Liu Zhenyu, Kong Huixi, Zhang Baoyu
Department of Clinical Medicine, Beijing Luhe Hospital, Capital Medical University, Tongzhou District, Beijing, China.
Department of Clinical Medicine, Beijing Shijitan Hospital, Capital Medical University, Haidian District, Beijing, China.
Endocr Connect. 2024 May 10;13(6). doi: 10.1530/EC-24-0070. Print 2024 Jun 1.
To optimize the treatment plan for patients with type 2 diabetes mellitus (T2DM) and hyperuricemia, this narrative literature review summarizes the effect of antidiabetic drugs on serum uric acid (SUA) levels using data from observational studies, prospective clinical trials, post hoc analyses, and meta-analyses. SUA is an independent risk factor for T2DM, and evidence has shown that patients with both gout and T2DM exhibit a mutually interdependent effect on higher incidences. We find that insulin and dipeptidyl peptidase 4 inhibitor (DPP-4i) except linagliptin could increase the SUA and other drugs including metformin, thiazolidinediones (TZDs), glucagon-like peptide-1 receptor agonists (GLP-1 RAs), linagliptin, sodium-glucose cotransporter 2 inhibitors (SGLT2i), and α-glucosidase inhibitors have a reduction effect on SUA. We explain the mechanisms of different antidiabetic drugs above on SUA and analyze them compared with actual data. For sulfonylureas, meglitinides, and amylin analogs, the underlying mechanism remains unclear. We think the usage of linagliptin and SGLT2i is the most potentially effective treatment of patients with T2DM and hyperuricemia currently. Our review is a comprehensive summary of the effects of antidiabetic drugs on SUA, which includes actual data, the mechanisms of SUA regulation, and the usage rate of drugs.
为优化2型糖尿病（T2DM）合并高尿酸血症患者的治疗方案，本叙述性文献综述利用观察性研究、前瞻性临床试验、事后分析和荟萃分析的数据，总结了抗糖尿病药物对血清尿酸（SUA）水平的影响。SUA是T2DM的独立危险因素，有证据表明痛风和T2DM患者对更高的发病率存在相互依存的影响。我们发现，胰岛素和除利格列汀之外的二肽基肽酶4抑制剂（DPP-4i）可使SUA升高，而其他药物包括二甲双胍、噻唑烷二酮类（TZDs）、胰高血糖素样肽-1受体激动剂（GLP-1 RAs）、利格列汀、钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）和α-葡萄糖苷酶抑制剂对SUA有降低作用。我们阐述了上述不同抗糖尿病药物对SUA的作用机制，并与实际数据进行了分析比较。对于磺脲类、格列奈类和胰淀素类似物，其潜在机制尚不清楚。我们认为，利格列汀和SGLT2i的使用是目前T2DM合并高尿酸血症患者最具潜在疗效的治疗方法。我们的综述全面总结了抗糖尿病药物对SUA的影响，包括实际数据、SUA调节机制和药物使用率。
