Képes Z, Aranyi Cs, Forgács A, Nagy F, Kukuts K, Hascsi Zs, Esze R, Somodi S, Káplár M, Varga J, Emri M, Garai I
Faculty of Medicine, Department of Medical Imaging, Division of Nuclear Medicine and Translational Imaging, University of Debrecen, Nagyerdei krt. 98, Debrecen, Hungary.
Scanomed Ltd. Nuclear Medicine Centers, Nagyerdei krt. 98, Debrecen, Hungary.
Eur J Hybrid Imaging. 2021 Feb 17;5(1):3. doi: 10.1186/s41824-021-00097-z.
Metabolic syndrome and its individual components lead to wide-ranging consequences, many of which affect the central nervous system. In this study, we compared the [F]FDG regional brain metabolic pattern of participants with type 2 diabetes mellitus (T2DM) and non-DM obese individuals.
In our prospective study, 51 patients with controlled T2DM (ages 50.6 ± 8.0 years) and 45 non-DM obese participants (ages 52.0 ± 9.6 years) were enrolled. Glucose levels measured before PET/CT examination (pre-PET glucose) as well as laboratory parameters assessing glucose and lipid status were determined. NeuroQ application (NeuroQ 3.6, Syntermed, Philips) was used to evaluate regional brain metabolic differences. [F]FDG PET/CT (AnyScan PC, Mediso) scans, estimating brain metabolism, were transformed to MNI152 brain map after T1 registration and used for SPM-based group comparison of brain metabolism corrected for pre-PET glucose, and correlation analysis with laboratory parameters.
NeuroQ analysis did not reveal significant regional metabolic defects in either group. Voxel-based group comparison revealed significantly (P<0.05) decreased metabolism in the region of the precuneus and in the right superior frontal gyrus (rSFG) in the diabetic group as compared to the obese patients. Data analysis corrected for pre-PET glucose level showed a hypometabolic difference only in the rSFG in T2DM. Voxel-based correlation analysis showed significant negative correlation of the metabolism in the following brain regions with pre-PET glucose in diabetes: precuneus, left posterior orbital gyrus, right calcarine cortex and right orbital part of inferior frontal gyrus; whilst in the obese group only the right rolandic (pericentral) operculum proved to be sensitive to pre-PET glucose level.
To our knowledge, this is the first study to perform pre-PET glucose level corrected comparative analysis of brain metabolism in T2DM and obesity. We also examined the pre-PET glucose level dependency of regional cerebral metabolism in the two groups separately. Large-scale future studies are warranted to perform further correlation analysis with the aim of determining the effects of metabolic disturbances on brain metabolism.
代谢综合征及其各个组成部分会导致广泛的后果，其中许多会影响中枢神经系统。在本研究中，我们比较了2型糖尿病（T2DM）患者和非糖尿病肥胖个体的[F]FDG脑区代谢模式。
在我们的前瞻性研究中，纳入了51例血糖控制良好的T2DM患者（年龄50.6±8.0岁）和45例非糖尿病肥胖参与者（年龄52.0±9.6岁）。测定了PET/CT检查前的血糖水平（PET前血糖）以及评估血糖和血脂状况的实验室参数。使用NeuroQ应用程序（NeuroQ 3.6，Syntermed，飞利浦）评估脑区代谢差异。估计脑代谢的[F]FDG PET/CT（AnyScan PC，Mediso）扫描在T1配准后转换为MNI152脑图谱，并用于基于SPM的脑代谢组间比较，该比较针对PET前血糖进行了校正，并与实验室参数进行了相关性分析。
NeuroQ分析未在任何一组中发现明显的脑区代谢缺陷。基于体素的组间比较显示，与肥胖患者相比，糖尿病组楔前叶区域和右侧额上回（rSFG）的代谢显著降低（P<0.05）。针对PET前血糖水平校正后的数据分析显示，T2DM患者仅在rSFG存在代谢减低差异。基于体素的相关性分析显示，糖尿病患者以下脑区的代谢与PET前血糖呈显著负相关：楔前叶、左侧眶后回、右侧距状皮质和右侧额下回眶部；而在肥胖组中，仅右侧中央沟盖（中央周围）对PET前血糖水平敏感。
据我们所知，这是第一项对T2DM和肥胖患者的脑代谢进行PET前血糖水平校正比较分析的研究。我们还分别研究了两组中区域脑代谢对PET前血糖水平的依赖性。有必要开展大规模的未来研究以进行进一步的相关性分析，目的是确定代谢紊乱对脑代谢的影响。
