In patients with type 2 diabetes and asymptomatic hyperuricemia, elevated serum uric acid was associated with increased cardiovascular risk, and empagliflozin significantly reduced serum uric acid and improved fasting plasma glucose over 6 months.
Asymptomatic hyperuricemia was prevalent in nearly one-third of patients with type 2 diabetes in this study population.
Patients with asymptomatic hyperuricemia had a significantly higher incidence of major adverse cardiovascular events (MACE) compared to those without hyperuricemia.
Serum uric acid demonstrated good predictive performance for MACE and specific cardiovascular outcomes.
Empagliflozin produced a significantly greater reduction in serum uric acid compared to background therapy without empagliflozin over 6 months.
Empagliflozin significantly improved fasting plasma glucose, but the reduction in HbA1c was not statistically significant.
This research suggests that among Vietnamese patients with type 2 diabetes, about 30% also had asymptomatic hyperuricemia — meaning high uric acid levels in the blood without symptoms like gout. Those with high uric acid were much more likely to have experienced serious heart-related events (such as heart attacks or cardiovascular death) compared to those with normal uric acid levels, with more than five times the odds of such events. The uric acid level itself also proved reasonably good at predicting who would experience these cardiovascular events, suggesting it may be a useful marker of cardiovascular risk in this population. The study also followed a subset of 63 patients with asymptomatic hyperuricemia for six months to compare those who received empagliflozin (a diabetes medication) against those who received other standard treatments. Those taking empagliflozin experienced roughly twice the reduction in serum uric acid levels compared to the control group, and this difference was statistically significant. Empagliflozin also led to meaningful improvements in fasting blood sugar levels, though improvements in a longer-term blood sugar measure (HbA1c) did not reach statistical significance during this short follow-up period. This research suggests that empagliflozin may offer benefits beyond blood sugar control in patients with type 2 diabetes and high uric acid levels, potentially helping to lower cardiovascular risk through uric acid reduction. However, because this was an observational study with a relatively small prospective group and short follow-up, larger and longer clinical trials are needed to confirm whether the cardiovascular benefits observed are directly caused by empagliflozin's effects on uric acid.
Nguyen M, Tran K, Tran S. (2026). Empagliflozin improves serum uric acid and early cardiometabolic outcomes in asymptomatic hyperuricemia among patients with type 2 diabetes: A 6-month observational study.. Medicine. https://doi.org/10.1097/MD.0000000000050589