Effects of antidiabetic drugs on the level of serum uric acid in patients who have type 2 diabetes.

IF 1.7 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Saudi Medical Journal Pub Date : 2025-03-01 DOI:10.15537/smj.2025.46.3.20240920

Gang Wang, Guixia Wang

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Abstract

Hyperuricemia and type 2 diabetes mellitus (T2DM) are interconnected, in that each disorder increases risk for the other. Some antidiabetic drugs may decrease the level of serum uric acid (SUA). This narrative review describes the effects of multiple antidiabetic drugs on the SUA level and their possible mechanisms of action in patients with T2DM. The results showed that sodium glucose contransporter-2 inhibitors (SGLT2is), thiazolidinediones, metformin, and linagliptin decreased the SUA; insulin, sitagliptin, and alogliptin increased the SUA; and glucagon-like peptide-1 receptor agonists (GLP-1 RAs), sulfonylureas, and alpha-glucosidase inhibitors had little effect on the SUA. Sodium glucose contransporter-2 inhibitors appeared to have the greatest effect on lowering SUA, possibly because they reduce pentose phosphate pathway metabolism and increase the renal excretion of urate by altering renal tubular uric acid transporters. Among all antidiabetic drugs currently used, SGTL2is appeared to be the most promising therapeutic option for T2DM patients with hyperuricemia.

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高尿酸血症和 2 型糖尿病（T2DM）是相互关联的，因为每种疾病都会增加患另一种疾病的风险。一些抗糖尿病药物可降低血清尿酸（SUA）水平。本综述介绍了多种抗糖尿病药物对 T2DM 患者 SUA 水平的影响及其可能的作用机制。结果显示，钠葡萄糖转运体-2抑制剂（SGLT2is）、噻唑烷二酮类药物、二甲双胍和利拉利汀可降低SUA；胰岛素、西格列汀和阿格列汀可增加SUA；而胰高血糖素样肽-1受体激动剂（GLP-1 RA）、磺脲类药物和α-葡萄糖苷酶抑制剂对SUA的影响很小。葡萄糖转运体钠-2 抑制剂似乎对降低 SUA 的作用最大，这可能是因为它们减少了磷酸戊糖途径的代谢，并通过改变肾小管尿酸转运体增加了尿酸盐的肾排泄。在目前使用的所有抗糖尿病药物中，SGTL2is 似乎是治疗患有高尿酸血症的 T2DM 患者最有希望的选择。

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来源期刊

Saudi Medical Journal 医学-医学：内科

CiteScore

2.30

自引率

6.20%

发文量

203

审稿时长

12 months

期刊介绍： The Saudi Medical Journal is a monthly peer-reviewed medical journal. It is an open access journal, with content released under a Creative Commons attribution-noncommercial license. The journal publishes original research articles, review articles, Systematic Reviews, Case Reports, Brief Communication, Brief Report, Clinical Note, Clinical Image, Editorials, Book Reviews, Correspondence, and Student Corner.