Effects of sodium-glucose cotransporter 2 inhibitors on serum uric acid in patients with type 2 diabetes mellitus: A systematic review and network meta-analysis

IF 5.4 2区医学 Q1 ENDOCRINOLOGY & METABOLISM Diabetes, Obesity & Metabolism Pub Date : 2021-10-06 DOI:10.1111/dom.14570

Xiaodong Hu MD, Yue Yang PhD, Xiaona Hu MD, Xiaomeng Jia MD, Hongzhou Liu MD, Minjie Wei PhD, Zhaohui Lyu MD

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引用次数: 19

Abstract

Aims

The present study aims to determine the effects of sodium-glucose cotransporter 2 (SGLT-2) inhibitors on the serum uric acid (SUA) levels of patients with type 2 diabetes mellitus (T2DM) in Asia.

Methods

PubMed, CENTRAL, Embase and Cochrane Library databases were searched for randomized controlled trials of SGLT-2 inhibitors in patients with T2DM up to 15 July 2021, without language or date restrictions.

Results

In total, 19 high-quality studies (4218 participants) were included in the present network meta-analysis. All of the included SGLT-2 inhibitors (empagliflozin, dapagliflozin, canagliflozin, ipragliflozin, luseogliflozin and tofogliflozin) significantly decreased SUA levels compared with those of the control [total standard mean difference –0.965, 95% CI (−1.029, −0.901), p = .000, I² = 98.7%] in patients with T2DM. Subgroup analysis and meta-regression showed that the combined analysis of different inhibitors might lead to heterogeneity of the results. Therefore, among the SGLT-2 inhibitors, the results of the subsequent network meta-analysis revealed that luseogliflozin and dapagliflozin ranked the highest in terms of lowering SUA levels among the SGLT-2 inhibitors. Moreover, the network meta-analysis declared that luseogliflozin (1 and 10 mg) and dapagliflozin (5 mg) led to a superior reduction in SUA in patients with T2DM.

Conclusions

SGLT-2 inhibitors could significantly reduce SUA levels in patients with T2DM, particularly luseogliflozin (1 and 10 mg) and dapagliflozin (5 mg) possess the best effects. Therefore, SGLT-2 inhibitors look extremely promising as an antidiabetes treatment option in patients with T2DM with high SUA.

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钠-葡萄糖共转运蛋白2抑制剂对2型糖尿病患者血清尿酸的影响:系统评价和网络荟萃分析

本研究旨在确定钠-葡萄糖共转运蛋白2 (SGLT-2)抑制剂对亚洲2型糖尿病(T2DM)患者血清尿酸(SUA)水平的影响。方法检索PubMed、CENTRAL、Embase和Cochrane图书馆数据库，检索截至2021年7月15日的T2DM患者中SGLT-2抑制剂的随机对照试验，无语言或日期限制。结果本网络荟萃分析共纳入19项高质量研究(4218名受试者)。与对照组相比，所有纳入的SGLT-2抑制剂(恩格列净、达格列净、卡格列净、伊格列净、卢西格列净和托格列净)均显著降低SUA水平[总标准平均差-0.965,95% CI (- 1.029， - 0.901)， p =。000, I2 = 98.7%]。亚组分析和meta回归分析显示，不同抑制剂联合分析可能导致结果的异质性。因此，在SGLT-2抑制剂中，随后的网络荟萃分析结果显示，在SGLT-2抑制剂中，鲁西格列净和达格列净在降低SUA水平方面排名最高。此外，网络荟萃分析表明，卢西格列净(1 mg和10 mg)和达格列净(5 mg)可显著降低T2DM患者的SUA。结论SGLT-2抑制剂可显著降低T2DM患者的SUA水平，尤以鲁西格列净(1、10 mg)和达格列净(5 mg)效果最好。因此，SGLT-2抑制剂作为高SUA T2DM患者的抗糖尿病治疗选择看起来非常有希望。

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来源期刊

Diabetes, Obesity & Metabolism 医学-内分泌学与代谢

CiteScore

10.90

自引率

6.90%

发文量

319

审稿时长

3-8 weeks

期刊介绍： Diabetes, Obesity and Metabolism is primarily a journal of clinical and experimental pharmacology and therapeutics covering the interrelated areas of diabetes, obesity and metabolism. The journal prioritises high-quality original research that reports on the effects of new or existing therapies, including dietary, exercise and lifestyle (non-pharmacological) interventions, in any aspect of metabolic and endocrine disease, either in humans or animal and cellular systems. ‘Metabolism’ may relate to lipids, bone and drug metabolism, or broader aspects of endocrine dysfunction. Preclinical pharmacology, pharmacokinetic studies, meta-analyses and those addressing drug safety and tolerability are also highly suitable for publication in this journal. Original research may be published as a main paper or as a research letter.