Secular Trends in the Global Burden of Gout: an Age-Period-cohort and Joinpoint Analysis

This study aims to explore the independent age, period, and cohort effects on the burden of gout globally and across different Socio-demographic Index (SDI) regions. We extracted data of age-standardized incidence, prevalence, and disability-adjusted life years (DALYs) rate from the Global Burden of Disease (GBD) database as gout burden measures. In the study, Joinpoint regression analysis was conducted to explore the temporal trends from 1990 to 2019. Trend analyses were explored according to 21 world regions (including high-income North America, Australasia, Southern Latin America, East Asia, etc.) and sociodemographic indices (SDI). The age-period-cohort (APC) model was performed to estimate the age, period, and cohort effects on gout. Globally, the age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), and DALYs increased from 1990 to 2019. The ASIR, ASPR, and DALYs for the age effect of gout in different SDI regions increased at first, and then decreased, peaking at 70–74 years. The period effect showed an upward trend, while the cohort effect continued to decrease. Surprisingly, the age, period, and cohort effect for global gout DALYs differed significantly from that in five SDI regions. Therefore, more specific interventions are urgently warranted to reduce the incidence and prevalence of gout, especially among older adults in high SDI regions.