中国痛风的全球负担及其变化趋势与预测：基于《2021年全球疾病负担研究》的分析

Global burden of gout and its changing trends and predictions in China: An analysis based on Global Burden of Disease Study 2021.

作者信息

Jin Shuai, Wang Yuhan, Yan Shuangtong, Fu Xiaomin, Hu Xiaodong, Lyu Zhaohui, Liu Hongzhou

机构信息

School of Biology and Engineering (School of Health Medicine Modern Industry), Guizhou Medical University, Guiyang, Guizhou 561113, China.

Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital, Beijing 100853, China.

出版信息

Chin Med J (Engl). 2025 Jul 2. doi: 10.1097/CM9.0000000000003631.

DOI:10.1097/CM9.0000000000003631

PMID:40596775

Abstract

BACKGROUND

Gout is a chronic disease primarily caused by elevated urate levels, severely affecting joint health. Its global distribution varies, and updated data for China are lacking. This study aimed to analyze the current burden and trends of gout globally and in China, examining the burden by gender, age, and risk factors while providing future predictions.

METHODS

This descriptive epidemiological secondary analysis utilized data from the Global Burden of Disease, Injuries, and Risk Factors (GBD) 2021 study. Age-standardized incidence (ASIR), prevalence (ASPR), and disability-adjusted life years (DALYs) rates (ASDR) were used to assess the gout burden. Trends from 1990 to 2021 were analyzed across global regions, genders, and sociodemographic index (SDI) levels. The burden in China was further examined by gender, age, and associated risk factors. The Bayesian age-period-cohort (BAPC) model was used to predict future trends. Gout burden in China and the United States was compared.

RESULTS

In 2021, gout affected 57 million people globally, with 9.4 million new cases and 1.75 million DALYs. From 1990 to 2021, the ASIR, ASPR, and ASDR increased by 17.2%, 21.9%, and 21.3%, respectively. Males experienced a significantly higher burden, with greater ASIR, ASPR, and ASDR increasing with higher SDI levels. In China, male ASIR, ASPR, and ASDR were over 2.8 times those of females, and the burden increased with age. In 2021, 31.4% of gout-related DALYs in China were attributed to high body mass index and 7.6% to kidney dysfunction. Between 1990 and 2021, the high body mass index-related burden rose annually for both genders, while the kidney dysfunction-related burden remained stable. By 2050, the burden of gout in China is expected to continue increasing, with a slower rise in females and a decline in males after an initial increase. However, the overall burden will remain substantial. In comparison, the gout burden will be higher in the United States than in China.

CONCLUSIONS

Gout is becoming a significant health burden globally and in China, particularly among Chinese males and older individuals. With the aging population and lifestyle changes exacerbating the issue, effective strategies and measures are essential to prevent or reduce gout-related health issues.

摘要

背景

痛风是一种主要由尿酸水平升高引起的慢性疾病，严重影响关节健康。其全球分布存在差异，且缺乏中国的最新数据。本研究旨在分析全球及中国痛风的当前负担和趋势，按性别、年龄和风险因素考察负担情况，并进行未来预测。

方法

本描述性流行病学二次分析利用了全球疾病、伤害及风险因素负担（GBD）2021研究的数据。采用年龄标准化发病率（ASIR）、患病率（ASPR）和伤残调整生命年率（DALYs率，ASDR）来评估痛风负担。分析了1990年至2021年全球各地区、性别和社会人口指数（SDI）水平的趋势。进一步按性别、年龄和相关风险因素考察了中国的负担情况。使用贝叶斯年龄-时期-队列（BAPC）模型预测未来趋势。比较了中国和美国的痛风负担。

结果

2021年，全球有5700万人受痛风影响，新增病例940万例，伤残调整生命年达175万。1990年至2021年，ASIR、ASPR和ASDR分别上升了17.2%、21.9%和21.3%。男性的负担显著更高，随着SDI水平升高，ASIR、ASPR和ASDR也更高。在中国，男性的ASIR、ASPR和ASDR是女性的2.8倍以上，且负担随年龄增加。2021年，中国痛风相关伤残调整生命年的31.4%归因于高体重指数，7.6%归因于肾功能不全。1990年至2021年，高体重指数相关负担在两性中均逐年上升，而肾功能不全相关负担保持稳定。到2050年，预计中国痛风负担将持续增加，女性上升较慢，男性在初期上升后下降。然而，总体负担仍将很大。相比之下，美国的痛风负担将高于中国。