Wang Shihan, Yuan Tao, Song Shuoning, Duo Yanbei, Zhao Tianyi, Gao Junxiang, Fu Yong, Dong Yingyue, Zhao Weigang
Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
J Pers Med. 2022 Dec 22;13(1):21. doi: 10.3390/jpm13010021.
We aimed to explore the medium- and long-term (≥12 weeks) effects of dapagliflozin on serum uric acid (SUA) level in patients with type 2 diabetes mellitus (T2DM) in the real world study and to explore the influencing factors of dapagliflozin on reducing SUA level. This observational, prospective cohort study was based on the real world. There were 77 patients included in this study. They were divided into two groups. Patients in treatment group (n = 38) were treated as dapagliflozin 10 mg/d combined with therapy of routine glucose-lowering drugs (GLDs), and patients in the control group (n = 39) were treated with their routine GLDs. All measurements of physical examinations, blood, and urine samples, including age, sex, weight, height, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), and SUA, were collected at baseline for all patients in these two groups and repeated after 12, 24, and 48 weeks of therapy. We compared the changes of metabolic indicators including SUA in these two groups to evaluate the effects of dapagliflozin and analyzed its influencing factors. In the dapagliflozin group, mean SUA levels significantly decreased from 334.2 ± 99.1 μmol/L at baseline to 301.9 ± 73.2 μmol/L after 12 weeks therapy (t = 2.378, p = 0.023). There was no significant statistical difference of SUA levels after 24 weeks treatment of dapagliflozin compared with 12-week and 48-week treatment with dapagliflozin (p > 0.05). We found that baseline SUA had a significant impact on the effect of dapagliflozin on reducing SUA (OR 1.014, 95%CI 1.003−1.025, p = 0.014) by logistic regression analysis. Receiver operating characteristic (ROC) curve showed that T2DM patients with SUA level ≥ 314.5 μmol/L had relative accuracy in recognizing the good effects of dapagliflozin on reducing SUA (sensitivity 76.9%, specificity 76.2%). Combination therapy of dapagliflozin with routine blood-glucose-lowering drugs in T2DM patients showed the significant and sustained stable effect of lowering SUA level in this real-world study.
在这项真实世界研究中，我们旨在探讨达格列净对2型糖尿病（T2DM）患者血清尿酸（SUA）水平的中长期（≥12周）影响，并探究达格列净降低SUA水平的影响因素。这项观察性前瞻性队列研究基于真实世界。本研究纳入了77例患者，将他们分为两组。治疗组（n = 38）患者接受达格列净10 mg/d联合常规降糖药物（GLDs）治疗，对照组（n = 39）患者接受常规GLDs治疗。收集两组所有患者基线时的所有体格检查、血液和尿液样本测量值（包括年龄、性别、体重、身高、收缩压（SBP）、舒张压（DBP）、空腹血糖（FBG）、糖化血红蛋白（HbA1c）和SUA），并在治疗12、24和48周后重复测量。我们比较了两组代谢指标（包括SUA）的变化，以评估达格列净的效果并分析其影响因素。在达格列净组中，治疗12周后，平均SUA水平从基线时的334.2±99.1μmol/L显著降至301.9±73.2μmol/L（t = 2.378，p = 0.023）。与达格列净治疗12周和48周相比，达格列净治疗24周后SUA水平无显著统计学差异（p>0.05）。通过逻辑回归分析，我们发现基线SUA对达格列净降低SUA的效果有显著影响（OR 1.014，95%CI 1.003−1.025，p = 0.014）。受试者工作特征（ROC）曲线显示，SUA水平≥314.5μmol/L的T2DM患者在识别达格列净降低SUA的良好效果方面具有相对准确性（敏感性76.9%，特异性76.2%）。在这项真实世界研究中，达格列净与常规降糖药物联合治疗T2DM患者显示出降低SUA水平的显著且持续稳定的效果。
