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Role of insulin resistance in heart and skeletal muscle F-18 fluorodeoxyglucose uptake in patients with noninsulin-dependent diabetes mellitus

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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Altered heart and skeletal glucose usage has been reported in patients with non-insulin-dependent diabetes mellitus (NIDDM). Although elevations in plasma free fatty acid (FFA) concentrations have been implicated in reduced myocardial 18fluorine-fluoro-2-deoxy-d-glucose uptake (MFU), the specific role of whole-body insulin resistance in MFU in patients with NIDDM compared with skeletal muscle metabolism remains controversial.

Purpose

MFU and skeletal muscle 18fluorine-fluoro-2-deoxy-d-glucose uptake (SMFU) were compared with positron emission tomography and the whole-body glucose disposal rate (GDR) during hyperinsulinemic euglycemic clamping in 26 normotensive asymptomatic patients with NIDDM who were not taking medication. These factors were also compared in 12 age-matched control subjects to increase the knowledge of the influence of whole-body insulin resistance on MFU. In addition, independent factors for both SMFU and MFU were investigated.

Results

GDR in control subjects (10.0±2.97 mg/min per kilogram) was significantly higher than in patients with NIDDM (4.05±2.37 mg/min per kilogram, P<.01). SMFU in patients with NIDDM (0.826 +-0.604 mg/min per 100g) was significantly lower than that in control subjects (1.86±1.06 mg/min per 100g, P<.01). MFU in patients with NIDDM (5.35±2.10 mg/min per 100 g) was also significantly lower than that of control subjects (7.05±1.66 mg/min per 100 g, P =.0182). SMFU significantly correlated with GDR (r=.727, P<.01) and FFA (r=-.52, P <.01) in patients with NIDDM. MFU also correlated with GDR (r=.778, P<.01) and FFA (r=-.72, P<.01) in patients with NIDDM. Multivariate stepwise regression analysis showed that GDR (F=36.8) was independently related to MFU (r=.85, P<.01) whereas FFA was not (F=1.763), where F is the value for statistical analysis of multivariate stepwise regression analysis.

Conclusion

Insulin resistance is the most essential factor for both heart and skeletal muscle FDG uptake in patients with NIDDM.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, University of Tokyo Graduate School of Medicine, 7-3-1 Hongoh Bunkyo-ku, 113-8655, Tokyo, Japan

    Ikuo Yokoyama, Katsunori Yonekura, Hidehiro Kawamura, Akihiro Matsumoto, Teruhiko Aoyagi, Seiryo Sugiura & Ryozo Nagai

  2. Department of Radiology, University of Tokyo Graduate School of Medicine, 7-3-1 Hongoh Bunkyo-ku, 113-8655, Tokyo, Japan

    Tohru Ohtake, Yusuke Inoue & Kuni Ohtomo

  3. Department of Gastroenterology, University of Tokyo Graduate School of Medicine, 7-3-1 Hongoh Bunkyo-ku, 113-8655, Tokyo, Japan

    Masao Omata

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  1. Ikuo Yokoyama
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  2. Katsunori Yonekura
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Correspondence to Ikuo Yokoyama.

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Yokoyama, I., Yonekura, K., Ohtake, T. et al. Role of insulin resistance in heart and skeletal muscle F-18 fluorodeoxyglucose uptake in patients with noninsulin-dependent diabetes mellitus. J Nucl Cardiol 7, 242–248 (2000). https://doi.org/10.1016/S1071-3581(00)70013-4

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  • DOI: https://doi.org/10.1016/S1071-3581(00)70013-4

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