Effects of metformin on the cerebral metabolic changes in type 2 diabetic patients.
Metformin, a widely used antidiabetic drug, has numerous effects on human metabolism. Based on emerging cellular, animal, and epidemiological studies, we hypothesized that metformin leads to cerebral metabolic changes in diabetic patients. To explore metabolism-influenced foci of brain, we used 2-deoxy-2-[(18)F]fluoro-D-glucose (FDG) positron emission tomography for type 2 diabetic patients taking metformin (MET, n = 18), withdrawing from metformin (wdMET, n = 13), and not taking metformin (noMET, n = 9). Compared with the noMET group, statistical parametric mapping showed that the MET group had clusters with significantly higher metabolism in right temporal, right frontal, and left occipital lobe white matter and lower metabolism in the left parahippocampal gyrus, left fusiform gyrus, and ventromedial prefrontal cortex. In volume of interest (VOI-) based group comparisons, the normalized FDG uptake values of both hypermetabolic and hypometabolic clusters were significantly different between groups. The VOI-based correlation analysis across the MET and wdMET groups showed a significant negative correlation between normalized FDG uptake values of hypermetabolic clusters and metformin withdrawal durations and a positive but nonsignificant correlation in the turn of hypometabolic clusters. Conclusively, metformin affects cerebral metabolism in some white matter and semantic memory related sites in patients with type 2 diabetes.
Department of Nuclear Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Dapi Road, Niaosong District, Kaohsiung 833, Taiwan.
Yung-Cheng
YC
Huang
Department of Nuclear Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Dapi Road, Niaosong District, Kaohsiung 833, Taiwan.
Chien-Chin
CC
Hsu
Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Dapi Road, Niaosong District, Kaohsiung 833, Taiwan.
Wei-Che
WC
Lin
Department of Computer Science and Information Engineering, 700 Kaohsiung University Road, Nanzih District, Kaohsiung 811, Taiwan.
Tang-Kai
TK
Yin
Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Dapi Road, Niaosong District, Kaohsiung 833, Taiwan.
Chi-Wei
CW
Huang
Department of Nuclear Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Dapi Road, Niaosong District, Kaohsiung 833, Taiwan ; Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Dapi Road, Niaosong District, Kaohsiung 833, Taiwan.
Pei-Wen
PW
Wang
Department of Nuclear Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Dapi Road, Niaosong District, Kaohsiung 833, Taiwan.
Han-Hsuan
HH
Chang
Department of Nuclear Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Shengli Road, Tainan 70428, Taiwan.
Nan-Tsing
0000-0002-7153-593X
NT
Chiu
D000368:Aged; D001921:Brain / Q000378:metabolism* / Q000473:pathology; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008297:Male; D008687:Metformin / Q000627:therapeutic use*; D008875:Middle Aged
D007004:Hypoglycemic Agents; D008687:Metformin