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 ¹⁸F-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 ( _meanSUV _gluc), mean of the maximum target-to-background ratio ( _meanTBR _gluc), and single hottest segment (SHS _gluc) 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 _meanSUV _gluc β = 0.324, _meanTBR _gluc β = 0.317, and SHS _gluc β = 0.298; for all, p < 0.0001). In addition, in diabetic patients, both body mass index <30 kg/m ² ( _meanSUV _gluc β = 0.4, _meanTBR _gluc β = 0.357, and SHS _gluc β = 0.388; for all, p < 0.015) and smoking ( _meanTBR _gluc, β = 0.312; SHS _gluc, β = 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.