Effect of SGLT2 Inhibitors on Serum Uric Acid Levels in Type 2 Diabetics

Abstract

Aim: Evidence has emerged on the cardio-renal protective effect of Sodium-Glucose Cotransporter 2 (SGLT2) inhibitors. The mechanisms are multifactorial, but the uric acid (UA) lowering effect of SGLT2 inhibitors may-at least in part-contribute to it. The present study explores whether the same holds true in our daily outpatient practice. Methods: The fluctuation of serum UA was monitored retrospectively in 114 patients who received SGLT2 inhibitors for a period of 24 weeks. Results: HbA1c, body weight, and BMI were significantly decreased (p<0.001). The overall serum UA value was reduced from 5.6±1.3 to 5.2±1.0 mg/dL (p<0.001). When divided into three quartiles based on the basal serum UA values, the UA level was significantly reduced in the high quartile group. On the other hand, the UA levels increased in the low quartile group in which the patients' pre-treatment UA levels were in the neighborhood of the lower normal range. Conclusion: The present study suggests that treatment with SGLT2 inhibitors lowers serum UA levels in type 2 diabetics with hyperuricemia. However, they may act as a UA-increasing agent in individuals with lower normal pre-treatment UA levels.