Burden, risk factors, and forecasts of gout in BRICS countries, 1990–2021: Insights from the Global Burden of Disease Study 2021

Abstract

Objectives To evaluate the temporal trends and projected burden of gout in BRICS (Brazil, Russia, India, China, and South Africa) countries from 1990 to 2021, based on Global Burden of Disease 2021 data, and to explore the contributions of key risk factors. Methods Age-standardized prevalence rates (ASPR), years lived with disability rates (ASYR), and case counts were extracted from the GBD Results Tool. Temporal trends were assessed using estimated annual percentage change (EAPC). Joinpoint regression evaluated time-varying changes in ASYR attributable to high BMI (Body Mass Index) and kidney dysfunction. ARIMA models forecasted ASPR and ASYR through 2036. Results From 1990 to 2021, ASPR and ASYR increased globally and in all BRICS nations. In 2021, China recorded the highest ASPR and ASYR in males (1232.34 and 38.83 per 100,000, respectively), with EAPC of 1.14 and 1.13. Brazil had the lowest burden. In 2021, China and India reported the highest absolute burdens of gout, with approximately 16.79 million prevalent cases and 525,967 YLDs in China, and 5.32 million prevalent cases and 164,153 YLDs in India. High BMI and kidney dysfunction were key contributors to ASYR, especially in older adults. Forecasts indicate ASPR and ASYR will decline globally by 2036, but rise in Brazil, India, Russia, and South Africa. Chinese males show projected declines, while female rates increase modestly. Conclusions The burden of gout is rising across BRICS countries, shaped by aging populations, metabolic risk exposures, and distinct sex-specific trends. These findings highlight the importance of developing locally adapted prevention and control strategies to address this growing challenge.