Objective: To analyze the changing trends in the burden of gout disease attributable to high body mass index (BMI) and impaired kidney function in China from 1990 to 2023, and predict the burden of gout disease attributable to high BMI and impaired kidney function in China from 2024 to 2035, to provide a scientific basis for gout prevention and control.
Methods: Based on the 2023 Global Burden of Disease (GBD) study data, this study analysed the characteristics of the burden of gout attributable to high BMI and impaired kidney function by gender and age group. It employed the Joinpoint regression model to examine trends in the age-standardized disability-adjusted life years (DALYs) rate and utilized the autoregressive integrated moving average (ARIMA) model to predict the disease burden trend from 2024 to 2035.
Results: From 1990 to 2023, the age-standardized DALYs rate for gout attributable to high BMI in China increased (1990: 3.79 per 100 000, 95% UI: 2.15 per 100 000-6.24 per 100 000; 2023: 7.34 per 100 000, 95% UI: 4.22 per 100 000-11.39 per 100 000). Joinpoint analysis results showed that from 1990 to 2023, the age-standardized DALYs rate for gout attributable to high BMI in China exhibited an overall upward trend [average annual percent change (AAPC) for males=2.12%, 95% CI: 2.02%-2.22%; AAPC for females=1.92%, 95% CI: 1.79%-2.04%, both P<0.05]. For gout attributable to impaired kidney function, the age-standardized DALYs rate showed a slow overall increase in males, while the change in females was not significant (AAPC for males=0.36%, 95% CI: 0.27%-0.45%, P<0.05; AAPC for females=0.11%, 95% CI: -0.11%-0.33%). According to the ARIMA model predictions, by 2035, the age-standardized DALYs rates of gout attributable to high BMI in males and females and attributable to impaired kidney function in females were projected to stabilize at 10.85 per 100 000, 3.48 per 100 000, and 1.75 per 100 000, respectively. In contrast, the age-standardized DALYs rate of gout attributable to impaired kidney function in males was predicted to continue rising until 2035, reaching an estimated 5.98 per 100 000.
Conclusion: The disease burden of gout associated with high BMI and impaired kidney function continues to worsen in China. The age-standardized DALYs rate for gout attributable to impaired kidney function in males is projected to continue rising until 2035. Therefore, there is an urgent need to improve population-wide BMI management strategies and enhance medical support for patients with kidney diseases, with targeted interventions prioritized among specific groups such as middle-aged obese individuals and middle-aged and elderly patients with kidney diseases.
目的: 分析1990—2023年中国归因于高身体质量指数（body mass index，BMI）和肾脏功能受损的痛风疾病负担变化趋势，并预测2024—2035年中国归因于高BMI和肾脏功能受损的痛风疾病负担，为痛风防控提供科学依据。.
方法: 基于2023年全球疾病负担研究（Global Burden of Disease，GBD）数据，分性别和年龄组解析高BMI和肾脏功能受损所致痛风的疾病负担特征，运用Joinpoint回归模型分析年龄标化伤残调整寿命年（disability-adjusted life years，DALYs）率变化趋势，并通过自回归积分滑动平均（autoregressive integrated moving average，ARIMA）模型预测2024—2035年的疾病负担趋势。.
结果: 1990—2023年中国归因于高BMI的年龄标化DALYs率上升（1990年：3.79/10万，95% UI：2.15/10万-6.24/10万；2023年：7.34/10万，95% UI：4.22/10万-11.39/10万）。Joinpoint分析结果示，1990—2023年中国归因于高BMI的痛风年龄标化DALYs率总体呈上升趋势 ［男性整体平均年度变化百分比（average annual percent change，AAPC）=2.12%，95% CI：2.02%-2.22%；女性 AAPC=1.92%，95% CI：1.79%-2.04%；均 P<0.05］，归因于肾脏功能受损的年龄标化DALYs率男性整体缓慢上升，女性整体变化不显著（男性AAPC=0.36%，95% CI：0.27%-0.45%， P<0.05；女性AAPC=0.11%，95% CI：−0.11%-0.33%）。根据ARIMA模型预测结果，归因于高BMI的男性与女性痛风年龄标化DALYs率和归因于肾脏功能受损的女性痛风年龄标化DALYs率在2035年分别预计稳定在10.85/10万、3.48/10万、1.75/10万；而归因于肾脏功能受损的男性痛风年龄标化DALYs率将持续上升至2035年，预测值达到5.98/10万。.
结论: 高BMI和肾脏功能受损相关痛风疾病负担在中国持续加重，归因于肾脏功能受损的男性痛风年龄标化DALYs率或将持续上升至2035年，因此亟需完善人群BMI管理策略与肾脏疾病患者的医疗支持，对中年肥胖人群、中老年肾脏疾病患者等特定群体施加重点干预。.
Keywords: Gout; disease burden; high body mass index; impaired kidney function.