Serum uric acid and diabetes: from pathophysiology to cardiovascular disease

2021 ◽  
Vol 27 ◽  
Author(s):  
Niki Katsiki ◽  
George D. Dimitriadis ◽  
Dimitri P Mikhailidis
Keyword(s):  
Uric Acid ◽  
Serum Uric Acid ◽  
Elevated Serum ◽  
Peripheral Artery ◽  
Alcoholic Fatty Liver ◽  
Dipeptidyl Peptidase 4 ◽  
Sodium Glucose Cotransporter ◽  
Dipeptidyl Peptidase 4 Inhibitors ◽  
Artery Disease

: Hyperuricemia, has been traditionally related to nephrolithiasis and gout. However, it has also been associated with the development of type 2 diabetes mellitus (T2DM) and cardiometabolic and cardiovascular diseases. Pathophysiologically, elevated serum uric acid (SUA) levels may be associated with abnormal lipid and glucose metabolism. In this narrative review, we consider the associations between hyperuricemia, hyperglycemia, atherosclerosis and thrombosis. Furthermore, we comment on the available evidence linking elevated SUA levels with the incidence and outcomes of coronary heart disease, stroke, peripheral artery disease and non-alcoholic fatty liver in subjects with T2DM. The effects of antidiabetic drugs (e.g. metformin, pioglitazone, sulfonylureas, dipeptidyl peptidase 4 inhibitors, glucagonlike peptide-1 receptor agonists, sodium-glucose cotransporter 2 inhibitors and insulin) on SUA concentrations are also reviewed.

scholarly journals The association of amputations and peripheral artery disease in patients with type 2 diabetes mellitus receiving sodium-glucose cotransporter type-2 inhibitors: real-world study

2020 ◽  
Author(s):  
Sanjoy K Paul ◽  
Deepak L Bhatt ◽  
Olga Montvida
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Peripheral Artery Disease ◽  
Peripheral Artery ◽  
Dipeptidyl Peptidase 4 ◽  
Sodium Glucose Cotransporter ◽  
Glucagon Like Peptide 1 ◽  
Artery Disease

Abstract Aims  The aim of this study was to evaluate the temporal pattern of amputations in patients with type 2 diabetes mellitus (T2DM), the risk of amputations by new and older anti-diabetic drugs (ADDs), and the interplay of peripheral artery disease (PAD) with therapy and amputation risk. Methods and results  Using Centricity Electronic Medical Records from USA, 3 293 983 patients with T2DM were identified: 169 739 received sodium-glucose cotransporter type-2 inhibitors (SGLT-2i; no exposure to incretins); 149 826 received glucagon-like peptide 1 receptor agonists [GLP-1RA, no SGLT-2i or dipeptidyl peptidase-4 inhibitor (DPP-4i) exposure]; 448 225 received DPP-4i (no exposure to GLP-1RA or SGLT-2i); and 1 954 353 received other ADDs. The proportion of incident amputations per 10 000 adults ranged between 4.7 and 6.8 during 2000–08 and significantly increased to 12.3 in 2017. Over 17 211 719 person-years follow-up post T2DM diagnosis, the rates per 1000 person-years of any and lower limb amputations (LLAs) were similar between SGLT-2i and incretins [95% confidence interval (CI) range: 1.06–1.67], and significantly higher in other groups (95% CI range: 1.96–2.29). In propensity score-adjusted pairwise analyses, the risk of LLA was not higher in SGLT-2i vs. GLP1-RA [hazard ratio (HR) (95% CI): 0.88 (0.73, 1.05)], and lower in SGLT-2i vs. DPP-4i/other ADD [HR (95% CI): 0.65 (0.56, 0.75)/0.43 (0.37, 0.49)]. The rate of LLA was similar in patients treated with canagliflozin, empagliflozin, or dapagliflozin. Patients with PAD had more than four-fold higher LLA risk (range of 95% CI of HR: 3.6–6.0). Conclusion  The risk of amputation in patients treated with SGLT-2i and incretins was not higher compared with other ADDs. Pre-existing PAD was the greatest driver of amputation risk.

Relation of elevated serum uric acid levels to first-degree heart block and other cardiac conduction defects in hospitalized patients with type 2 diabetes

2017 ◽  
Vol 31 (12) ◽  
pp. 1691-1697 ◽  
Author(s):  
Alessandro Mantovani ◽  
Riccardo Rigolon ◽  
Isabella Pichiri ◽  
Giovanni Morani ◽  
Stefano Bonapace ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Uric Acid ◽  
Serum Uric Acid ◽  
Heart Block ◽  
Elevated Serum ◽  
Hospitalized Patients ◽  
Cardiac Conduction ◽  
Degree Heart Block

scholarly journals Serum uric acid level in type 2 diabetes mellitus

2019 ◽  
Vol 6 (4) ◽  
pp. 1265
Author(s):  
D. Vasantha Kalyani ◽  
M. Ilamaran ◽  
P. Suresh Kumar ◽  
Saranya Nagalingam
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Uric Acid ◽  
Serum Uric Acid ◽  
Uric Acid Level ◽  
Acid Level ◽  
Serum Uric Acid Level ◽  
The Mean ◽  
Artery Disease

Background: Diabetes mellitus is the most important risk factor associated with two to four fold increased incidence of coronary artery disease. The major risk factors for CAD are hypercholesterolemia, hypertension, diabetes mellitus, and cigarette smoking Objectives: To study the level of serum uric acid in type 2 diabetes mellitus and the correlation between elevated serum uric acid level and the component of metabolic syndrome like obesity, hypertension, dyslipidemia.Methods: The study was done as descriptive analytical study among the diabetic patients in a tertiary care setting during the period January 2018 to February 2019. The inclusion and exclusion criteria were clearly defined and the study participants were recruited for the study after getting the informed consent. The socio demographic profile, clinical and laboratory data were collected from the blood sample obtained from the patients with the standardized procedures. Data was entered in Microsoft excel spread sheet and analyzed statistically using SPSS statistical software. Student ‘t’ test and Chi-square test values were applied for significance.Results: Serum uric acid in the study population and control varied from 3.0 to 8.1 and 2.7 to 5.5 mg/dl respectively. The mean and standard deviation of uric acid among cases was 5.08±1.42 while in control it was 3.55±0.62 respectively. The serum uric acid level of diabetics was very much elevated compare with controls and it was highly significant. Significant correlation was noticed between serum uric acid and BMI as well as WHR. Elevated uric acid levels were significantly noticed among those with hypertension, dyslipidemia, coronary artery disease and chronicity of the diabetes.Conclusions: Uric acid was significantly elevated in diabetic population and the mean value of serum uric acid level was higher in longer duration of diabetes, hypertension, dyslipidemia, central obesity which are the components of metabolic syndrome.

scholarly journals Treatment of type 2 diabetes: the stability of the effectiveness of hypoglycemic medications

2016 ◽  
Vol 13 (3) ◽  
pp. 32-36
Author(s):  
Tat'yana Morgunova ◽  
Valentin Fadeev
Keyword(s):  
Type 2 Diabetes ◽  
Meta Analysis ◽  
Original Research ◽  
Dipeptidyl Peptidase 4 ◽  
Sodium Glucose Cotransporter ◽  
Dipeptidyl Peptidase 4 Inhibitors ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1 ◽  
The Stability

This article is dedicated to the problem of glycaemic durability of drugs used in treatment of type 2 diabetes. The results of studies comparing durability of glycemic control as monotherapy or in combination of metformin with different drugs: dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists, sulfonylurea, inhibitors of sodium-glucose cotransporter-2 are shown. The article discusses the results of original research and meta-analysis.

scholarly journals The risk of new-onset atrial fibrillation in patients with type 2 diabetes mellitus treated with sodium glucose cotransporter 2 inhibitors versus dipeptidyl peptidase-4 inhibitors

2020 ◽  
Author(s):  
Ann Wan-Chin Ling ◽  
Cze-Ci Chan ◽  
Shao-Wei Chen ◽  
Wei-Yi Kao ◽  
Chien-Ying Huang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Atrial Fibrillation ◽  
Type 2 Diabetes ◽  
Lower Risk ◽  
Dipeptidyl Peptidase 4 ◽  
Sodium Glucose Cotransporter ◽  
Dipeptidyl Peptidase 4 Inhibitors ◽  
Onset Atrial Fibrillation ◽  
New Onset

Abstract Purpose: Sodium glucose cotransporter 2 inhibitor (SGLT2i) reduced the risk of hard cardiovascular endpoints in type 2 diabetes mellitus (T2DM) patients with/without established cardiovascular diseases. Whether SGLT2i is associated with a lower risk of new-onset atrial fibrillation (AF) in T2DM patients is unclear. We aimed to evaluate the risk of new-onset AF associated with the use of SGLT2i compared to dipeptidyl peptidase-4 inhibitors (DPP4i) among a longitudinal cohort of diabetic patients. Methods: We used medical data from a multi-center healthcare provider in Taiwan, which included a total of 21,480 and 22,989 patients treated with SGLT2i and DPP4i, respectively, from June 1, 2016 to December 31, 2018. We used propensity-score weighting to balance covariates across study groups. Patients were followed up from the drug index date until the occurrence of new-onset AF, discontinuation of the index drug, or the end of the study period, whichever occurred first. Results: Overall, 56%, 42%, and 2% of the patients were treated with empagliflozin, dapagliflozin, and canagliflozin, respectively. Most patients in the DPP4i group were prescribed with linagliptin (51%), followed by sitagliptin (24%), saxagliptin (13%), vildagliptin (8%) and alogliptin (4%). The use of SGLT2i was associated with a lower risk of new-onset AF compared with DPP4i after propensity-score weighting [adjusted hazard ratio: 0.69; 95% confidential interval: 0.64-0.74; P < 0.001]. Subgroup analysis revealed that the use of SGLT2i was associated with a lower risk of new-onset AF compared with DPP4i across several subgroups including old age, the presence of congestive heart failure, cardiovascular disease, overweight patients, hemoglobin A1c 8%, and chronic kidney disease. The advantage of SGLT2i over DPP4i persisted with different SGLT2i (dapagliflozin or empagliflozin) and either low- or standard-dose SGLT2i. Conclusions: SGLT2i was associated with a lower risk of new-onset AF compared with DPP4i among T2DM patients in real-world practice.

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