Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, Korea.
Dig Dis Sci. 2014 Mar;59(3):607-13. doi: 10.1007/s10620-013-2957-6. Epub 2013 Dec 11.
Subjects with fatty liver disease (FLD) can show increased hepatic 2-deoxy-2-((18)F)fluoro-D-glucose (FDG) uptake, but the role of hepatic inflammation has not been explored.
We investigated whether hepatic inflammatory response, as implicated by elevated serum markers, is associated with increased liver FDG uptake in FLD.
Liver sonography and FDG positron emission tomography was performed in 331 asymptomatic men with nonalcoholic FLD (NAFLD), 122 with alcoholic FLD (AFLD), and 349 controls. Mean standard uptake value (SUV) of liver FDG uptake was compared to cardiac risk factors and serum markers of liver injury.
Hepatic FDG mean SUV was increased in NAFLD (2.40 ± 0.25) and AFLD groups (2.44 ± 0.25) compared to controls (2.28 ± 0.26; both P < 0.001). Both FLD groups also had higher serum γ-glutamylranspeptidase (GGT), triglyceride (TG), hepatic transaminases, and LDL. High GGT and TG levels were independent determinants of increased FDG uptake for both FLD groups. Hepatic mean SUV significantly increased with high compared to low GGT for NAFLD (2.48 ± 0.28 vs. 2.37 ± 0.24), AFLD (2.51 ± 0.27 vs. 2.39 ± 0.23), and control groups (2.39 ± 0.22 vs. 2.26 ± 0.26). High TG increased hepatic mean SUV in AFLD and control groups. Furthermore, serum GGT and TG levels significantly correlated to hepatic mean SUV in all three groups.
Hepatic FDG uptake is closely associated with elevated TG and GGT regardless of the presence of FLD. Thus, inflammation response may play a major role in increased hepatic glucose uptake.
患有脂肪肝(FLD)的患者肝脏 2-脱氧-2-(18)F 氟代葡萄糖(FDG)摄取增加,但肝脏炎症反应的作用尚未得到探索。
我们研究了非酒精性脂肪肝(NAFLD)和酒精性脂肪肝(AFLD)患者血清标志物升高所暗示的肝脏炎症反应是否与 FLD 患者肝脏 FDG 摄取增加有关。
对 331 例无症状的非酒精性 FLD(NAFLD)男性、122 例酒精性 FLD(AFLD)男性和 349 例对照组男性进行肝脏超声检查和 FDG 正电子发射断层扫描。比较肝脏 FDG 摄取的平均标准摄取值(SUV)与心脏危险因素和肝损伤的血清标志物。
与对照组(2.28 ± 0.26;均 P < 0.001)相比,NAFLD 组(2.40 ± 0.25)和 AFLD 组(2.44 ± 0.25)的肝脏 FDG 平均 SUV 增加。两个 FLD 组的血清 γ-谷氨酰转肽酶(GGT)、甘油三酯(TG)、肝转氨酶和 LDL 也较高。高 GGT 和 TG 水平是两个 FLD 组 FDG 摄取增加的独立决定因素。NAFLD(2.48 ± 0.28 比 2.37 ± 0.24)、AFLD(2.51 ± 0.27 比 2.39 ± 0.23)和对照组(2.39 ± 0.22 比 2.26 ± 0.26)中,高 GGT 组的肝脏平均 SUV 显著高于低 GGT 组。高 TG 增加了 AFLD 和对照组的肝脏平均 SUV。此外,三组患者的血清 GGT 和 TG 水平与肝脏平均 SUV 显著相关。
无论是否存在 FLD,肝脏 FDG 摄取均与 TG 和 GGT 升高密切相关。因此,炎症反应可能在肝脏葡萄糖摄取增加中起主要作用。