Background: Oral semaglutide has been shown to be particularly effective for a range of goals, including reducing HbA1c and weight. No studies have investigated its effects on the urinary albumin to creatinine ratio (UACR), however. This study investigated the effects of switching to oral semaglutide from dipeptidyl peptidase-4 (DPP4) inhibitors on UACR in patients with type 2 diabetes.

　Methods: Thirty patients with type 2 diabetes (15 men, 15 women; average age, 60.3 years) whose UACR was measured before and after switching from DPP4 inhibitors to oral semaglutide were investigated. The effects were compared between before and after 6.6 months on average body weight, systolic and diastolic blood pressure, HbA1c, low-density lipoprotein cholesterol (LDL-C), and UACR.

　Results: After switching from a DPP4 inhibitor to oral semaglutide, HbA1c decreased significantly (8.3 ± 1.1％ before switching, 7.4 ± 0.9％ after switching, p＜0.001). Body weight (71.8 ± 13.7 kg before switching, 68.4 ± 12.6 kg after switching, p＜0.001), systolic blood pressure (140.4 ± 17.0 mmHg before switching, 135.4 ± 13.8 mmHg after switching, p＜0.01), LDL-C (111.1 ± 20.4 mg/dL before switching, 98.8 ± 21.5 mg/dL after switching, p＜0.01), and UACR (194.2±311.8 mg/g･Cre before switching, 121.2 ± 224.3 mg/g･Cre after switching, p＜0.001) also significantly decreased.

　Conclusion: Switching from DPP4 inhibitors to oral semaglutide resulted in reductions in HbA1c, body weight, systolic blood pressure, LDL-C, and UACR in patients with type 2 diabetes.

　Background: The pathogenesis of hyperuricemia in the working generation remains to be clarified.

　Objectives and Methods: This study investigated change in various cardiovascular risk factors by job category, treatment effect, and their mutual relationship using the following 3 cohorts: (1) 2813 employees with normal uric acid levels in 2010 for whom regular health checkup data from 2010 to 2020 could be compared (multivariate analysis group); (2) 322 patients with 7.0 mg/dL or more in both 2010 and 2020 (sustained group); and (3) 432 patients with 7.0 mg/dL or higher in 2010 and normal in 2020 (improved group).

　Results: Using under treatment and/or untreated hyperuricemia as the endpoint in 2020, the odds ratios in 2010 for obesity, hypertension, and chronic kidney disease showed significant elevation, while showing a significant reduction for diabetes in multivariate analysis. In the sustained group, eGFR was significantly reduced. On the other hand, no reduction in eGFR and a significant reduction in blood pressure and LDL-C were observed in the improved group. No differences were observed by job category.

　Conclusion: Analysis of the pathogenesis and progression of hyperuricemia revealed that its onset and persistence was linked to chronic kidney disease and associated with obesity and hypertension. These changes could be prevented by early intervention.

　Background: The relationship between hyperuricemia and diabetes is complex and unclear.

　Subjects and Methods: Mean uric acid levels were compared between each HbA1c category in 4259 people untreated for hyperuricemia. They were then divided into a non-diabetic treatment category (3888 patients; prescription (－) group) and a diabetic treatment category (371 patients; prescription (＋) group). The impact of eGFR was also investigated.

　Results: 1) The mean uric acid level in the prescription (－) group was significantly higher than that in the prescription (＋) group (6.0 ± 1.2 mg/dL vs 5.5 ± 1.2 mg/dL, p＜0.001). 2) In the prescription (－) group, the mean uric acid level increased with a rise in the HbA1c level within the normal range, but declined when the HbA1c exceeded 6.5, exhibiting an inverse U-shape. 3) On the other hand, in the prescription (＋) group, the mean uric acid level in each HbA1c category remained flat, and the above relationship was not observed. 4) The mean uric acid level was significantly higher in the reduced renal function group (eGFR＜60) than in the normal renal function group (eGFR≧60) (6.6 ± 1.2 mg/dL vs 5.9 ± 1.2 mg/dL, p＜0.001). An inverse U-shaped relationship was observed between HbA1c and uric acid levels in the normal renal function group, but no such relation was observed in the reduced renal function group.

　Conclusion: An inverse U-shaped relationship between serum uric acid and HbA1c levels was observed in the non-diabetic treatment group, but was not observed in the diabetic treatment group. In addition, a similar inverse U-shaped relationship was observed in the normal renal function group, but was not observed in the reduced renal function group. These results suggest the need for caution in assessing cardiovascular risk.