title: Serum lipids associated with inflammation-related PET-FDG uptake in symptomatic carotid plaque.
abstract: OBJECTIVE
  We hypothesized that serum lipids, which experimental data suggest may be key initiators of carotid plaque inflammation, would be associated with plaque inflammation on (18)fluorodeoxyglucose (FDG)-PET in patients with acutely symptomatic carotid stenosis.
  
  
  METHODS
  In this cohort study, consecutive patients with acute symptomatic internal carotid artery (ICA) stenosis (≥50%) underwent carotid PET-CT. We quantified plaque FDG uptake as follows: (1) average maximum standardized uptake values (SUVmax) across 10 regions of interest (ROI); (2) highest single ROI SUV measure (SUVROImax); (3) averaged mean SUV across 10 ROIs (SUVmean).
  
  
  RESULTS
  Sixty-one patients were included. Plaque inflammatory FDG SUVmax was associated with increasing tertiles of low-density lipoprotein (LDL) (trend p = 0.004), total cholesterol (p = 0.009), and triglycerides (p = 0.01), and with lower high-density lipoprotein (HDL) (p = 0.005). When analyzed as a continuous variable, LDL was associated with symptomatic ICA SUVmean (Spearman rho 0.44, p = 0.009), SUVROImax (rho 0.33, p = 0.01), and SUVmax (rho 0.35, p = 0.06). Total cholesterol was associated with SUVmean (rho 0.33, p = 0.009), with trends for SUVmax (rho 0.24, p = 0.059) and SUVROImax (rho 0.23, p = 0.08). Triglycerides were associated with SUVmax (rho 0.32, p = 0.01) and SUVROImax (rho 0.35, p = 0.005). HDL was associated with lower SUVmax (rho -0.37, p = 0.004) and SUVROImax (rho -0.44, p = 0.0004). On multivariable linear regression analysis adjusting for age, sex, degree of carotid stenosis, statins, and smoking, LDL (p = 0.008) and total cholesterol (p = 0.04) were independently associated with SUVmax.
  
  
  CONCLUSIONS
  Serum LDL and total cholesterol were associated with acutely symptomatic carotid plaque FDG uptake, supporting experimental data suggesting lipids may promote plaque inflammation, mediating rupture and clinical events.
authors.affiliation: From the Neurovascular Unit for Translational and Therapeutics Research (D. Ní C., M.M., L.A., Á.M., E.F., G.H., S.M., K. O'Rourke, P.J.K.) and the Departments of Vascular Surgery (K. O'Malley, M. O'Donohoe, C.M.) and Radiology (E.K., M. O'Connell), Mater University Hospital/University College Dublin; Connolly Hospital (E.D.); and St Vincent's University Hospital (I.N., M.B., M.C.), Dublin, Ireland.
authors.forename: Danielle Ní
authors.initials: DN
authors.lastname: Chróinín
authors.forename: Michael
authors.initials: M
authors.lastname: Marnane
authors.forename: Layan
authors.initials: L
authors.lastname: Akijian
authors.forename: Aine
authors.initials: A
authors.lastname: Merwick
authors.forename: Emer
authors.initials: E
authors.lastname: Fallon
authors.forename: Gillian
authors.initials: G
authors.lastname: Horgan
authors.forename: Eamon
authors.initials: E
authors.lastname: Dolan
authors.forename: Sean
authors.initials: S
authors.lastname: Murphy
authors.forename: Killian
authors.initials: K
authors.lastname: O'Rourke
authors.forename: Kevin
authors.initials: K
authors.lastname: O'Malley
authors.forename: Martin
authors.initials: M
authors.lastname: O'Donohoe
authors.forename: Ciaran
authors.initials: C
authors.lastname: McDonnell
authors.forename: Imelda
authors.initials: I
authors.lastname: Noone
authors.forename: Mary
authors.initials: M
authors.lastname: Barry
authors.forename: Morgan
authors.initials: M
authors.lastname: Crowe
authors.forename: Eoin
authors.initials: E
authors.lastname: Kavanagh
authors.forename: Martin
authors.initials: M
authors.lastname: O'Connell
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Kelly
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016893:Carotid Stenosis / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology; D002784:Cholesterol / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D019788:Fluorodeoxyglucose F18; D059907:Functional Neuroimaging; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D058226:Plaque, Atherosclerotic / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed; D014280:Triglycerides / Q000097:blood*
chemical_list: D019275:Radiopharmaceuticals; D014280:Triglycerides; D019788:Fluorodeoxyglucose F18; D002784:Cholesterol