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Sodium-Glucose Cotransporter-2 Inhibitor Immediately Decreases Serum Uric Acid Levels in Type 2 Diabetic Patients

Naro Ohashi, Taro Aoki, Takashi Matsuyama, Sayaka Ishigaki, Shinsuke Isobe, Tomoyuki Fujikura, Takuya Hashimoto, Daisuke Tsuriya, Hiroshi Morita, Akihiko Kato, Hideo Yasuda

Department of Internal Medicine 1, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan

Med Sci Monit 2020; 26:e926086

DOI: 10.12659/MSM.926086

Available online: 2020-08-17

Published: 2020-10-02

BACKGROUND: Sodium-glucose cotransporter-2 (SGLT2) inhibitors are new antihyperglycemic drugs for type 2 diabetes. SGLT2 inhibitors ameliorate cardiovascular morbidity and mortality as well as kidney disease progression by reducing body weight (BW), blood pressure (BP), visceral adiposity, albuminuria, and serum uric acid and blood glucose levels. However, it is not clear which effects are pronounced, and what mechanisms are associated with these effects.
MATERIAL AND METHODS: This study recruited patients with type 2 diabetes who were prescribed an SGLT2 inhibitor for the first time in our outpatient department. Clinical parameters were measured before and 6 months after the administration of the SGLT2 inhibitor, without the addition of new drugs and dose changes for all prescribed drugs.
RESULTS: This study recruited 24 patients with type 2 diabetes. No significant differences in BP, glycated hemoglobin (HbA1c) levels, and low-density lipoprotein cholesterol levels were observed after SGLT2 inhibitor administration. In contrast, BW and serum uric acid levels decreased significantly, and the fractional excretion of uric acid (FEUA) increased significantly after administration. While no significant relationships were observed between serum uric acid and FEUA with respect to the percentage changes from baseline values, the percentage changes in serum uric acid levels from baseline were significantly and positively associated with those in serum creatinine levels.
CONCLUSIONS: Serum uric acid levels were immediately decreased owing to the administration of SGLT2 inhibitor, but BP, blood glucose, and serum lipid levels were unchanged. These changes in serum uric acid levels may be associated with changes in renal function.

Keywords: Diabetes Mellitus, Type 2, Sodium-Glucose Transporter 2, Uric Acid