿酸血症分析。患病率数字存在很大差异，主要是由于研究设计和样本年龄范围不同。使用自我报告的痛风诊断病例定义的研究报告患病率在4.5%至6.8%之间。其余研究使用来自全科医生的电子编码数据或通过废水估算别嘌呤醇消费量，并记录成人患病率在1.5%至2.9%之间。患病率随年龄、男性性别和时间推移而增加，与全球数据一致。在白种人或澳大利亚代表性人群中，高尿酸血症患病率在10.5%至16.6%之间。AIHW的估计在澳大利亚国民健康调查中对痛风病例采用了慢性病状态定义，即当前存在且持续或预计持续超过六个月。这可能导致报告的澳大利亚痛风患病率被低估。
与全球相比，痛风在澳大利亚的患病率很高，且随时间持续上升。高尿酸血症患病率也很高，尽管当代数据有限。
