Altun Tuzcu S, Cetin F A, Pekkolay Z, Tuzcu A K
Dicle University Department of Nuclear Medicine, Diyarbakir, Turkey.
Private Baglara Hospital - Radiology, Diyarbakir, Turkey.
Acta Endocrinol (Buchar). 2019 Oct-Dec;15(4):539-543. doi: 10.4183/aeb.2019.539.
Insulin resistance is routinely measured by homeostasis model assessment of insulin resistance (HOMA-IR).Positron emission tomography of 18F-fluorodeoxyglucose combined with computed tomography (18F-FDG PET/CT) is a valuable assessment tool for patients with cancer or staging tumors. 18F-FDG PET/CT imaging can also be utilised to detect the metabolic activity of glucose in the adipose tissue, liver and muscles. The aim of this study was to determine insulin sensitivity in the liver, muscle visceral adipose and subcutaneous adipose tissue separately via18F-FDG PET/CT.
Sixty three adult patients who underwent whole body 18F-FDG PET/CT scanning for clinical purposes (diagnosis or staging of cancer) between July and August of 2016 were included in the study. Patients were divided into two groups according to their BMI (Group 1: BMI<25kg/m, Group 2: BMI>25kg/m). HOMA-IR,fasting glucose,insulin, triglycerides, total cholesterol, HDL levels were measured. We calculated SUV as the tissue activity of the ROI (MBq/g)/(injected dose [MBq]/ body weight [g]) on PET images and measured the maximum SUVs (SUVmax) of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT),liver and rectus muscle ROIs (2 cm). SUV corrected by blood glucose level (SUVgluc) was calculated as SUVmax×blood glucose level/100. Student-t test, Chi-square test and Pearson correlation test were used for statistical analysis.
Mean glucose,insulin,HOMA-IR levels of the group-2 were statistically higher than of group-1. Muscle SUVmax and liver SUVmax of group-1 were statistically higher than of group-2. Muscle SUVgluc of group-1 was statistically higher than of group-2. HOMA-IR was negatively correlated with both SUVmax(r=-0.340, p=0.01) and muscle SUVmax(r=-0.373, p=0.005).
18F-FDG PET/CT has shown that the muscle tissue maximum FDG uptake was lower in the insulin resistance group. Therefore, 18-FDG PET/CT could be a valuable tool for diagnosing insulin resistance.
胰岛素抵抗通常通过胰岛素抵抗稳态模型评估（HOMA-IR）来测量。18F-氟脱氧葡萄糖正电子发射断层扫描结合计算机断层扫描（18F-FDG PET/CT）是癌症患者或肿瘤分期的一种有价值的评估工具。18F-FDG PET/CT成像也可用于检测脂肪组织、肝脏和肌肉中葡萄糖的代谢活性。本研究的目的是通过18F-FDG PET/CT分别测定肝脏、肌肉、内脏脂肪和皮下脂肪组织中的胰岛素敏感性。
纳入2016年7月至8月间因临床目的（癌症诊断或分期）接受全身18F-FDG PET/CT扫描的63例成年患者。根据BMI将患者分为两组（第1组：BMI<25kg/m，第2组：BMI>25kg/m）。测量HOMA-IR、空腹血糖、胰岛素、甘油三酯、总胆固醇、高密度脂蛋白水平。我们将SUV计算为PET图像上ROI的组织活性（MBq/g）/（注射剂量[MBq]/体重[g]），并测量内脏脂肪组织（VAT）、皮下脂肪组织（SAT）、肝脏和腹直肌ROI（2 cm）的最大SUV（SUVmax）。通过血糖水平校正的SUV（SUVgluc）计算为SUVmax×血糖水平/100。采用Student-t检验、卡方检验和Pearson相关检验进行统计分析。
第2组的平均血糖、胰岛素、HOMA-IR水平在统计学上高于第1组。第1组的肌肉SUVmax和肝脏SUVmax在统计学上高于第2组。第1组的肌肉SUVgluc在统计学上高于第2组。HOMA-IR与SUVmax（r=-0.340，p=0.01）和肌肉SUVmax（r=-0.373，p=0.005）均呈负相关。
18F-FDG PET/CT显示胰岛素抵抗组的肌肉组织最大FDG摄取较低。因此，18F-FDG PET/CT可能是诊断胰岛素抵抗的一种有价值的工具。
