Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.
Division of Rheumatology, Allergy, and Immunology, Department of Medicine, and the Mongan Institute, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
BMJ Open. 2024 Jan 29;14(1):e079665. doi: 10.1136/bmjopen-2023-079665.
The incidence of gout in the UK appears to have declined since 2013; however, whether such a trend occurred across participants born in different years (ie, birth cohort) is unknown. We aimed to examine the effects of the birth cohort on gout incidence using an age-period-cohort (APC) model.
Cross-sectional study.
Nationwide data from the UK primary care database.
Individuals between 30 and 89 years of age were included. We excluded individuals who had gout history when entering the database and individuals with less than 1 year of continuous follow-up between 1 January 1999 and 31 December 2019.
Gout was identified using READ codes assigned by general practitioners. The incidence of gout between 1999-2013 and 2011-2019 was analysed with APC model.
The incidence of gout between 1999 and 2013 increased with birth cohorts. Compared with those born in 1949-1953 (reference), the age-adjusted and period-adjusted rate ratios (RRs) of incident gout increased from 0.39 (95% CI 0.34 to 0.46) in participants born in 1910-1914 to 2.36 (95% CI 2.09 to 2.66) in participants born in 1979-1983 (p for trend <0.001). In contrast, the incidence of gout between 2011 and 2019 decreased with birth cohorts. Compared with those born in 1949-1953 (reference), the age-adjusted and period-adjusted RRs of incident gout declined from 2.75 (95% CI 2.30 to 3.28) in participants born in 1922-1926 to 0.75 (95% CI 0.65 to 0.87) in participants born in 1976-1980 but then increased slightly to 0.95 (95% CI 0.77 to 1.17) in participants born in 1985-1989.
The gout incidence between 1999 and 2013 in the UK increased with the birth cohorts and then decreased between 2011 and 2019 except for those born after 1980. Future monitoring is needed to help identify aetiological factors and guide preventive and treatment strategies for gout.
自 2013 年以来，英国痛风的发病率似乎有所下降；然而，不同年份（即出生队列）出生的参与者中是否存在这种趋势尚不清楚。我们旨在使用年龄-时期-队列（APC）模型研究出生队列对痛风发病率的影响。
横断面研究。
来自英国初级保健数据库的全国性数据。
年龄在 30 至 89 岁之间的个体被纳入研究。我们排除了在进入数据库时就有痛风病史的个体，以及在 1999 年 1 月 1 日至 2019 年 12 月 31 日之间连续随访时间少于 1 年的个体。
痛风使用全科医生分配的 READ 代码来确定。使用 APC 模型分析了 1999 年至 2013 年和 2011 年至 2019 年之间的痛风发病率。
1999 年至 2013 年间，痛风的发病率随出生队列而增加。与出生于 1949-1953 年的人群（参照）相比，出生于 1910-1914 年的参与者的年龄调整和时期调整的痛风发病率比值（RR）从 0.39（95%CI 0.34-0.46）增加到出生于 1979-1983 年的参与者的 2.36（95%CI 2.09-2.66）（p<0.001）。相比之下，2011 年至 2019 年间，痛风的发病率随出生队列而降低。与出生于 1949-1953 年的人群（参照）相比，出生于 1922-1926 年的参与者的年龄调整和时期调整的痛风发病率 RR 从 2.75（95%CI 2.30-3.28）下降到出生于 1976-1980 年的参与者的 0.75（95%CI 0.65-0.87），但随后略有上升至出生于 1985-1989 年的参与者的 0.95（95%CI 0.77-1.17）。
1999 年至 2013 年期间，英国痛风的发病率随出生队列而增加，而在 2011 年至 2019 年期间，除了 1980 年后出生的人之外，发病率有所下降。需要进一步监测，以帮助确定病因，并指导痛风的预防和治疗策略。
