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Basic Science Investigation |
1 Turku PET Centre, University of Turku, Turku, Finland; 2 PET Centre, Institute of Clinical Physiology, CNR National Research Council, Pisa, Italy; 3 Department of Surgery, University of Turku, Turku, Finland; 4 Department of Internal Medicine, University of Pisa School of Medicine, Pisa, Italy; and 5 Department of Medicine, University of Turku, Turku, Finland
Correspondence: For correspondence or reprints contact: Patricia Iozzo, MD, Turku PET Centre, University of Turku, P.O. Box 52, FIN-20521, Turku, Finland. E-mail: patricia.iozzo{at}ifc.cnr.it
The glucose analog 18F-FDG is commonly used to quantify regional glucose uptake in vivo. The aim of this study was to test whether the analysis of plasma 18F-FDG kinetics could be used to estimate endogenous glucose production (EGP) and the total rate of appearance (Ra), total rate of disappearance (Rd), and the metabolic clearance rate (MCR) of glucose. Methods: Fourteen pigs were coinjected with 18F-FDG and 6,6-2H-glucose (2H-G) during fasting (n = 6) and during physiologic (1.0 mU·kg–1·min–1, n = 4) and supraphysiologic (5.0 mU·kg–1·min–1, n = 4) euglycemic hyperinsulinemia. Arterial plasma was sampled for 180 min to quantify the parameters for the 2 tracers. Results: Fasting Rd2H-G and RdFDG were 12.3 ± 2.1 and 13.3 ± 1.3 µmol·kg–1·min–1 (difference not statistically significant [NS]). M values were more than doubled between the 2 clamp studies (P < 0.0001). Rd2H-G and RdFDG were dose-dependently higher during the hyperinsulinemic state (19.8 ± 3.7 vs. 18.9 ± 1.1 and 31.4 ± 4.1 vs. 31.9 ± 2.3 in 1.0 and 5.0 mU·kg–1·min–1 studies, respectively; difference between tracers NS) than during the fasting state, with a parallel suppression of EGP2H-G and EGPFDG. Parameters estimated by 18F-FDG and 2H-G were equivalent in all groups; their agreement was confirmed by Bland–Altman examination. Total RdFDG correlated with Rd2H-G (r = 0.74; P = 0.003), M (r = 0.92; P = 0.001), MCR2H-G (r = 0.52; P = 0.037), and EGP2H-G (r = –0.71; P = 0.004). EGPFDG correlated with EGP2H-G (r = 0.62; P = 0.018), Rd2H-G (r = –0.78; P = 0.001), and MCR2H-G (r = –0.67; P = 0.008). The 18F-FDG mean transit time correlated inversely with the M and Rd values and positively with EGP. Conclusion: The glucose analog 18F-FDG can be used in the simultaneous estimation of whole-body glucose turnover and production and regional 18F-FDG PET measurements under both fasting and insulin-stimulated conditions.
Key Words: 18F-FDG • 6,6-2H-glucose • glucose turnover • glucose production • insulin
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