Mohanad M Elfishawi1,2, Nour Zleik1,2, Zoran Kvrgic1,2, Clement J Michet1,2, Cynthia S Crowson3,4, Eric L Matteson1,2, Tim Bongartz3,4. 1. From Department of Rheumatology, Kasr Alainy Hospital, Cairo University, Cairo, Egypt; Division of Rheumatology, Mayo Clinic College of Medicine; Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine; Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minnesota; Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, Queens Hospital Center, New York, New York; Division of Rheumatology, Augusta University, Atlanta, Georgia; Department of Emergency Medicine, Vanderbilt University, Nashville, Tennessee, USA. 2. M.M. Elfishawi, MD, Internal Medicine Resident, Icahn School of Medicine at Mount Sinai; N. Zleik, MD, Internal Medicine Resident, Division of Rheumatology, Augusta University; Z. Kvrgic, CCRP, Study coordinator, Mayo Clinic; C.J. Michet Jr MD, Consultant, Mayo Clinic; C.S. Crowson, MS, Associate Professor, Mayo Clinic; E.L. Matteson, MD, MPH, Consultant, Mayo Clinic; T. Bongartz, MD, MS, Vanderbilt University. 3. From Department of Rheumatology, Kasr Alainy Hospital, Cairo University, Cairo, Egypt; Division of Rheumatology, Mayo Clinic College of Medicine; Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine; Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minnesota; Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, Queens Hospital Center, New York, New York; Division of Rheumatology, Augusta University, Atlanta, Georgia; Department of Emergency Medicine, Vanderbilt University, Nashville, Tennessee, USA. Tim.Bongartz@Vanderbilt.edu crowson@mayo.edu. 4. M.M. Elfishawi, MD, Internal Medicine Resident, Icahn School of Medicine at Mount Sinai; N. Zleik, MD, Internal Medicine Resident, Division of Rheumatology, Augusta University; Z. Kvrgic, CCRP, Study coordinator, Mayo Clinic; C.J. Michet Jr MD, Consultant, Mayo Clinic; C.S. Crowson, MS, Associate Professor, Mayo Clinic; E.L. Matteson, MD, MPH, Consultant, Mayo Clinic; T. Bongartz, MD, MS, Vanderbilt University. Tim.Bongartz@Vanderbilt.edu crowson@mayo.edu.
Abstract
OBJECTIVE: To examine the incidence of gout over the last 20 years and to evaluate possible changes in associated comorbid conditions. METHODS: The medical records were reviewed of all adults with a diagnosis of incident gout in Olmsted County, Minnesota, USA, during 2 time periods (January 1, 1989-December 31, 1992, and January 1, 2009-December 31, 2010). Incident cases had to fulfill at least 1 of 3 criteria: the American Rheumatism Association 1977 preliminary criteria for gout, the Rome criteria, or the New York criteria. RESULTS: A total of 158 patients with new-onset gout were identified during 1989-1992 and 271 patients during 2009-2010, yielding age- and sex-adjusted incidence rates of 66.6/100,000 (95% CI 55.9-77.4) in 1989-1992 and 136.7/100,000 (95% CI 120.4-153.1) in 2009-2010. The incidence rate ratio was 2.62 (95% CI 1.80-3.83). At the time of their first gout flare, patients diagnosed with gout in 2009-2010 had higher prevalence of comorbid conditions compared with 1989-1992, including hypertension (69% vs 54%), diabetes mellitus (25% vs 6%), renal disease (28% vs 11%), hyperlipidemia (61% vs 21%), and morbid obesity (body mass index ≥ 35 kg/m2; 29% vs 10%). CONCLUSION: The incidence of gout has more than doubled over the recent 20 years. This increase together with the more frequent occurrence of comorbid conditions and cardiovascular risk factors represents a significant public health challenge.
OBJECTIVE: To examine the incidence of gout over the last 20 years and to evaluate possible changes in associated comorbid conditions. METHODS: The medical records were reviewed of all adults with a diagnosis of incident gout in Olmsted County, Minnesota, USA, during 2 time periods (January 1, 1989-December 31, 1992, and January 1, 2009-December 31, 2010). Incident cases had to fulfill at least 1 of 3 criteria: the American Rheumatism Association 1977 preliminary criteria for gout, the Rome criteria, or the New York criteria. RESULTS: A total of 158 patients with new-onset gout were identified during 1989-1992 and 271 patients during 2009-2010, yielding age- and sex-adjusted incidence rates of 66.6/100,000 (95% CI 55.9-77.4) in 1989-1992 and 136.7/100,000 (95% CI 120.4-153.1) in 2009-2010. The incidence rate ratio was 2.62 (95% CI 1.80-3.83). At the time of their first gout flare, patients diagnosed with gout in 2009-2010 had higher prevalence of comorbid conditions compared with 1989-1992, including hypertension (69% vs 54%), diabetes mellitus (25% vs 6%), renal disease (28% vs 11%), hyperlipidemia (61% vs 21%), and morbid obesity (body mass index ≥ 35 kg/m2; 29% vs 10%). CONCLUSION: The incidence of gout has more than doubled over the recent 20 years. This increase together with the more frequent occurrence of comorbid conditions and cardiovascular risk factors represents a significant public health challenge.
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