Stone C K, Holden J E, Stanley W, Perlman S B
Department of Medicine, University of Wisconsin-Madison Medical School, USA.
J Nucl Med. 1995 Jun;36(6):996-1002.
Clinical assessment of myocardial glucose uptake with 18F-fluorodeoxyglucose (18F-FDG) and PET requires the control of circulating substrates to achieve acceptable image quality.
To determine the efficacy of the hypolipemic effect of oral niacin upon myocardial 18F-FDG uptake, five volunteers were studied with 18F-FDG and PET in the fasting state, with and without treatment with niacin. Levels of glucose, fatty acids, insulin and catecholamines were measured at baseline and before and after 18F-FDG administration by programmed infusion.
No significant changes in glucose or insulin levels occurred with niacin. A significant decrease in fatty acid levels with niacin treatment was associated with a two- to three-fold increase in myocardial glucose utilization rates relative to the fasting state. Furthermore, regional variation in tracer distribution with greater uptake in the lateral wall than the septum or anterior wall in the fasting studies was not present after niacin treatment.
As determined by programmed infusion of 18F-FDG and PET imaging, niacin treatment in normal volunteers was associated with an increase in exogenous glucose utilization by the heart and a decrease in the cardiac regional variation of 18F-FDG. Further studies are needed to compare the relative value of niacin therapy and oral glucose loading for determination of myocardial exogenous glucose utilization rates.
使用18F-氟脱氧葡萄糖（18F-FDG）和正电子发射断层扫描（PET）对心肌葡萄糖摄取进行临床评估需要控制循环底物以获得可接受的图像质量。
为了确定口服烟酸的降血脂作用对心肌18F-FDG摄取的效果，对五名志愿者在空腹状态下进行了18F-FDG和PET研究，分别在服用烟酸和未服用烟酸的情况下进行。通过程序化输注在基线以及18F-FDG给药前后测量葡萄糖、脂肪酸、胰岛素和儿茶酚胺的水平。
烟酸治疗后葡萄糖或胰岛素水平无显著变化。烟酸治疗使脂肪酸水平显著降低，与空腹状态相比，心肌葡萄糖利用率提高了两到三倍。此外，烟酸治疗后，空腹研究中示踪剂分布的区域差异消失，即侧壁摄取量大于间隔或前壁的情况不再存在。
通过程序化输注18F-FDG和PET成像确定，正常志愿者服用烟酸与心脏对外源性葡萄糖利用率增加以及18F-FDG的心脏区域差异减小有关。需要进一步研究以比较烟酸疗法和口服葡萄糖负荷在确定心肌外源性葡萄糖利用率方面的相对价值。
