The global burden and epidemiological trends of gout, particularly cases attributable to high Body Mass Index (BMI) in adolescents and young adults (aged 15-39 years): a secondary analysis from global burden of disease study 2021.

Objectives: This study aims to analyze the burden and epidemiological trends of early-onset gout (EOG) and its association with high body mass index (BMI) in individuals aged 15 to 39 globally from 1990 to 2021.

Methods: Using the Global Burden of Disease (GBD) 2021 data, global incidence, prevalence, disability-adjusted life years (DALYs), and DALYs attributable to high BMI were analyzed. We examined EOG burden across global, regional, and national levels, along with trends, decomposition, health inequality, and correlations with socio-demographic index (SDI).

Results: In 2021, EOG accounted for 1,296,983 incident cases globally, with 5,077,197 prevalent cases and 170,599 DALYs, of which 54,909 were attributed to high BMI. The age-standardized incidence rate (ASIR) rose from 36.52 per 100,000 in 1990 to 43.60 per 100,000 in 2021. Significant regional variations were observed, with high-income North America having the highest incidence (115.02 per 100,000). EOG burden was higher in males. Additionally, the percentage of DALYs attributable to high BMI continues to rise. EOG burden growth was mainly due to population growth, while DALYs attributable to high BMI rose due to epidemiological shifts. Absolute inequality in EOG burden grew, but relative inequality remained moderate. DALYs attributable to high BMI were concentrated in regions with higher SDI.

Conclusions: The global burden of EOG has increased from 1990 to 2021, with high BMI playing a significant role. Strengthened prevention and management of gout and high BMI in adolescents and young adults are necessary. Key Points • The study investigates the spatiotemporal trends of incidence, prevalence, and DALYs of early-onset gout (aged 15-39 years) globally over the past 30 years, as well as the impact of high BMI on its DALYs. • The findings reveal a significant increase in the global burden of early-onset gout from 1990 to 2021, with both the number and proportion of DALYs attributable to high BMI showing marked increases across different sexes, age groups, and SDI levels. • The burden of early-onset gout is distributed unevenly across regions and countries, with a clear correlation to SDI levels, and the burden is concentrated in countries with higher SDI.