Gout burden and socioeconomic inequalities in the global working-age population from the Global Burden of Disease Study

Using Global Burden of Disease Study estimates, we assessed gout burden among adults aged 15–64 years across 204 countries and territories over a 32-year observation period. Analyses covered temporal trends, socioeconomic inequality, demographic and epidemiological drivers, and Bayesian age–period–cohort projections to 2050. In the final observed year, gout caused 1.05 million years lived with disability (YLDs; 95% uncertainty interval 0.72–1.55 million), more than double the initial burden. The age-standardised YLD rate was 19.43 (13.35–28.71) per 100,000. Age-standardised rates were 3.4–3.9 times as high in men as in women. The absolute YLD rate gap between countries at the highest and lowest sociodemographic index (SDI) widened from 8.16 to 14.69 per 100,000. Population growth explained over 95% of the YLD increase in low-SDI settings, whereas epidemiological change accounted for nearly half in high-SDI settings. Rates are projected to plateau, while absolute burden continues rising to 2050. These findings support prevention and gout care tailored to sex and socioeconomic context.