Effect of Glomerular Filtration Rate on Uric Acid Metabolism in a Retrospective Cohort of Type-2 Diabetes Mellitus Patients on SGLT-2 Inhibitor Therapy.

OBJECTIVE

This study aimed to investigate the effects of different glomerular filtration rates (GFRs) on serum uric acid (SUA) levels in patients with type 2 diabetes mellitus receiving sodium-glucose transporter 2 (SGLT-2) inhibitor therapy.

MATERIALS AND

METHODS

A total of 3,004 patients with type 2 diabetes mellitus treated with SGLT-2 inhibitors between January 2017 and September 2022 were analyzed. Patients who did not attend follow-up visits, had missing data, discontinued SGLT-2 inhibitors, were taking medications that affect SUA levels, or were being treated for gout were excluded. The final study group consisted of 410 patients. Biochemical parameters were retrospectively compared before treatment and at the 3rd and 12th months of drug therapy. To evaluate the effect of GFR on uric acid levels during SGLT-2 inhibitor treatment, patients were analyzed with and without grouping based on GFR levels.

RESULTS

The study showed that glycated hemoglobin, fasting plasma glucose, creatinine, low-density lipoprotein, triglycerides, and SUA levels decreased with SGLT-2 inhibitor treatment, while high-density lipoprotein and urine glucose levels increased. The efficacy of SGLT-2 inhibitors in reducing SUA levels was found to correlate closely with changes in GFR, with a notable reduction observed at GFR levels below 60 mL/min/1.73 m2. Moreover, the effect was independent of the specific active substance used.

CONCLUSION

SGLT-2 inhibitors not only regulate blood glucose levels and lipid profiles but also have a significant impact on uric acid levels. However, this study found that this effect is considerably diminished in patients with extremely low GFR.