Department of Endocrinology, Erciyes University Medical School, Kayseri, Turkey.
Department of Nuclear Medicine, Erciyes University Medical School, Kayseri, Turkey.
Acta Diabetol. 2022 Jul;59(7):929-937. doi: 10.1007/s00592-022-01890-3. Epub 2022 Apr 16.
Metformin causes diffuse and intense fluorodeoxyglucose (FDG) uptake more frequently in the colon and less frequently in the small intestine. In this study, we aimed to investigate the effect of simultaneous use of acarbose and metformin on FDG uptake in positron emission tomography/computed tomography (PET/CT), which has not been investigated previously.
Totally 145 patients with a median age of 65 years (range: 18-80 years), who underwent FDG PET/CT in the Department of Nuclear Medicine of Erciyes University Medical School between 2018 and 2021, were involved in the study. The patients undergoing PET/CT were categorized as metformin plus acarbose users (group MA), metformin users (group M), and control subjects without diabetes (group C). The maximum and mean standard uptake values (SUVmax and SUVmean) of FDG uptake of the all intestine segments were measured separately.
The number of participants in each group was 35, 51 and 59 in group MA, group M and group C, respectively. The FDG uptake of all intestine was significantly higher in group MA and group M than in group C. The FDG uptake of ascending, transverse, descending, and sigmoid colon was significantly lower in group MA than in group M. The FDG uptake of the small intestine was not different between group MA and group M. The FDG uptake of the rectum was lower in group MA than group M and it was significant for SUVmean, but not significant for SUVmax.
The addition of acarbose to metformin therapy decreased SUV and artificially high FDG uptake in the colon and may be an alternative recommendation to discontinuing metformin in patients going to PET/CT imaging.
二甲双胍更频繁地导致结肠弥漫性和强烈的氟脱氧葡萄糖（FDG）摄取，而在小肠中摄取则较少。在这项研究中，我们旨在研究阿卡波糖和二甲双胍同时使用对正电子发射断层扫描/计算机断层扫描（PET/CT）中 FDG 摄取的影响，这在以前尚未研究过。
共有 145 名年龄中位数为 65 岁（范围：18-80 岁）的患者参与了这项研究，这些患者在 2018 年至 2021 年间在埃尔吉耶斯大学医学院核医学系接受了 FDG PET/CT。接受 PET/CT 的患者被分为二甲双胍加阿卡波糖使用者（MA 组）、二甲双胍使用者（M 组）和无糖尿病的对照组（C 组）。分别测量了所有肠段 FDG 摄取的最大和平均标准摄取值（SUVmax 和 SUVmean）。
MA 组、M 组和 C 组的参与者人数分别为 35、51 和 59。与 C 组相比，MA 组和 M 组的所有肠段的 FDG 摄取均显著更高。与 M 组相比，MA 组的升结肠、横结肠、降结肠和乙状结肠的 FDG 摄取显著降低。MA 组和 M 组的小肠 FDG 摄取无差异。MA 组的直肠 FDG 摄取低于 M 组，SUVmean 差异有统计学意义，但 SUVmax 无统计学意义。
阿卡波糖联合二甲双胍治疗降低了 SUV 和结肠中人为的 FDG 摄取过高，可能是在进行 PET/CT 成像前停止使用二甲双胍的替代建议。
