Hepatic and splenic 18 F-FDG blood clearance rates (Ki) in hepatic steatosis and diabetes mellitus.

Autor: Keramida G; Clinical Imaging Sciences Centre, Brighton and Sussex Medical School, Brighton, UK., Roldao Pereira L; Department of Nuclear Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK., Kaya G; Department of Nuclear Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK., Peters AM; Clinical Imaging Sciences Centre, Brighton and Sussex Medical School, Brighton, UK.; Department of Nuclear Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.
Jazyk: angličtina
Zdroj: Clinical physiology and functional imaging [Clin Physiol Funct Imaging] 2020 Mar; Vol. 40 (2), pp. 99-105. Date of Electronic Publication: 2019 Dec 20.
DOI: 10.1111/cpf.12610
Abstrakt: Aim: The study aim was to investigate the relationships of blood glucose level (BGL) with hepatic and splenic blood FDG clearances (Ki) in patients with diabetes mellitus (DM) and/or hepatic steatosis (HS).
Methods: This was a retrospective study of 238 patients, including 92 with type 2 DM (DM2) and 11 with type 1 DM (DM1), having routine whole body FDG PET/CT. Patients with lymphoma were excluded. Patients were divided into the following groups: HS-DM-, HS-DM2+, HS+DM-, HS+DM2+ and 2 DM1 groups (hypoglycaemic and hyperglycaemic). ROI were placed over liver and spleen for measurement of SUV max , and left ventricular cavity (LV) for measurement of SUV mean . Tissue SUV max was divided by LV SUV mean . This division, giving Z, eliminates bias from the whole body metric used to calculate SUV and renders SUV max a closer surrogate of Ki. HS was diagnosed when hepatic unenhanced CT was ≤40 HU.
Results: In all patients, individual hepatic Z and individual splenic Z correlated significantly with individual BGL. Highest mean hepatic Z and highest mean BGL were recorded in HS+ DM2+ group and lowest in hypoglycaemic DM1 group. Patients with DM1 and hyperglycaemia showed low hepatic Z in relation to BGL. Hepatic and splenic Z correlated inversely with CT density in patients without DM but not in those with DM2.
Conclusion: As BGL increases, hepatocyte glucokinase is up-regulated. This includes patients with HS and DM2 but not DM1. We speculate that in HS and DM2, up-regulation results from insulin resistance and hyperinsulinaemia. The data also support a hepato-splenic metabolic axis.
(© 2019 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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