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Eur J Clin Invest. 2019 Jul;49(7):e13120. doi: 10.1111/eci.13120. Epub 2019 Apr 29.

PET imaging during hypoglycaemia to study adipose tissue metabolism.

Author information

1
Department of Radiology and Nuclear Medicine, Nijmegen, the Netherlands.
2
Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.

Abstract

BACKGROUND:

Disturbances in adipose tissue glucose uptake may play a role in the pathogenesis of type 2 diabetes, yet its examination by 2-deoxy-2-[18 F]fluorodeoxyglucose ([18 F]FDG) PET/CT is challenged by relatively low uptake kinetics. We tested the hypothesis that performing [18 F]FDG PET/CT during a hypoglycaemic clamp would improve adipose tissue tracer uptake to allow specific comparison of adipose tissue glucose handling between people with or without type 2 diabetes.

DESIGN:

We enrolled participants with or without diabetes who were at least overweight, to undergo a hyperinsulinaemic hypoglycaemic clamp or a hyperinsulinaemic euglycaemic clamp (n = 5 per group). Tracer uptake was quantified using [18 F]FDG PET/CT.

RESULTS:

Hypoglycaemic clamping increased [18 F]FDG uptake in visceral adipose tissue of healthy participants (P = 0.002). During hypoglycaemia, glucose uptake in visceral adipose tissue of type 2 diabetic participants was lower as compared to healthy participants (P < 0.0005). No significant differences were observed in skeletal muscle, liver or pancreas.

CONCLUSIONS:

The present findings indicate that [18 F]FDG PET/CT during a hypoglycaemic clamp provides a promising new research tool to evaluate adipose tissue glucose metabolism. Using this method, we observed a specific impairment in visceral adipose tissue [18 F]FDG uptake in type 2 diabetes, suggesting a previously underestimated role for adipose tissue glucose handling in type 2 diabetes.

KEYWORDS:

[18F]FDG PET; adipose tissue; glucose metabolism; obesity; type 2 diabetes mellitus

PMID:
31002171
PMCID:
PMC6618104
DOI:
10.1111/eci.13120
[Indexed for MEDLINE]
Free PMC Article

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