Kochanowska Anna, Rusztyn Przemysław, Szczerkowska Karolina, Surma Stanisław, Gąsecka Aleksandra, Jaguszewski Miłosz J, Szarpak Łukasz, Filipiak Krzysztof J
1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland.
Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland.
J Cardiovasc Dev Dis. 2023 Jun 22;10(7):268. doi: 10.3390/jcdd10070268.
Sodium-glucose cotransporter 2 inhibitors (SGLT2is) are glucose-lowering agents whose positive impact on cardiovascular risk has been described extensively. Not only do they influence lipid profile, blood pressure, atherosclerosis risk, hemoglobin level, and insulin resistance, but they also reduce cardiovascular events, all-cause mortality, and hospitalization rates. Some of these effects may be due to their impact on serum uric acid (SUA) concentration. Findings from nine meta-analyses showed that, indeed, SGLT2is significantly reduce SUA. The data on the drug- and dose-dependency of this effect were inconclusive. Several factors alternating the beneficial effects of SGLT2is on SUA, such as glycated hemoglobin concentration (HbA1c), presence of diabetes, and baseline SUA level, were described. Even though there is a consensus that the lowering of SUA by SGLT2is might be due to the increased urinary excretion rate of uric acid (UEUA) rather than its altered metabolism, the exact mechanism remains unknown. The influence of SGLT2is on SUA may not only be used in gout treatment but may also be of huge importance in explaining the observed pleiotropic effects of SGLT2is.
钠-葡萄糖协同转运蛋白2抑制剂（SGLT2is）是一类降糖药物，其对心血管风险的积极影响已被广泛描述。它们不仅会影响血脂、血压、动脉粥样硬化风险、血红蛋白水平和胰岛素抵抗，还能降低心血管事件、全因死亡率和住院率。其中一些作用可能归因于它们对血清尿酸（SUA）浓度的影响。九项荟萃分析的结果表明，SGLT2is确实能显著降低SUA。关于这种效应的药物和剂量依赖性的数据尚无定论。文中描述了几个影响SGLT2is对SUA有益作用的因素，如糖化血红蛋白浓度（HbA1c）、糖尿病的存在和基线SUA水平。尽管人们一致认为SGLT2is降低SUA可能是由于尿酸尿排泄率（UEUA）增加而非其代谢改变，但确切机制仍不清楚。SGLT2is对SUA的影响不仅可用于痛风治疗，在解释SGLT2is所观察到的多效性作用方面可能也具有重要意义。
