Estimation of the spatial pattern of gout prevalence across China by wastewater-based epidemiology

• Published in: The Science of the total environment 2024-05, Vol.924, p.171565-171565, Article 171565
• Main Authors: Zhou, Xinxin, Liu, Kexin, Shi, Chen, Zhang, Manlei, Liu, Shucheng, Hou, Chenzhi, Di, Bin
• Format: Article
• Language: English
• Subjects: China - epidemiology; Chromatography, Liquid; Febuxostat; Febuxostat - therapeutic use; Gout; Gout - diagnosis; Gout - epidemiology; Humans; Hyperuricemia - diagnosis; Hyperuricemia - epidemiology; Prevalence; Spatial distribution; Tandem Mass Spectrometry; Temporal analysis; Wastewater; Wastewater-Based Epidemiological Monitoring; Wastewater-based epidemiology
• ISSN: 0048-9697; 1879-1026
• DOI: 10.1016/j.scitotenv.2024.171565

Gout is a metabolic arthritis caused by hyperuricemia. In recent years, the prevalence of gout has been increased significantly in China due to the improvement of the living standards, and gout has become another common metabolic disease following diabetes mellitus. Gout severely affects the health status and life quality of human. In order to monitor the near real-time prevalence of gout, a wastewater-based epidemiology (WBE) approach was carried out in 257 Chinese cities using febuxostat as the biomarker. Febuxostat in wastewater was measured by a LC-MS/MS method with satisfactory results of method validation. The average concentration of febuxostat in wastewater was 53.05 ± 31.76 ng/L, with the estimated per capita consumption of 124.40 ± 73.37 mg/day/1000 inhabitant. The calculated prevalence of febuxostat was 0.41 % ± 0.24 %, and the prevalence of gout was finally estimated to be 1.30 % ± 0.77 % (0.60 % to 2.11 %), which was nearly consistent with value of 1.10 % obtained from the Guideline for the diagnosis and management of hyperuricemia and gout in China (2019). The results indicated that the febuxostat-based WBE approach might be reasonable to assess the near real-time gout prevalence in China. [Display omitted] •The consumption of febuxostat was assessed in 257 Chinese cities by WBE approach.•Febuxostat consumption was sustainably increased from 2020 to 2023 in Nanjing.•Gout prevalence was 1.30 % ± 0.77 % with regional differences in China in 2020.•Febuxostat consumption was significantly correlated with GDP.