LAUSR

OBJECTIVE The prevalence of gout is increasing but studies of its clinical features in large samples are lacking. This study aimed to clarify changes in the clinical manifestations of gout in China over the last decade and investigate the clinical features and risk factors of early-onset gout. METHODS Clinical manifestations were compared between 9,754 gout patients who first presented at our clinic with gout in 2008-2012 (earlier group) or 2013-2018 (later group). Gout onset ≤ 30 years old was defined as early-onset and > 30 years as late-onset. Clinical features and risk factors were compared between the groups. RESULTS The gout-onset age was 4.14 years younger and the percentage of early-onset gout (3,827 patients) was higher in the later 2013-2018 group (5,979 patients). The disease duration was significantly shorter (5.72 ± 0.09 vs. 6.01 ± 0.11, P = 0.036) and the ratio of patients with tophi was correspondingly lower in the later group (22.0% vs. 20.0%, P = 0.029). More patients were obese (32.6% vs. 37.7%, P < 0.001) and serum urate levels (465.06 ± 1.95 μmol/L vs. 485.57 ± 1.59 μmol/L) were significantly higher in the later group. As the age of gout-onset became younger, we did the multivariate logistic regression and identified a positive family history, male sex, obesity, elevated serum urate, and sugar-sweetened soft drinks as independent predictors of early-onset gout. CONCLUSION The manifestations of gout in China have changed over the last decade, associated with a trend towards younger onset.