Gout is a common inflammatory arthropathy driven by hyperuricemia, with a continuously growing global disease burden in recent decades. However, systematic analysis of the long-term epidemiological trends of gout in China based on the latest Global Burden of Disease 2023 (GBD 2023) data remains insufficient. This study aimed to systematically evaluate the temporal trends in incidence, prevalence, and years lived with disability (YLD) of gout in China from 1990 to 2023, characterize its age and gender-specific distribution patterns, and provide up-to-date evidence for the formulation of targeted prevention and control strategies for gout in China.

Based on the data from the GBD 2023 study, we systematically analyzed the incidence, prevalence, and YLD of gout in China between 1990 and 2023. A Joinpoint regression model was applied to quantify the temporal trends and calculate the annual percentage change (APC) and average annual percentage change (AAPC) of relevant rates, with statistical significance set at P < 0.05.

 In 2023, the number of new incident cases, total prevalent cases, and YLD attributed to gout in China reached 3 215 471, 17 672 307, and 545 814 person-years, respectively. Compared with 1990, the absolute numbers and crude rates of gout incidence, prevalence, and YLD all increased substantially in 2023. Over the 34-year study period, the age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), and age-standardized YLD rate of gout in China all presented a significant upward trend (all AAPC > 0, P < 0.05). The disease burden of gout was consistently higher in males than in females throughout the study period. In 2023, the gout-related YLD rate in China showed a prominent age-dependent increasing pattern: no YLD burden was detected in the population younger than 15 years; the YLD rate increased gradually from adolescence, and reached a peak of 121.41 per 100 000 population in the group aged 95 years and older.

From 1990 to 2023, the overall disease burden of gout in China has maintained a continuous and significant upward trend, with a heavy burden concentrated in male and elderly populations. The growing burden of gout in China may be closely related to the changes in dietary structure, the rising prevalence of obesity and metabolic syndrome, population aging, and the improvement of disease diagnosis levels in recent decades. Targeted prevention and control strategies focusing on high-risk groups (especially males and middle-aged and elderly people), as well as comprehensive intervention for modifiable risk factors of hyperuricemia and gout, are urgently needed to curb the rising burden of gout in China. This study provides the latest and comprehensive epidemiological evidence for optimizing the public health prevention and management system of gout in China.