Global and regional burden of gout in middle-aged adults, 1990–2021, with projections to 2046: An observational study analysis for GBD 2021

The prevalence of gout among middle-aged populations are rising notably. However, there is a lack of comprehensive data on their global burden and epidemiological trends. This study aimed to examine the global trend of gout in middle-aged populations from the Global Burden of Disease (GBD) 2021 database. Using GBD 2021, this study evaluated trends of incidence, prevalence, years lived with disability (YLDs) of gout in middle-aged populations. Multidimensional stratification analyzed temporal patterns, sex patterns, geographic variations, and Socio-demographic Index (SDI). Comprehensive methods included Estimated Annual Percentage Change, Joinpoint regression, decomposition analysis, and Nordpred predictive modeling. From 1990 to 2021, the global burden of gout in middle-aged populations increased significantly, with prevalence, incidence, and YLDs rising by 154%, 147%, and 153% respectively, and age-standardized rates all showing an upward trend. High SDI regions exhibited the highest standardized rates. Furthermore, High-income North America had the highest standardized rates. The burden of gout was significantly higher in men than in women. Projections are expected to continue to rise by 2046, with a larger increase in men. The global burden of gout in middle-aged adults has increased significantly from 1990 to 2021, with marked regional and national disparities and a stronger correlation with higher SDI. Our study uniquely focuses on the middle-aged population, a group increasingly affected by gout but often overlooked in previous research. Projections indicate a continued upward trend through 2046, especially among men. It is strongly recommended to strengthen targeted prevention measures in high-burden regions and among middle-aged adults.