Impact of noninsulin-dependent type 2 diabetes on carotid wall 18F-fluorodeoxyglucose positron emission tomography uptake.
OBJECTIVE
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.
Translational and Molecular Imaging Institute, Mount Sinai School of Medicine, New York, New York 10029, USA.
Jan
J
Bucerius
Venkatesh
V
Mani
Colin
C
Moncrieff
James H F
JH
Rudd
Josef
J
Machac
Valentin
V
Fuster
Michael E
ME
Farkouh
Zahi A
ZA
Fayad
D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D001167:Arteritis / Q000000981:diagnostic imaging* / Q000209:etiology; D001786:Blood Glucose / Q000032:analysis; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000209:etiology*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000175:diagnosis; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D049268:Positron-Emission Tomography / Q000379:methods; D011379:Prognosis; D019275:Radiopharmaceuticals; D012016:Reference Values; D012044:Regression Analysis; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors
D001786:Blood Glucose; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18