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OtherClinical Investigations

Insulin Stimulates Liver Glucose Uptake in Humans: An 18F-FDG PET Study

Patricia Iozzo, Fabian Geisler, Vesa Oikonen, Maija Mäki, Teemu Takala, Olof Solin, Ele Ferrannini, Juhani Knuuti and Pirjo Nuutila
Journal of Nuclear Medicine May 2003, 44 (5) 682-689;
Patricia Iozzo
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Fabian Geisler
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Vesa Oikonen
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Maija Mäki
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Teemu Takala
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Olof Solin
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Ele Ferrannini
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Juhani Knuuti
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Pirjo Nuutila
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  • FIGURE 1.
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    FIGURE 1.

    (Top) Transaxial images at level of heart (A) and liver (B) show image quality and ROIs. (Bottom) Time–activity curves were derived from ROIs placed inside left ventricular chamber (A) and right lobe of liver (B).

  • FIGURE 2.
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    FIGURE 2.

    Single-patient insulin-stimulated hepatic influx rate constant (H-Ki) changes (▿) in subjects who underwent repeated study (low IS) show consistent upward shift in all subjects and significant 98% ± 74% average increase (▪ P < 0.01, Student paired t test).

  • FIGURE 3.
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    FIGURE 3.

    Net HGU as measured by graphical analysis in each study population. *P < 0.05 vs. fasting. §P = 0.1 vs. fasting.

  • FIGURE 4.
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    FIGURE 4.

    Correlation between whole-body glucose uptake during clamp (M value) and hepatic glucose phosphorylation/dephosphorylation ratios.

  • FIGURE 5.
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    FIGURE 5.

    Graph shows nonlinear least squares fit for 3-compartment model and corresponding measured data. Table gives numeric values for the example shown.

  • FIGURE 6.
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    FIGURE 6.

    Linear least squares fit for Patlak plot and corresponding measured data during fasting (A) and clamp (B) in 1 study subject.

  • FIGURE 7.
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    FIGURE 7.

    Correlations between 3-compartment model and graphical analysis influx rate constants during fasting (A) and clamp (B) in whole study group.

Tables

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    TABLE 1

    Characteristics of Study Groups

    VariablePET during fasting: normal ISPET during clampPET during fasting and clamp: low IS
    Normal ISHigh IS
    n7987
    Age (y)34 ± 828 ± 428 ± 262 ± 9*
    EF (%)—62 ± 665 ± 362 ± 8
    Weight (kg)82 ± 977 ± 976 ± 681 ± 10
    Height (cm)181 ± 7182 ± 5186 ± 4179 ± 5†
    Fasting plasma levels
     Glucose (mmol·L−1)5.4 ± 0.55.2 ± 0.35.3 ± 0.45.2 ± 0.5
     Insulin (pmol·L−1)18 ± 15‡45 ± 1530 ± 1844 ± 16
     FFA (mmol·L−1)0.70 ± 0.23†0.54 ± 0.190.39 ± 0.120.67 ± 0.17†
    Clamp plasma levels
     Glucose (mmol·L−1)—5.1 ± 0.85.1 ± 0.35.4 ± 0.8
     Insulin (pmol·L−1)—420 ± 100§430 ± 160§460 ± 120§
     FFA (mmol·L−1)—0.11 ± 0.04§0.10 ± 0.03§0.07 ± 0.03*§
     M (μmol·min−1·kg−1)—35 ± 765 ± 8‖24 ± 3†‖
    • ↵* P < 0.05 vs. other groups.

    • ↵† P < 0.05 vs. high IS.

    • ↵‡ P < 0.05 vs. normal IS (PET during clamp) and low IS.

    • ↵§ P < 0.05 vs. fasting.

    • ↵‖ P < 0.05 vs. normal IS during clamp.

    • M = whole-body glucose utilization, which was computed during steady-state phase of clamp; EF = ejection fraction.

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    TABLE 2

    Nonlinear Least Squares Fit and Graphical Analysis Parameters

    GroupnNonlinear least squares fitGraphical analysis
    k1k2k3k4VBKiKi[G]KiKi[G]
    Fasting
     All groups140.63 ± 0.140.78 ± 0.180.36 ± 0.190.23 ± 0.627 ± 80.29 ± 0.141.5 ± 0.70.22 ± 0.121.2 ± 0.6
     Normal IS70.62 ± 0.120.76 ± 0.150.43 ± 0.240.47 ± 0.8312 ± 80.34 ± 0.181.8 ± 0.90.23 ± 0.141.3 ± 0.8
     Low IS70.64 ± 0.160.79 ± 0.220.29 ± 0.070.001 ± 0.00031 ± 10.23 ± 0.061.2 ± 0.30.21 ± 0.091.1 ± 0.5
    Clamp
     All groups240.63 ± 0.190.79 ± 0.270.55 ± 0.24*0.11 ± 0.3310 ± 80.43 ± 0.15*2.3 ± 0.9*0.42 ± 0.18*2.2 ± 0.9*
     Normal IS90.60 ± 0.160.74 ± 0.200.57 ± 0.250.02 ± 0.06*13 ± 220.45 ± 0.182.3 ± 1.10.39 ± 0.16†2.0 ± 0.8
     High IS80.62 ± 0.210.77 ± 0.260.50 ± 0.170.001 ± 0.0003*6 ± 60.40 ± 0.132.0 ± 0.70.42 ± 0.14*2.1 ± 0.8*
     Low IS70.68 ± 0.230.88 ± 0.360.59 ± 0.30*0.34 ± 0.569 ± 160.44 ± 0.15*2.4 ± 1.0*0.45 ± 0.24*2.4 ± 1.2*
    • ↵* P ≤ 0.05 vs. fasting.

    • ↵† P = 0.07 vs. fasting.

    • Units of measure: k1 = mL·min−1·mL−1 (tissue); k2 = min−1; k3 = min−1·10−2; k4 = min−1·10−4; Ki = mL·min−1·100 mL−1 (tissue); Ki[G] = μmol·min−1·100 mL−1 (tissue).

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Journal of Nuclear Medicine
Vol. 44, Issue 5
May 1, 2003
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Insulin Stimulates Liver Glucose Uptake in Humans: An 18F-FDG PET Study
Patricia Iozzo, Fabian Geisler, Vesa Oikonen, Maija Mäki, Teemu Takala, Olof Solin, Ele Ferrannini, Juhani Knuuti, Pirjo Nuutila
Journal of Nuclear Medicine May 2003, 44 (5) 682-689;

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Insulin Stimulates Liver Glucose Uptake in Humans: An 18F-FDG PET Study
Patricia Iozzo, Fabian Geisler, Vesa Oikonen, Maija Mäki, Teemu Takala, Olof Solin, Ele Ferrannini, Juhani Knuuti, Pirjo Nuutila
Journal of Nuclear Medicine May 2003, 44 (5) 682-689;
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