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Association between non-alcoholic fatty liver disease and myocardial glucose uptake measured by 18F-fluorodeoxyglucose positron emission tomography

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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Non-alcoholic fatty liver disease (NAFLD) has emerged as an independent risk factor for cardiovascular diseases. However, there were few studies evaluating the condition of myocardial glucose metabolism in patients with NAFLD. Therefore, the aim of this study was to investigate the association between NAFLD and myocardial glucose uptake assessed by using 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) and whether or not alteration of myocardial glucose uptake could be an indicator linking to cardiac dysfunction in NAFLD individuals.

Methods and Results

A total of 743 asymptomatic subjects (201 with NAFLD, 542 without NAFLD) were retrospectively studied. The ratio of maximum myocardium FDG uptake to the mean standardized uptake value of liver (SUVratio) was calculated to estimate myocardial glucose uptake by using 18F-FDG PET. The diagnosis of fatty liver and fatty liver grading was confirmed by unenhanced CT according to diagnostic criterion of previous studies. The myocardial geometric and functional data were obtained by echocardiogram. Myocardial glucose uptake was significantly lower in individuals with NAFLD compared with those without fatty liver (P < .001). When analysis of association trend was performed, SUVratio quartiles showed correlated inversely and strongly with liver steatosis (P < .001). NAFLD patients with lower myocardial glucose uptake were more likely to have higher proportion of increased LV filling pressure (P < .05). A significant relationship between myocardial SUVratio and E/e’ ratio was presented in the trend analysis (P < .05). Moreover, multivariate regression analysis showed that myocardial glucose uptake was independently associated with NAFLD after adjusting for clinical important factors (all P < .001).

Conclusions

The presence of NAFLD in otherwise healthy subjects is closely associated with decreased myocardial glucose uptake assessing by 18F-FDG PET imaging. Furthermore, the NAFLD individuals with lower myocardial glucose uptake are more likely to have high risk of having impaired diastolic heart function.

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Abbreviations

BMI:

Body mass index

CT:

Computed tomography

CVD:

Cardiovascular diseases

FDG:

Fluorodeoxyglucose

FFA:

Free fatty acids

LV:

Left ventricular

NAFLD:

Non-alcoholic fatty liver disease

OR:

Odds ratio

PET:

Positron emission tomography

SUV:

Standardized uptake value

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Author Contributions

KT drafted the manuscript and contributed to the data analysis. XZ and JL contributed to clinical data acquisition and PET images analysis. MZ contributed to the data Statistical analysis. HL contributed to echocardiographic images analysis. TL contributed to CT images analysis. LW contributed to the study design and manuscript drafting. All authors read and approved the final version of the manuscript.

Disclosure

None declared.

Author information

Authors and Affiliations

  1. Department of PET/CT, The First Affiliated Hospital of Wenzhou Medical University, Xuefu North Road, Wenzhou, 325000, Zhejiang, China

    Kun Tang MD, Xiangwu Zheng MD, Jie Lin MD & Tiancheng Li MD

  2. Department of Infection and Liver Diseases, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China

    Minghua Zheng MD

  3. Department of Ultrasound, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China

    Haixia Lin MD

  4. Department of Nuclear Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China

    Ling Wang MD, PhD

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  1. Kun Tang MD
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Correspondence to Ling Wang MD, PhD.

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Tang, K., Zheng, X., Lin, J. et al. Association between non-alcoholic fatty liver disease and myocardial glucose uptake measured by 18F-fluorodeoxyglucose positron emission tomography. J. Nucl. Cardiol. 27, 1679–1688 (2020). https://doi.org/10.1007/s12350-018-1446-x

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