Hypouricemic effect of sodium glucose transporter-2 inhibitors: a network meta-analysis and meta-regression of randomized clinical trials.

IF 2.7 Q3 ENDOCRINOLOGY & METABOLISM Expert Review of Endocrinology & Metabolism Pub Date : 2025-03-01 Epub Date: 2025-01-21 DOI:10.1080/17446651.2025.2456504
Kannan Sridharan, Maya Mohammed Osman Hussein Alkhidir
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Abstract

Background: Sodium-glucose cotransporter-2 inhibitors (SGLT2is) are known for their cardiovascular benefits, but their impact on serum uric acid levels is not well understood. This study evaluates the hypouricemic effects of SGLT2is and their potential cardiovascular implications.

Methods: A network meta-analysis was performed, including 56 studies (16,788 participants) contributing data to the meta-analysis. The effects of SGLT2is on serum uric acid levels were analyzed with weighted mean difference (WMD) as the effect estimate. Bootstrapped meta-analysis, trial sequential analysis, and meta-regression were utilized to validate the findings and assess the influence of covariates. The certainty of the evidence was evaluated.

Results: The analysis revealed that SGLT2is significantly reduced serum uric acid levels (WMD: -40.01 μmol/L). Specific reductions were noted for ertugliflozin (-42.17 μmol/L), dapagliflozin (-40.28 μmol/L), empagliflozin (-46.75 μmol/L), canagliflozin (-35.55 μmol/L), and ipragliflozin (-10.48 μmol/L). Both low and high doses were effective, with empagliflozin showing the highest efficacy. No significant associations were found with covariates. The evidence was of moderate certainty.

Conclusion: SGLT2is significantly lower serum uric acid levels, with empagliflozin being the most effective. These findings suggest a potential role in reducing cardiovascular risk. Further research is needed to explore their effects on hyperuricemic patients, and monitoring serum uric acid levels is recommended.

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葡萄糖转运蛋白-2抑制剂钠的降尿酸作用:随机临床试验的网络荟萃分析和荟萃回归
背景:钠-葡萄糖共转运蛋白-2抑制剂(SGLT2is)因其心血管益处而闻名,但其对血清尿酸水平的影响尚不清楚。本研究评估了SGLT2is的降糖作用及其潜在的心血管影响。方法:进行网络荟萃分析,包括56项研究(16,788名参与者),为荟萃分析提供数据。SGLT2is对血清尿酸水平的影响以加权平均差(WMD)作为效果估计。采用自举荟萃分析、试验序列分析和元回归来验证研究结果并评估协变量的影响。对证据的确定性进行了评估。结果:sglt2dm显著降低血清尿酸水平(WMD: -40.01 μmol/L)。埃图格列净(-42.17 μmol/L)、达格列净(-40.28 μmol/L)、恩帕格列净(-46.75 μmol/L)、坎格列净(-35.55 μmol/L)、ipragliflozin (-10.48 μmol/L)特异性降低。低剂量和高剂量都有效,以恩格列净显示出最高的疗效。未发现与协变量有显著关联。证据有一定程度的确定性。结论:sglt2dm显著降低血清尿酸水平,以恩格列净最为有效。这些发现表明它在降低心血管风险方面具有潜在作用。需要进一步研究它们对高尿酸血症患者的影响,建议监测血清尿酸水平。
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来源期刊
Expert Review of Endocrinology & Metabolism
Expert Review of Endocrinology & Metabolism ENDOCRINOLOGY & METABOLISM-
CiteScore
4.80
自引率
0.00%
发文量
44
期刊介绍: Implicated in a plethora of regulatory dysfunctions involving growth and development, metabolism, electrolyte balances and reproduction, endocrine disruption is one of the highest priority research topics in the world. As a result, we are now in a position to better detect, characterize and overcome the damage mediated by adverse interaction with the endocrine system. Expert Review of Endocrinology and Metabolism (ISSN 1744-6651), provides extensive coverage of state-of-the-art research and clinical advancements in the field of endocrine control and metabolism, with a focus on screening, prevention, diagnostics, existing and novel therapeutics, as well as related molecular genetics, pathophysiology and epidemiology.
期刊最新文献
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