[18F]FDG Uptake in Adipose Tissue Is Not Related to Inflammation in Type 2 Diabetes Mellitus

Purpose 2-deoxy-2-[F-18]fluoro-d-glucose ([F-18]FDG) uptake is a marker of metabolic activity and is therefore used to measure the inflammatory state of several tissues. This radionuclide marker is transported through the cell membrane via glucose transport proteins (GLUTs). The aim of this study is to investigate whether insulin resistance (IR) or inflammation plays a role in [F-18]FDG uptake in adipose tissue (AT). Procedures This study consisted of anin vivoclinical part and anex vivomechanistic part. In the clinical part, [F-18]FDG uptake in abdominal visceral AT (VAT) and subcutaneous AT (SAT) was determined using PET/CT imaging in 44 patients with early type 2 diabetes mellitus (T2DM) (age 63 [54-66] years, HbA1c [6.3 +/- 0.4 %], HOMA-IR 5.1[3.1-8.5]). Plasma levels were measured with ELISA. In the mechanistic part, AT biopsies obtained from 8 patients wereex vivoincubated with [F-18]FDG followed by autoradiography. Next, a qRT-PCR analysis was performed to determine GLUT and cytokine mRNA expression levels. Immunohistochemistry was performed to determine CD68(+)macrophage infiltration and GLUT4 protein expression in AT. Results In vivoVAT [F-18]FDG uptake in patients with T2DM was inversely correlated with HOMA-IR (r = - 0.32,p = 0.034), and positively related to adiponectin plasma levels (r = 0.43,p = 0.003).Ex vivo[F-18]FDG uptake in VAT was not related to CD68(+)macrophage infiltration, and IL-1ss and IL-6 mRNA expression levels.Ex vivoVAT [F-18]FDG uptake was positively related to GLUT4 (r = 0.83,p = 0.042), inversely to GLUT3 (r = - 0.83,p = 0.042) and not related to GLUT1 mRNA expression levels. Conclusions In vivo[F-18]FDG uptake in VAT from patients with T2DM is positively correlated with adiponectin levels and inversely with IR.Ex vivo[F-18]FDG uptake in AT is associated with GLUT4 expression but not with pro-inflammatory markers. The effect of IR should be taken into account when interpreting data of [F-18]FDG uptake as a marker for AT inflammation.

Automated summary

This study investigated the role of insulin resistance and inflammation in [F-18]FDG uptake in adipose tissue of patients with type 2 diabetes. The results showed that in vivo VAT [F-18]FDG uptake was negatively correlated with HOMA-IR and positively correlated with adiponectin levels, while ex vivo VAT [F-18]FDG uptake was associated with GLUT4 expression.