Epidemiology of Gout in Southeast Iran: Unexpected Risk Factor Patterns in a Population-Based Study

BackgroundGout is an increasingly recognized public health concern in low- and middle-income regions experiencing rapid socioeconomic change. However, contemporary evidence from southeastern Iran is limited. This study provides the first population-based estimate of gout prevalence in Zahedan and examines its association with demographic, metabolic, and medication-related factors.MethodsThis cross-sectional analysis included ۶,۳۲۲ adults from the Persian Cohort in Zahedan, with a clinically profiled subsample of ۲,۱۶۶ participants aged ۳۵–۷۵ years. Gout diagnosis was based on standardized clinical criteria. Associations with age, sex, body mass index, comorbidities, and medication use were assessed using univariate and multivariable models.ResultsThe overall prevalence of gout was ۵.۷% (۹۵% CI: ۵.۱–۶.۳%) in the full cohort and ۴.۷% (۹۵% CI: ۳.۸–۵.۶%) in the subsample. Contrary to global literature, gout was not significantly associated with older age, male sex, obesity, hypertension, or diabetes. Instead, loop diuretic use particularly furosemide demonstrated a strong independent association with gout after adjustment for confounders, whereas other medications, alcohol consumption, and cardiometabolic conditions did not show significant relationships.ConclusionGout affects nearly one in twenty adults in Zahedan, representing a meaningful disease burden. While traditional predictors were not influential, furosemide use emerged as a key modifiable risk factor, emphasizing the need for medication review and gout monitoring among patients receiving loop diuretics. Longitudinal studies incorporating genetic, dietary, and biochemical profiling are warranted to refine prevention and management strategies in this region.

Keywords:

Gout , Epidemiology , Risk factors , Southeast Iran , Population-Based Study