SGLT2抑制剂对2型糖尿病患者血尿酸水平的影响

钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂是一种新型降糖药,可控制血糖、降低心血管事件、改善肾功能等。越来越多的数据表明,SGLT2抑制剂也可降低血尿酸水平。可能的机制是近端肾小管腔内葡萄糖的排泄增强,通过顶端膜上葡萄糖转运蛋白(GLUT)9亚型2促进细胞内尿酸盐的交换,导致尿酸分泌增加,且SGLT2抑制剂抑制肾小管重吸收葡萄糖,导致尿中葡萄糖增加,这可能会抑制集合管中GLUT9亚型2介导的尿酸重吸收。另一种可能的机制是SGLT2抑制剂通过降低血清胰岛素浓度,减少尿酸盐重吸收转运蛋白1(URAT1)对尿酸的重吸收。

Effect of SGLT2 inhibitors on serum uric acid level in patients with type 2 diabetes mellitus

Inhibitors of sodium-glucose co-transporter 2(SGLT2)is a novel hypoglycemic agent.They can improve hyperglycemia,reduce cardiovascular events and improve renal function.Increasing data suggests that SGLT2 inhibitors reduce serum uric acid level.The possible mechanism is that the enhanced delivery of glucose in the lumen of the proximal tubule may facilitate the exchange for intracellular urate through glucose transporter(GLUT)9 isoform 2 in the apical membrane,thereby enhancing urinary urate excretion,and SGLT2 inhibitors inhibit the reabsorption of glucose in renal tubules,resulting in increased glucose in urine,which may inhibit the reabsorption of uric acid mediated by GLUT9 isoform 2 in the collecting tubule.Another possible mechanism is that SGLT2 inhibitors reduce uratetransporter 1(URAT1)reabsorption of uric acid by reducing serum insulin concentration.