Impact of noninsulin-dependent type 2 diabetes on carotid wall 18F-fluorodeoxyglucose positron emission tomography uptake

J Am Coll Cardiol. 2012 Jun 5;59(23):2080-8. doi: 10.1016/j.jacc.2011.11.069.

Abstract

Objectives: In this study, the impact of noninsulin-dependent type 2 diabetes mellitus on carotid wall (18)F-fluorodeoxyglucose (FDG) uptake in patients with documented or suspected cardiovascular disease was evaluated.

Background: Inflammation is a pivotal process in the progression of atherosclerosis, which can be noninvasively imaged by FDG positron emission tomography (FDG-PET).

Methods: Carotid artery wall FDG uptake was quantified in 134 patients (age 60.2 ± 9.7 years; diabetic subjects, n = 43). The pre-scan glucose (gluc) level corrected mean of the maximum standardized uptake value (SUV) values ((mean)SUV(gluc)), mean of the maximum target-to-background ratio ((mean)TBR(gluc)), and single hottest segment (SHS(gluc)) of FDG uptake in the artery wall were calculated. Associations between FDG uptake, the presence of risk factors for atherosclerosis, and diabetes were then assessed by multiple regression analysis with backward elimination.

Results: The study demonstrated a significant association between diabetes and FDG uptake in the arterial wall (diabetes (mean)SUV(gluc) β = 0.324, (mean)TBR(gluc) β = 0.317, and SHS(gluc) β = 0.298; for all, p < 0.0001). In addition, in diabetic patients, both body mass index ≥ 30 kg/m(2) ((mean)SUV(gluc) β = 0.4, (mean)TBR(gluc) β = 0.357, and SHS(gluc) β = 0.388; for all, p < 0.015) and smoking ((mean)TBR(gluc), β = 0.312; SHS(gluc), β = 0.324; for all, p < 0.04) were significantly associated with FDG uptake.

Conclusions: Type 2 diabetes was significantly associated with carotid wall FDG uptake in patients with known or suspected cardiovascular disease. In diabetic patients, obesity and smoking add to the risk of increased FDG uptake values.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Analysis of Variance
  • Arteritis / diagnostic imaging*
  • Arteritis / etiology
  • Blood Glucose / analysis
  • Carotid Artery Diseases / diagnostic imaging*
  • Carotid Artery Diseases / etiology*
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetic Angiopathies / diagnostic imaging*
  • Diabetic Angiopathies / etiology
  • Diabetic Angiopathies / physiopathology
  • Female
  • Fluorodeoxyglucose F18
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Positron-Emission Tomography / methods
  • Prognosis
  • Radiopharmaceuticals
  • Reference Values
  • Regression Analysis
  • Risk Assessment
  • Severity of Illness Index
  • Sex Factors

Substances

  • Blood Glucose
  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18