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

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.