Background: We aimed to evaluate the effects of short-term therapy with dapagliflozin on serum uric acid (SUA) and urinary uric acid (UUA) levels in patients with type 2 diabetes.Methods: In this prospective pilot trial, 8 patients with type 2 diabetes mellitus were assigned to the treatment group with dapagliflozin 10 mg once daily for one week, and 7 subjects with normal glucose tolerance were recruited into the control group. Data of anthropometric measurements, SUA, 24-hour UUA, fractional excretion of UA (FEUA), serum lipid parameters and 3-hour oral glucose tolerance test (OGTT) were collected in both treatment and control groups; all examinations were repeated after treatment. The area under the curve of glucose (AUCGlu) was calculated to reflect the general glucose levels, while insulin resistance and islet β-cell function were reflected by indexes calculated according to the data obtained from the OGTT.Results: The weight and serum lipid parameters showed no differences before and after treatment with dapagliflozin for one week. We found SUA levels decreased from 347.75 ± 7.75 μmol/L before treatment to 273.25 ± 43.18 μmol/L after treatment, with a statistically significant difference (P=0.001) and was accompanied by a significant increase in FEUA from 0.009 to 0.029 (P=0.035); there was a linear correlation between SUA and FEUA levels. Glucose control, insulin sensitivity and islet β-cell function were improved to a certain extent. We also found a positive correlation between the decrease in glucose levels and the improvement in islet β-cell function.Conclusions: The SUA-lowering effect of dapagliflozin could be driven by increasing UA excretion within one week of treatment, and a certain degree of improvement in glucose levels and islet β-cell function were observed. Trial registration: ClinicalTrials.gov identifier, NCT04014192. Registered 12 July 2019, https://www.clinicaltrials.gov/ct2/show/NCT04014192?term=NCT04014192&draw=2&rank=1. Yes.
Background We aimed to investigate the clinical characteristics and islet β-cell function in patients with Klinefelter syndrome (KS) and hyperglycemia. Methods This is a retrospective study. There were 22 patients diagnosed of KS identified from electronic medical record system including 9 patients with hyperglycemia (THG-KS group). There were 5 hyperglycemic KS patients with oral glucose tolerance test (OGTT) results (HG-KS group), other 5 subjects with hyperglycemia and 5 euglycemic subjects matched in body mass index were included as HG group and NGT group, respectively. Clinical data and laboratory examinations were collected. We further performed a systematic literature review of KS and hyperglycemia. Results We found KS patients developed abnormal glucose metabolism earlier in life than those without KS. There were 35.3% patients diagnosed of DM and 17.6% patients diagnosed of prediabetes. Among 10 patients had both fasting blood glucose and insulin levels drawn, there were 47.1% patients with KS and insulin resistance. The incidence of hypertension and dyslipidemia were higher in patients with hyperglycemia and KS than euglycemic KS patients. Comparing with HG group, the level of insulin sensitivity was lower in HG-KS group, while the value of HOMA-β (p = 0.030) was significantly increased which indicated higher insulin secretion level in HG-KS group. Conclusions KS patients with hyperglycemia are more likely to combine other metabolic diseases. Compared with hyperglycemic patients without KS, they present lower insulin sensitivity and higher insulin secretion.
Background: We aimed to evaluate the effects of short-term therapy with dapagliflozin on serum uric acid (SUA) and urinary uric acid (UUA) levels in patients with type 2 diabetes.Methods: In this prospective pilot trial, 8 patients with type 2 diabetes mellitus were assigned to the treatment group with dapagliflozin 10 mg once daily for one week, and 7 subjects with normal glucose tolerance were recruited into the control group. Data of anthropometric measurements, SUA, 24-hour UUA, fractional excretion of UA (FEUA), serum lipid parameters and 3-hour oral glucose tolerance test (OGTT) were collected in both treatment and control groups; all examinations were repeated after treatment. The area under the curve of glucose (AUCGlu) was calculated to reflect the general glucose levels, while insulin resistance and islet β-cell function were reflected by indexes calculated according to the data obtained from the OGTT.Results: The weight and serum lipid parameters showed no differences before and after treatment with dapagliflozin for one week. We found SUA levels decreased from 347.75 ± 7.75 μmol/L before treatment to 273.25 ± 43.18 μmol/L after treatment, with a statistically significant difference (P=0.001) and was accompanied by a significant increase in FEUA from 0.009 to 0.029 (P=0.035); there was a linear correlation between SUA and FEUA levels. Glucose control, insulin sensitivity and islet β-cell function were improved to a certain extent. We also found a positive correlation between the decrease in glucose levels and the improvement in islet β-cell function.Conclusions: The SUA-lowering effect of dapagliflozin could be driven by increasing UA excretion within one week of treatment, and a certain degree of improvement in glucose levels and islet β-cell function were observed.
Background: We aimed to examine the relationship between serum uric acid (SUA) levels and glucose disposal rate value (M value) evaluated by hyperinsulinemic euglycemic clamp technique in euglycemic Chinese subjects.Methods: There were 19 non-diabetic Chinese subjects included in this study. The participants accepted physical examination, laboratory examination and standardized questionnaire. Insulin resistance was evaluated by M value. Some other indices were also calculated by data obtained from 3-hour oral glucose tolerance test (OGTT). Subjects were divided into two groups based on the median of SUA levels.Results: The level of systolic blood pressure (SBP) (P=0.035), waist circumference (P=0.009), waist-to-hip ratio (P=0.004), Chinese visceral adiposity index (CAVI) (P=0.028), weight (P=0.01), serum creatinine (Cr) (P=0.05) and the percentage of drinking habits (P=0.03) were all significantly increased in high SUA group. The level of M value and high-density lipoprotein cholesterol (HDL-c) were significantly decreased in high SUA group (P=0.041 for M value and P=0.09 for HDL-c). There were no significant differences between those indirect insulin resistance indices and SUA. In addition, the SUA levels were inversely correlated with M value (r=-0.666, P=0.002) and HDL-c (r=-0.619, P=0.005), positively correlated with waist circumference (r=0.615, P=0.005), CVAI (r=0.630, P=0.004), SBP (r=0.521, P=0.022) and Cr (r-0.550, P=0.015) levels. Analysis of stepwise multiple regression showed the independent association between SUA and M value in both male and female euglycemic subjects.Conclusions: There is a significant correlation between SUA levels and glucose disposal rate value in euglycemic Chinese subjects, which suggested that UA played an important role on insulin resistance even in those non-diabetic subjects
Background: Few studies focused on the effects of medium-to-low dose glucocorticoids on glucose profiles and glucose metabolism in patients with interstitial pneumonia with autoimmune features (IPAF). Continuous glucose monitoring system (CGMS) can provide more detailed glucose features than fingertip blood samplings.Methods: This was a observational study in a teaching hospital. Outpatients with IPAF on 15mg prednisone per day for at least 3 months were recruited to receive CGMS and blood tests. The primary data of CGMS were analyzed to demonstrate the glucose features. Data were compared between subjects with a glucocorticoid treatment duration of more than 2 years(Group 1) and subjects with that of less than 2 years(Group 2). In subgroup analysis, among all subjects, subjects who tapered the daily dose to 7.5mg for at least 3 months received second tests. Results: 93% (27/29) on daily 15mg prednisone and all subjects on daily 7.5mg prednisone were with glucocorticoid induced hyperglycemia(GIH). Among subjects on daily 15mg prednisone, glucose AUC of 3 hours post-lunch was significantly higher than those post-breakfast and post-dinner, and mean glucose levels of half an hour pre-lunch and pre-dinner were significantly higher than that pre-breakfast. 81.9% of nocturnal glucose nadirs presented after 5AM, leading to relatively low fasting glucose values. There were no significant differences of glucose profiles between Group 1 and Group 2. No significant differences of CGMS and laboratory parameters were found between on daily 15mg prednisone and on daily 7.5mg prednisone.Conclusions: A large proportion of outpatients on medium-to-low-dose glucocorticoids are with GIH. Post-lunch glucose or post-dinner glucose are good indicators, while fasting glucose is not. The similar glycemic effects of daily 15mg and 7.5mg prednisone provide evidence for physicians to choose long-term maintaining glucocorticoid dose.Clinical Research Registration: This research is registered at clinicaltrials.gov(No.NCT02824757) with the registry named The Effects of Glucocorticoids on Glucose Metabolism in Patients With Interstitial Lung Disease. The URL is https://clinicaltrials.gov/ct2/show/NCT02824757?term=NCT02824757&draw=2&rank=1.This research is registered at July 7th,2016, retrospectively.
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