Effects of dapagliflozin on serum uric acid levels in hospitalized type 2 diabetic patients with inadequate glycemic control: a randomized controlled trial

Hao, Zhaohu; Huang, Xiao; Shao, Hailin; Tian, Fengshi

doi:10.2147/tcrm.s186347

Cited by 19 publications

(13 citation statements)

References 39 publications

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“…9 Similar results were observed in a randomized control study conducted in china, which showed dapagliflozin effectively reduced serum uric acid level of hospitalized patients having inadequate glycemic control. 10 Both these results are consistent with finding of our study, as significant reduction in uric acid as well as HbA1c were observed when total population is concerned includes both dapagliflozin and canagliflozin groups. It can be said SGLT2 inhibitors as a whole has a decremental effect on serum uric acid, apart from the drugs used in our study, another molecule in this class i.e., empagliflozin also showed similar effect on serum uric acid as well as blood pressure of diabetic population.…”

Section: Discussionsupporting

confidence: 93%

Effect of sodium-glucose transport protein 2 inhibitors on serum uric acid: an outpatient based prospective interventional study

Saha

Das

Maiti

et al. 2020

Int J Basic Clin Pharmacol

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Background: Hyperuricemia is considered to be associated with increased risk of cardiovascular diseases. It has been found to be related to features of metabolic syndromes like hyperglycemia and dyslipidemia. Sodium-glucose transport protein 2 (SGLT2) inhibitors are known to have a decremental effect on serum uric acid level. We evaluated the effect of SGLT2 inhibitors on serum uric acid of diabetic population.Methods: In this prospective study we recruited 50 type 2 diabetes mellitus (T2DM) patients who were on metformin monotherapy and were having inadequate glycemic control. Patients were prescribed SGLT2 inhibitors as an add-on therapy. Serum uric acid of the subjects was measured at the baseline and after 3 months. The primary outcome was to observe changes in serum uric acid (SUA) levels from the baseline to the end of the study. Glycemic changes were determined by observing the changes in glycated haemoglobin (HbA1c) levels (if any).Results: The study population was predominantly male (82%). BMI wise most of the subjects (44%) were overweight. Mean HbA1c of total population was 7.65±0.5, whereas mean serum uric acid was 6.31±0.72 at the baseline. After 3 months HbA1C and serum uric acid levels were 7.45±0.50 and 6.06±0.64 respectively. Both the changes were statistically significant (p<0.005).Conclusions: SGLT2 inhibitors could improve glycemic control and lower SUA levels in patients with uncontrolled T2DM. Randomized study with bigger sample size and longer study period are required to further demonstrate the effect of SGLT2 inhibitors on serum uric acid and explore the potential underlying mechanisms.

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Section: Discussionsupporting

confidence: 93%

Effect of sodium-glucose transport protein 2 inhibitors on serum uric acid: an outpatient based prospective interventional study

Saha

Das

Maiti

et al. 2020

Int J Basic Clin Pharmacol

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“…Furthermore, the EMPA-REG OUTCOME trial (8,9) and the CANVAS program (14,15) reported that the beneficial effects of SGLT2 inhibitors on the eGFR occurred concomitantly with glycemic improvements. The reduction in the UA levels was also observed concurrently with the improvement in the glucose metabolism following SGLT2 inhibitor administration (28)(29)(30)(31)(32). These results suggest that the renal benefits of SGLT2 inhibitors are involved in the changes in several parameters, including UA levels and glucose metabolism.…”

Section: Discussionmentioning

confidence: 59%

Beneficial Effects of Ipragliflozin on the Renal Function and Serum Uric Acid Levels in Japanese Patients with Type 2 Diabetes: A Randomized, 12-week, Open-label, Active-controlled Trial

et al. 2020

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Objective To examine the add-on effects, compared to the existing antidiabetes treatment, of the sodiumglucose cotransporter 2 inhibitor ipragliflozin on glycemic control and the risk factors of cardiovascular disease (CVD) and chronic kidney disease (CKD) in patients with inadequately controlled type 2 diabetes. Methods This 12-week, randomized, open-label, active-controlled trial included 30 patients with type 2 diabetes who were randomized 1:1 to ipragliflozin and control groups (n=15 each). The ipragliflozin group received 50 mg of ipragliflozin once daily in addition to conventional therapy. The primary outcome was the change in hemoglobin A1c (HbA1c) from the baseline. Secondary outcomes were changes from the baseline in indices of glycemic control, uric acid (UA), renal function, and arterial stiffness. Results The patients' diminished estimated glomerular filtration rate (eGFR) was alleviated in the ipragliflozin group compared to the control group [difference between groups (Δ)=4.6 (95% confidence interval (CI): 1.5-7.7) mL/min/1.73 m 2 , p=0.006] prior to significant improvements in HbA1c and other parameters, including anthropometric indices and arterial stiffness. Furthermore, ipragliflozin add-on therapy resulted in a greater reduction in serum UA levels than control therapy [Δ=-52.3 (95% CI:-85.5-19.1) μmol/L, p=0.003]. The changes in the eGFR with ipragliflozin treatment were associated with ipragliflozin-mediated changes in the UA, even after adjusting for the age, sex, baseline HbA1c, baseline UA, and baseline eGFR (standardized regression coefficient=-0.535, p=0.010). Conclusion Ipragliflozin add-on therapy was associated with beneficial renal effects in parallel with reducing serum UA levels.

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“…Firstly, we do not analyze whether oral hypoglycemic agents have an effect on SUA. Sodium-glucose co-transporter 2 inhibitor (SGLT-2i) could improve glycemic control and lower SUA levels in T2DM (Hao et al, 2018). However, other hypoglycemic drugs, including metformin, rosiglitazone, glibenclamide, and pharmacologic insulin, do not have a large impact on SUA concentration (Hussain et al, 2018; Iliadis et al, 2007; MacFarlane, Liu & Solomon, 2015).…”

Section: Discussionmentioning

confidence: 99%

The relationship between serum uric acid within the normal range and β-cell function in Chinese patients with type 2 diabetes: differences by body mass index and gender

Zhong¹,

Zhang²,

Yang³

et al. 2019

PeerJ

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Background Elevated serum uric acid (SUA) has a positive correlation with insulin secretion and insulin resistance indexes. However, whether weight- and gender-specific differences regarding the relationship between SUA within the normal range and β-cell function and insulin resistance exist is unknown in type 2 diabetes mellitus (T2DM) patients. Methods A total of 380 patients with type 2 diabetes were divided into two groups as overweight/obesity (n = 268) and normal weight (n = 112). Each group were again divided into low (LSUA) and high normal SUA (HSUA). The HbA1c, C-peptide, SUA, creatinine, and lipids profiles were measured. HOMA2IR and HOMA%2B were estimated using fasting glucose and C-peptide by homeostasis model assessment (HOMA). Pearson’s correlations and multiple linear regression analyses were conducted to assess the associations between SUA levels and islet function indexes. Results In overweight/obesity subgroup, the levels of body mass index, fasting C-peptide (FCP), P2hCP, fasting CPI (FCPI), postprandial CPI (PPCPI), ΔC-peptide, HOMA2%B, and HOMA2IR were higher in HSUA group than in LSUA group. In contrast, the HbA1c, FBS, and P2hBS were lower in HSUA than in LSUA. In normal weight subgroup, there were no differences between the HSUA than LSUA group in terms of clinical characteristics. Pearson’s correlations indicated that there were no significant correlations between SUA and insulin secretory capacity in normal weight group, but in overweight/obesity group, SUA had positive significant correlations with P2hCP, FCPI, PPCPI, ΔC-peptide, and HOMA2%B. In the female group, there were no significant correlations between SUA and insulin secretory capacity. However, in the male group, SUA had positive significant correlations with insulin secretory capacity include P2hCP, FCPI, PPCPI, ΔC-peptide, and HOMA2%B. Multiple linear regression showed that SUA was significantly associated with HOMA2%B, but not with HOMA2IR in overweight/obesity and male group. Conclusions Our study shows that SUA levels within normal range were associated with β-cell function in T2DM patients with overweight/obesity or male. This finding supports that the association between SUA within normal range and insulin secretion ability differs by weight and sex.

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Effects of dapagliflozin on serum uric acid levels in hospitalized type 2 diabetic patients with inadequate glycemic control: a randomized controlled trial

Cited by 19 publications

References 39 publications

Effect of sodium-glucose transport protein 2 inhibitors on serum uric acid: an outpatient based prospective interventional study

Effect of sodium-glucose transport protein 2 inhibitors on serum uric acid: an outpatient based prospective interventional study

Beneficial Effects of Ipragliflozin on the Renal Function and Serum Uric Acid Levels in Japanese Patients with Type 2 Diabetes: A Randomized, 12-week, Open-label, Active-controlled Trial

The relationship between serum uric acid within the normal range and β-cell function in Chinese patients with type 2 diabetes: differences by body mass index and gender

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