Arterial and fat tissue inflammation are highly correlated : a prospective 18F-FDG PET/CT study
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There is evidence that the link between obesity and cardiovascular disease might relate to inflammation in both fat tissue and the arterial wall. 18F-FDG uptake on PET is a surrogate marker of vessel wall inflammation. The aim of the study was to measure FDG uptake in both regions using PET and identify links between adipose and arterial inflammation.
Included in the study were 173 cardiovascular patients who were prospectively imaged with FDG PET/CT. Arterial FDG uptake was measured in the carotid arteries and ascending aorta. The same was done in fat tissue in the neck, the presternal region (both subcutaneous) and the pericardium. FDG uptake was quantified as average maximal target-to-background ratio (meanTBRmax). Multivariate regression analyses were performed to identify significant associations between arterial and adipose tissue FDG uptake and clinical variables as given by the standardized correlation coefficient (β).
FDG uptake values in all fat tissue regions were highly predictive of vascular FDG uptake in both the carotids (β 0.262, p < 0.0001, in the neck subcutaneous region) and aorta (β 0.22, p = 0.008, in the chest pericardial region; β 0.193, p = 0.019, in the chest subcutaneous region). Obesity was significantly associated with elevated FDG uptake in adipose tissue (β 0.470, p < 0.0001, in the neck subcutaneous region; β 0.619, p = 0.028, in the chest subcutaneous region; β 0.978, p = 0.035, in the chest pericardial region).
FDG uptake in diverse fat tissue regions was significantly associated with arterial FDG uptake, a reasonable surrogate of inflammation. Increasing body weight significantly predicted the level of fatty inflammation. FDG PET therefore provides imaging evidence of an inflammatory link between fat tissue and the vasculature in patients with cardiovascular disease.
KeywordsFDG PET Inflammation Atherosclerosis Fat tissue Carotid arteries Aorta
The authors wish to thank Ash Rafique, RT, BS, CNMT, for his assistance with image acquisition. Work on this study was partly supported by the NIHR Cambridge Biomedical Research Centre (J.H.F.R.). Partial support was provided by: NIH/NHLBI R01 HL071021 (Z.A.F.), NIH/NHLBI R01 HL078667 (Z.A.F. and M.E.F.), and NIH/NCATS CTSA UL1TR000067 (Imaging Core) (Z.A.F.).
Conflicts of interest
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