Contemporary Prevalence of Gout and Hyperuricemia in the United States (National Health and Nutrition Examination Survey [NHANES] 2015-2016) and Decadal Trends (NHANES 2007-2016)

Michael Chen-Xu¹, Chio Yokose², Michael Pillinger³ and Hyon K. Choi², ¹General Medicine, Wairarapa District Health Board, Masterton, New Zealand, ²Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston, MA, ³Medicine/Rheumatology, NYU School of Medicine, New York, NY

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: gout and hyperuricemia

Session Information

Date: Monday, October 22, 2018

Title: Epidemiology and Public Health Poster II: Gout, Ankylosing Spondylitis, Osteoarthritis, Osteoporosis, Pain, and Function

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: The prevalences of gout and hyperuricemia from the National Health and Nutrition Examination Survey (NHANES) 2007-2008 were 3.9% (8.3 million) and 21.4% (43.3 million individuals), respectively, representing increases of 44% and 18% from a decade earlier (Zhu et al., Arthr Rheum. Oct 2011, pp 3136–3141). Our objective was to determine the latest national prevalence estimates (NHANES 2015-2016) of gout and hyperuricemia and their decadal trends from NHANES 2007-2016.

Methods: Using data from 5,467 participants in the NHANES 2015-2016, we estimated the prevalence of gout and hyperuricemia. During the home interview in each NHANES survey cycle, all participants were asked about a history of health professional- or physician-diagnosed gout. Our definition of hyperuricemia was a serum urate level (SUL) >7.0mg/dL in men and >5.7mg/dL in women. We explored potential secular trends in these estimates and their possible explanations by comparing the latest estimates with those from 22,654 participants from NHANES 2007-2014. All statistical analyses were conducted using survey commands of Stata (Version 15.1, Stata Corporation, College Station, Texas) to adjust for clusters and strata of the complex sample design as well as incorporate sample weights to generate estimates for the total civilian, non-institutionalized population of the US. Population estimates (in millions) were calculated as per the NHANES analytic guidelines.

Results: The prevalence of gout was 3.9% (9.2 million) among US adults in 2015-2016 (5.2% [5.9 million] among men and 2.7% [3.3 million] among women) (Table). The mean SULs were 6.0mg/dL among men and 4.8mg/dL among women, which corresponds to hyperuricemia prevalences of 20.2% and 20.0%, respectively. The prevalence of gout and hyperuricemia among US adults was stable over the past decade (P-value for trend= 0.69 and 0.24 for men and women, respectively). The decadal trends for gout remained stable when stratified by sex, hypertension, chronic kidney disease (CKD) and obesity (all P-values for trend> 0.05).

Conclusion: These findings from this nationally-representative sample of US adults suggest that the prevalences of gout and hyperuricemia remain substantial (9.2 and 47.1 million adults, respectively), although they appeared to have plateaued over the past decade. This may be related to plateauing frequency of CKD (Murphy et al., Ann Intern Med. Oct 2016, pp 473–481), and hypertension (Fryar et al., NCHS data brief, no., 289. Oct 2017).

Table. Prevalence of Gout and Hyperuricemia and Number of Affected Adults in the US, NHANES 2015-2016*

	Gout		Hyperuricemia
	Prevalence, % (95% CI)	N of US adults, millions	Prevalence % (95% CI)	N of US adults, millions
All	3.9 (3.3, 4.7)	9.18	20.1 (17.8, 22.4)	47.13
Sex
Male	5.2 (4.4, 6.2)	5.86	20.2 (16.6, 24.3)	22.76
Female	2.7 (2.0, 3.8)	3.33	20.0 (17.8, 22.4)	24.37
Age
20-39	0.7 (0.3, 1.5)	0.56	16.6 (13.6, 20.1)	14.07
40-59	3.4 (2.2, 5.3)	2.89	18.7 (15.1, 22.9)	15.71
60-79	8.8 (7.2, 10.7)	4.77	26.1 (22.7, 29.8)	14.20
³ 80	8.7 (5.8, 12.7)	0.97	27.8 (21.0, 35.8)	3.10
Race/ethnicity
Non-Hispanic White	4.0 (3.1, 5.3)	6.13	21.4 (18.1, 25.1)	32.59
Non-Hispanic Black	4.8 (3.8, 6.0)	1.31	22.6 (20.9, 24.3)	6.15
Hispanic	2.0 (1.4, 2.9)	0.73	14.9 (12.6, 17.5)	5.33
Other	5.2 (3.4, 7.9)	0.99	17.0 (13.8, 20.7)	3.23
* The data were adjusted for clusters and strata of the complex sample design of the National Health and Nutrition Examination Survey (NHANES) 2015–2016, with incorporation of sample weights. 95% CI = 95% confidence interval

Disclosure: M. Chen-Xu, None; C. Yokose, None; M. Pillinger, Horizon Pharmaceuticals, 5,Ironwood, 5,SOBI, 5; H. K. Choi, Takeda, Selecta, Kowa, and Horizon, 5,Selecta and Horizon, 2.

To cite this abstract in AMA style:

Chen-Xu M, Yokose C, Pillinger M, Choi HK. Contemporary Prevalence of Gout and Hyperuricemia in the United States (National Health and Nutrition Examination Survey [NHANES] 2015-2016) and Decadal Trends (NHANES 2007-2016) [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/contemporary-prevalence-of-gout-and-hyperuricemia-in-the-united-states-national-health-and-nutrition-examination-survey-nhanes-2015-2016-and-decadal-trends-nhanes-2007-2016/. Accessed .

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