Department of Nuclear Medicine, Hanyang University School of Medicine, Seoul, South Korea.
Department of Internal Medicine, Hanyang University School of Medicine, Seoul, South Korea.
J Cachexia Sarcopenia Muscle. 2019 Aug;10(4):894-902. doi: 10.1002/jcsm.12430. Epub 2019 May 15.
Skeletal muscle glucose utilization is an important component of whole-body glucose consumption in normal humans. Fluorine-18-labelled fluoro-2-deoxy-d-glucose ( F-FDG) is a non-invasive molecular imaging probe for evaluating tissue glucose utilization. It remains unclear whether or not F-FDG uptake by skeletal muscle has utility as a biomarker for metabolic derangement. We investigated the utility of measurement of muscle F-FDG positron emission tomography/computed tomography uptake as a surrogate marker for existing and incipient metabolic abnormalities.
Fluorine-18-labelled fluoro-2-deoxy-d-glucose ( F-FDG) uptakes of insulin-sensitive organs (liver, pancreas, mesenteric visceral fat, psoas muscle, and abdominal subcutaneous fat) and their association with metabolic abnormalities were evaluated in an experimental group comprising 91 men and 66 women (mean age 49.9 ± 11.1 years). In this cross-sectional cohort, we assessed the predictive power of the optimal cut-off F-FDG uptake [maximum standardized uptake value (SUV )]. We confirmed its feasibility and reliability for diagnosis of existing and incipient metabolic derangement in the validation group (longitudinal cohort comprising 91 men and 67 women; mean age 52.6 ± 7.9 years).
Fluorine-18-labelled fluoro-2-deoxy-d-glucose ( F-FDG) uptake (SUV ) of psoas muscle was strongly correlated with clinical metabolic parameters in the experimental group. It was positively correlated with waist circumference, body mass index, fasting glucose, triglyceride, systolic and diastolic pressure, and negatively correlated with high-density lipoprotein cholesterol levels (for all, P < 0.05). SUV of the psoas muscle also showed the best area under the curve value (0.779) as a predictor of metabolic syndrome (MetS) in the experimental group. Using the optimal cut-off SUV of 1.34, the sensitivity, specificity, accuracy, positive, and negative predictive value for predicting existing MetS in the experimental group were 70.0%, 84.6%, 80.9%, 60.9%, and 89.2%, respectively. In the validation group, corresponding values were 47.6%, 92.3%, 86.1%, 50.0%, and 91.6%, respectively. Existing and incipient MetS were significantly higher in subjects with high F-FDG uptake by the psoas muscle (SUV > 1.34). Subjects with higher psoas muscle SUV had a 3.3-fold increased risk of developing MetS (P = 0.017).
Fluorine-18-labelled fluoro-2-deoxy-d-glucose ( F-FDG) uptake of psoas muscle is a promising surrogate marker for existing and incipient metabolic derangement.
骨骼肌葡萄糖利用率是正常人全身葡萄糖消耗的一个重要组成部分。氟-18 标记的氟代-2-脱氧-d-葡萄糖（18F-FDG）是评估组织葡萄糖利用的非侵入性分子成像探针。目前尚不清楚骨骼肌摄取 18F-FDG 是否可用作代谢紊乱的生物标志物。我们研究了测量骨骼肌 18F-FDG 正电子发射断层扫描/计算机断层扫描摄取作为现有和初期代谢异常的替代标志物的效用。
在一个由 91 名男性和 66 名女性（平均年龄 49.9±11.1 岁）组成的实验组中，评估了胰岛素敏感器官（肝脏、胰腺、肠系膜内脏脂肪、腰大肌和腹部皮下脂肪）的氟-18 标记的氟代-2-脱氧-d-葡萄糖（18F-FDG）摄取及其与代谢异常的关系。在这项横断面队列研究中，我们评估了最佳摄取 18F-FDG 摄取[最大标准化摄取值（SUV）]的最佳截断值的预测能力。在验证组（由 91 名男性和 67 名女性组成的纵向队列；平均年龄 52.6±7.9 岁）中，我们确认了其诊断现有和初期代谢紊乱的可行性和可靠性。
在实验组中，18F-FDG 摄取（SUV）与临床代谢参数密切相关。它与腰围、体重指数、空腹血糖、甘油三酯、收缩压和舒张压呈正相关，与高密度脂蛋白胆固醇水平呈负相关（所有 P<0.05）。腰大肌 SUV 作为预测代谢综合征（MetS）的指标，曲线下面积（AUC）值也最好（0.779）。在实验组中，使用最佳截断 SUV 值 1.34，预测现有 MetS 的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为 70.0%、84.6%、80.9%、60.9%和 89.2%。在验证组中，相应的值分别为 47.6%、92.3%、86.1%、50.0%和 91.6%。腰大肌 18F-FDG 摄取较高的患者，现有的和初期的 MetS 明显较高（SUV>1.34）。SUV 较高的腰大肌患者发生 MetS 的风险增加 3.3 倍（P=0.017）。
腰大肌 18F-FDG 摄取是现有和初期代谢紊乱的一个很有前途的替代标志物。
