Impact of Noninsulin-Dependent Type 2 Diabetes on Carotid Wall 18F-Fluorodeoxyglucose Positron Emission Tomography Uptake

Objectives In this study, the impact of noninsulin-dependent type 2 diabetes mellitus on carotid wall F-18-fluorodeoxyglucose (FDG) uptake in patients with documented or suspected cardiovascular disease was evaluated. Background Inflammation is a pivotal process in the progression of atherosclerosis, which can be noninvasively imaged by FDG positron emission tomography (FDG-PET). Methods Carotid artery wall FDG uptake was quantified in 134 patients (age 60.2 +/- 9.7 years; diabetic subjects, n = 43). The pre-scan glucose (gluc) level corrected mean of the maximum standardized uptake value (SUV) values (meanSUVgluc), mean of the maximum target-to-background ratio (meanTBRgluc), and single hottest segment (SHSgluc) of FDG uptake in the artery wall were calculated. Associations between FDG uptake, the presence of risk factors for atherosclerosis, and diabetes were then assessed by multiple regression analysis with backward elimination. Results The study demonstrated a significant association between diabetes and FDG uptake in the arterial wall (diabetes meanSUVgluc beta = 0.324, meanSUVgluc beta = 0.317, and SHSgluc beta = 0.298; for all, p < 0.0001). In addition, in diabetic patients, both body mass index >= 30 kg/m(2) (meanSUVgluc beta = 0.4, meanTBRgluc beta = 0.357, and SHSgluc beta = 0.388; for all, p < 0.015) and smoking (meanSUVgluc, beta = 0.312; SHSgluc, beta = 0.324; for all, p < 0.04) were significantly associated with FDG uptake. Conclusions Type 2 diabetes was significantly associated with carotid wall FDG uptake in patients with known or suspected cardiovascular disease. In diabetic patients, obesity and smoking add to the risk of increased FDG uptake values. (J Am Coll Cardiol 2012;59:2080-8) (C) 2012 by the American College of Cardiology Foundation