Glycosuria Lowers Serum Uric Acid in Type 2 Diabetics

Abstract

Aim : Evidence has emerged that glycosuria is associated with lowering of serum uric acid （ UA ） levels in patients with diabetes mellitus （ DM ） . The present study investigated whether glycosuria, per se, is involved in the lowering of UA levels in type 2 diabetic patients without hypoglycemic agents with uricosuric property. Subjects & Methods: Individuals who underwent a annual medical check - up and met the inclusion criteria were recruited for this cross - sectional analysis. Diabetic patients being treated with sodium glucose cotransporter 2 （ SGLT2 ） inhibitors were excluded from the analysis. The final participants were a total of 11,649 males, which consisted of euglycemics, prediabetics, and diabetics. Multiple regression analysis was employed to estimate factors in fl uencing serum UA level. Results: The UA level in the overall diabetics （ 5.9 ± 1.4mg/dL, n=704 ） was comparable with that in euglycemics （ 6.0 ± 1.1mg/dL, n=9,871 ） . Prediabetics had the highest UA level among the subgroups （ 6.6 ± 1.3mg/dL, n=1,074 ） . The UA level in diabetics with glycosuria （ 5.5 ± 1.3mg/dL, n=197 ） was lower than that in diabetics without glycosuria （ 6.0 ± 1.2mg/ dL, n=507, p<0.01 ） . In addition, the severity of glycosuria had a negative correlation with the lowering of UA levels in diabetics. In addition, poor diabetic control was associated with the severity of glycosuria. Multiple regression analysis revealed that factors to predict the lowering of UA levels in diabetics were: age, estimated glomerular fi ltration rate （ eGFR ） , and presence of glycosuria. Conclusion: There is a close association between glycosuria and lowering of serum UA levels in patients with DM not being treated with SGLT2 inhibitors. where glucose intolerance becomes apparent, the serum uric acid （ UA ） level increases due to the reduction of UA excretion through the kidney. This occurs in concert with increased insulin resistance and/or hyperinsulinemia, which act on the kidney to increase UA reabsorption, leading to an increase in the circulating serum UA level. A large number of studies have shown that hyperuricemia is closely associated with DM 1 - 7 ） . The prevalence of hyperuricemia was found to be 33% in Type 2 DM patients with central obesity in Asia 8 ） . Hyperuricemia, in addition, is