Vascular inflammation in patients with impaired glucose tolerance and type 2 diabetes: analysis with 18F-fluorodeoxyglucose positron emission tomography.
BACKGROUND
Type 2 diabetes mellitus (T2DM) is associated with an increased risk of atherosclerotic cardiovascular disease. Vascular inflammation is a key factor in both the pathogenesis and outcome of atherosclerosis. (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) is a promising tool for indentifying and quantifying vascular inflammation within atherosclerotic plaques. This study was designed to examine the vascular inflammation measured using FDG-PET in patients with impaired glucose tolerance and T2DM, in comparison with age- and sex-matched control subjects with normal glucose tolerance.


RESULTS
We investigated vascular inflammation using FDG-PET in 90 age- and sex-matched subjects with different glucose tolerance (30 normal glucose tolerance subjects, 30 impaired glucose tolerance subjects, and 30 T2DM subjects). Vascular 18F-FDG uptake was measured as both the mean and maximum blood-normalized standardized uptake value, known as the target-to-background ratio (TBR). Both mean and maximum TBR measurements were significantly different, based on glucose tolerance, although the carotid intima-media thickness measurements were not significantly different. The maximum TBR values in patients with impaired glucose tolerance and T2DM were significantly increased compared with the normal subjects. In addition, subjects with metabolic syndrome had increased maximum TBR values compared with those without metabolic syndrome. Age-, sex-, and body mass index-adjusted maximum TBR levels were positively correlated with triglyceride, hemoglobin A1c, insulin resistance, high-sensitivity C-reactive protein, and Framingham risk score and were negatively correlated with high-density lipoprotein cholesterol and adiponectin levels.


CONCLUSIONS
The results of the present study suggest that impaired glucose tolerance and T2DM are associated with vascular inflammation in carotid atherosclerosis detected by FDG-PET.
Kim
Tae Nyun
TN
Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Kim
Sungeun
S
Yang
Sae Jeong
SJ
Yoo
Hye Jin
HJ
Seo
Ji A
JA
Kim
Sin Gon
SG
Kim
Nan Hee
NH
Baik
Sei Hyun
SH
Choi
Dong Seop
DS
Choi
Kyung Mook
KM
D052242:Adiponectin / Q000032:analysis; D000704:Analysis of Variance; D015415:Biomarkers / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003924:Diabetes Mellitus, Type 2 / Q000473:pathology*; D005260:Female; D019788:Fluorodeoxyglucose F18; D018149:Glucose Intolerance; D006801:Humans; D007249:Inflammation / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D012307:Risk Factors; D018709:Statistics, Nonparametric; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000473:pathology
D052242:Adiponectin; D015415:Biomarkers; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D002097:C-Reactive Protein