Increased urinary glucose excretion is associated with a reduced risk of hyperuricaemia

Chen, Juan; Qiu, Shanhu; Guo, Hai; Li, W.; Sun, Zilin

doi:10.1111/dme.13956

Cited by 14 publications

(26 citation statements)

References 32 publications

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“…Notably, our recent work found that urine glucose excretion (UGE) was an independent factor for hyperuricemia in individuals with newly diagnosed diabetes and further indicated that increased UGE was closely correlated with a reduced risk of hyperuricemia. 1 Moreover, other studies have confirmed a significant decrease in UA levels in subjects treated with sodium-glucose cotransporter 2 (SGLT2) inhibitors, a class of medications for the treatment of diabetes through increasing UGE. 23 Subsequently, the UA-lowering effect of SGLT2 inhibitors is attributed to increased glycosuria.…”

Section: Introductionmentioning

confidence: 99%

“…Hyperuricemia, mainly attributed to decreased excretion of uric acid (UA), has become a major health challenge worldwide due to its significant role in the development of hypertension, diabetes mellitus, and renal disease. 1,2 Moreover, elevated UA levels have been reported to be independently and significantly associated with the risk of cardiovascular diseases, nonalcoholic fatty liver disease, and metabolic syndrome. [3][4][5][6][7] Besides, a recent study suggested that UA may be a predictor of non-dipping pattern of blood pressure.…”

Section: Introductionmentioning

confidence: 99%

“…11,12 Our recent research also found that individuals with elevated body mass index (BMI) were at increased risk for hyperuricemia. 1 BMI is widely used to identify overweight or obesity, but it is unable to estimate body fat distribution. Current evidences have revealed that a variety of physiological aberrations caused by obesity depend not simply on overweight or obesity per se, but importantly, the distribution of body fat.…”

Section: Introductionmentioning

confidence: 99%

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<p>Urine Glucose Excretion Attenuates the Association Between Lipid Accumulation Product and Serum Uric Acid in Subjects with Prediabetes</p>

Chen

Liu

Guo

et al. 2020

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Purpose: Obesity is known to be strongly associated with hyperuricemia. Moreover, the impact of urine glucose excretion (UGE) on serum uric acid (UA) levels has gained much more attention in recent years. Yet concern is raised about whether UGE influences the relationship between obesity and hyperuricemia. The aim of this study was to assess the effect of UGE on the association between lipid accumulation product (LAP), a novel marker of visceral adipose accumulation, and UA in subjects with prediabetes. Materials and Methods: Data were obtained from a cross-sectional study. A total of 3645 subjects with prediabetes were included in the present study. The separate and joint associations of LAP and UGE with hyperuricemia were examined using logistic regression analyses. Results: LAP was positively associated with UA in both genders. Subgroup analysis based on UGE revealed that the association was strongest in subjects with low UGE (r = 0.328, p < 0.001), whereas the positive association was weakened, but still remained significant in subjects with moderate and high UGE. High LAP was significantly associated with an increased odds ratio for hyperuricemia after adjustment for potential confounders in the overall population (OR = 2.07, 95% CI: 1.66-2.58, p < 0.001). However, a downward trend in odds ratios for hyperuricemia was observed across UGE categories. In addition, the joint association analysis confirmed that the relationship between LAP and hyperuricemia was attenuated by UGE. Conclusion: The positive association between LAP and UA appears to be attenuated by UGE, indicating that promoting UGE may be an effective strategy for controlling UA levels, especially for people with obesity who are at increased risk for hyperuricemia.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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<p>Urine Glucose Excretion Attenuates the Association Between Lipid Accumulation Product and Serum Uric Acid in Subjects with Prediabetes</p>

Chen

Liu

Guo

et al. 2020

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“…Moreover, serum uric acid has been reported to fall with increasing duration of the diabetes (36). Our previous study also suggested that with increasing blood glucose, enhanced concentration of glucose in the lumen of the proximal convoluted tubule inhibited uric acid reabsorption, leading to decreased uric acid (26). Therefore, ULT may not cause a significant change in FBG in patients with diabetes since they have obviously lower serum uric acid levels.…”

Section: Comparison With Existing Literaturementioning

confidence: 93%

“…Moreover, it has also been reported that uric acid is positively associated with glycated hemoglobin A1c (HbA1c) in individuals with normal glucose tolerance (21). However, the positive associations between uric acid and glycemic parameters no longer exist once the disease progresses to the stage of diabetes, instead, turn into negative correlations (21,25,26). As early as three decades ago, study has showed that uric acid is obviously higher in individuals with prediabetes, whereas lower in individuals with diabetes compared with those with normal glucose tolerance (27).…”

Section: Introductionmentioning

confidence: 99%

Effects of Uric Acid-Lowering Treatment on Glycemia: A Systematic Review and Meta-Analysis

Chen

Zha

et al. 2020

Front. Endocrinol.

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Background: Serum uric acid levels have been shown to be associated with increased risk of diabetes. However, it remains unclear whether uric acid-lowering therapy (ULT) is associated with improved glycemic status. This study aimed to summarize evidence from randomized controlled trials (RCTs) to investigate whether ULT reduces fasting blood glucose (FBG) and glycated hemoglobin A1c (HbA1c) levels. Methods: PubMed, Embase, and the Cochrane Library were searched from inception until April 10, 2019. Moreover, in order to maximize the search for articles on the same topic, the reference lists of included studies, relevant review articles and systematic reviews were reviewed. Parallel RCTs investigating the effect of ULT on FBG or HbA1c levels were considered for inclusion. An English language restriction was applied. Data were screened and extracted independently by two researchers. Meta-analyses were performed using random-effects models to calculate the weighted mean differences (WMDs) and 95% confidence intervals (CIs). Results: Four trials with 314 patients reported the effect of ULT with allopurinol on FBG and 2 trials with 141 patients reported the effect of ULT with allopurinol on HbA1c. Treatment with allopurinol resulted in a significant decrease in FBG (WMD: −0.61 mmol/L, 95% CI: −0.93 to −0.28), but only a trend of reduction in HbA1c (WMD: −0.47%, 95% CI: −1.16 to 0.22). Notably, the subgroup analyses showed that treatment with allopurinol was associated with reduced FBG levels in patients without diabetes (WMD: −0.60 mmol/L, 95% CI: −0.99 to −0.20), but not in patients with diabetes. In addition, the dose of allopurinol treatment ≥200 mg daily resulted in a reduction of FBG levels (WMD: −0.59 mmol/L, 95% CI: −0.95 to −0.23), whereas low-dose allopurinol (<200 mg daily) had no effect on FBG levels. Conclusions: The findings suggest that ULT with allopurinol may be effective at reducing glycemia, but such an improvement does not appear to be observed in patients with diabetes. The findings require confirmation in additional trials with larger sample sizes.

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High urinary excretion rate of glucose attenuates serum uric acid level in type 2 diabetes with normal renal function

Qin

Zhang

Cui

et al. 2021

J Endocrinol Invest

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Aims/Introduction The relationship between urinary excretion rate of glucose (UEGL) and uric acid (UA) metabolism in adults with type 2 diabetes (T2D) remains unclear to date. This study aimed to investigate the relationships of UEGL with serum UA (SUA), urinary excretion rate of uric acid (UEUA), and renal clearance of uric acid (CLUA) in adults with T2D. We hypothesised that high UEGL increases UA excretion, which in turn leads to lower SUA. Materials and methods This was a cross-sectional study of 635 inpatients with T2D recruited between 2018 and 2019. The relationships of UEGL with UEUA, CLUA, and hyperuricaemia were assessed using analysis of covariance and multivariate regression analysis. Results Patients in the higher quartile of UEGL tended to have lower SUA levels than those in the lower quartile. In contrast, patients in the higher quartile of UEGL tended to have higher CLUA (p for trend < 0.0001), and a similar trend was observed for UEUA. In adjusted multivariable linear regression model, UEGL was negatively correlated with SUA (β = − 0.023, 95% CI − 0.034 to − 0.013, p < 0.0001). However, positive correlations of UEGL with UEUA (β = 0.046, 95% CI 0.018–0.074, p = 0.001) and CLUA (β = 0.063, 95% CI 0.042–0.085, p < 0.0001) were found. Furthermore, consistent significant inverse associations were observed between quartiles of UEGL and hyperuricaemia in the adjusted multivariate logistic regression model. Conclusions A high UEGL level was positively correlated with UEUA and CLUA. Moreover, it was inversely associated with SUA level, and a consistently increased UEGL level reduced the risk of hyperuricaemia in patients with T2D.

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Increased urinary glucose excretion is associated with a reduced risk of hyperuricaemia

Cited by 14 publications

References 32 publications

<p>Urine Glucose Excretion Attenuates the Association Between Lipid Accumulation Product and Serum Uric Acid in Subjects with Prediabetes</p>

<p>Urine Glucose Excretion Attenuates the Association Between Lipid Accumulation Product and Serum Uric Acid in Subjects with Prediabetes</p>

Effects of Uric Acid-Lowering Treatment on Glycemia: A Systematic Review and Meta-Analysis

High urinary excretion rate of glucose attenuates serum uric acid level in type 2 diabetes with normal renal function

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