Effects of dapagliflozin on serum and urinary uric acid levels in patients with type 2 diabetes: a prospective pilot trial

Abstract

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.

Effects of sodium‐glucose cotransporter 2 inhibitors on serum uric acid in patients with type 2 diabetes mellitus: A systematic review and network meta‐analysis

“…For the use of dapagliflozin, Yuan et al found that SUA levels decreased from 347.75 ± 7.75 μmol/L before dapagliflozin treatment to 273.25 ± 43.18 μmol/L after dapagliflozin treatment, with a statistically significant difference (p = .001), and the SUA-lowering effect of dapagliflozin could be driven by increasing UA excretion within 1 week of treatment, which may be the mechanism of SGLT-2 inhibitors in lowering SUA. 52 In addition, dapagliflozin has early cardiorenal benefits, which included anti-inflammatory, antifibrotic, antioxidative, antiapoptotic properties, renoprotective and haemodynamic effects, as well as attenuation of glucotoxicity, reduction of SUA levels and epicardial adipose tissue, modification of the neurohumoral system and cardiac fuel energetics, and inhibition of the sodium-hydrogen exchange. 53 However, different doses and durations of the same SGLT-2 inhibitor may have different SUA-lowering effects.…”