Skip to main content
Erschienen in: Wiener klinische Wochenschrift 1-2/2015

01.01.2015 | original article

Evaluation of liver perfusion in diabetic patients using 99mTc-sestamibi

verfasst von: Assist. Prof. Hacer Şen, Yusuf Ziya Tan, Emine Binnetoğlu, Mehmet Aşik, Fahri Güneş, Gökhan Erbağ, Emine Gazi, Sibel Cevizci, Semra Özdemir, Erdem Akbal, Kubilay Ükinç

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 1-2/2015

Einloggen, um Zugang zu erhalten

Summary

Objective

The liver is an important organ for various aspects of glucose metabolism, including glucose uptake, storage, and synthesis. It is a major organ in the metabolic process with perfusion provided by both the portal vein and hepatic artery. In diabetic patients organ perfusion is reduced and this is linked to atherosclerosis, and as a result complications occur. In this study, we aimed to evaluate liver perfusion by scintigraphic methods in diabetic patients.

Design and patients

We retrospectively investigated 1,100 myocardial perfusion scintigraphies taken between January 2011 and December 2012 at Canakkale Onsekiz Mart University Medical Faculty Nuclear Medicine Department. A total of 66 patients who were diagnosed with diabetes mellitus and had myocardial perfusion scintigraphies were included in the study. The control subjects included 127 patients without diabetes mellitus who were chosen at random. Patients with chronic liver disease were not included in the study. The values from liver regions of interest (liver-ROI) rates and heart regions of interest (heart-ROI) rates were compared between the patients and controls.

Results

Patients were grouped according to the presence of diabetes. In the diabetes mellitus group, the liver-ROI average was lower (p = 0.66) than in the controls. In the control group, the average liver-ROI/heart-ROI ratios were higher than the ratio in the diabetes mellitus group (p = 0.019). Multivariate variance analysis showed that the diabetes mellitus liver-ROI/heart-ROI ratio was independent of other risk factors (p = 0.003; F: 9.6). Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation.

Conclusions

This study shows that liver perfusion in diabetic patients is reduced compared with those without diabetes. Prospective studies with larger patient groups are required.
Literatur
1.
Zurück zum Zitat Morrish NJ, Wang SL, Stevens LK, Fuller JH, Keen H. Mortality and causes of death in the WHO multinational study of vascular disease in diabetes. Diabetologia. 2001;44(2):14–21. Morrish NJ, Wang SL, Stevens LK, Fuller JH, Keen H. Mortality and causes of death in the WHO multinational study of vascular disease in diabetes. Diabetologia. 2001;44(2):14–21.
2.
Zurück zum Zitat Naka KK, Papathanassiou K, Bechlioulis A, et al. Determinants of vascular function in patients with type 2 diabetes. Cardiovasc Diabetol. 2012;11:127. Naka KK, Papathanassiou K, Bechlioulis A, et al. Determinants of vascular function in patients with type 2 diabetes. Cardiovasc Diabetol. 2012;11:127.
3.
Zurück zum Zitat Beckman JA, Creager MA, Libby P. Diabetes and atherosclerosis: epidemiology, patophysiology, and management. JAMA. 2002;287:2570–81. Beckman JA, Creager MA, Libby P. Diabetes and atherosclerosis: epidemiology, patophysiology, and management. JAMA. 2002;287:2570–81.
4.
Zurück zum Zitat The Diabetes Control and Complications Trial research group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329:977–86. The Diabetes Control and Complications Trial research group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329:977–86.
5.
Zurück zum Zitat Schaefer WM, Moka D, Brockmann HA, Schomaecker K, Schicha H. Tl-201, Tc-99 m MIBI, Tc-99 m tetrofosmin and Tc-99 m furifosmin: relative retention and clearance kinetics in retrogradely perfused guinea pig hearts. Nucl Med Biol. 2002;29:243–54. Schaefer WM, Moka D, Brockmann HA, Schomaecker K, Schicha H. Tl-201, Tc-99 m MIBI, Tc-99 m tetrofosmin and Tc-99 m furifosmin: relative retention and clearance kinetics in retrogradely perfused guinea pig hearts. Nucl Med Biol. 2002;29:243–54.
6.
Zurück zum Zitat Wackers FJ, Berman DS, Maddahi J, et al. Technetium-99 m hexakis 2-methoxyisobutyl isonitrile: human biodistribution, dosimetry, safety, and preliminary comparison to thallium-201 myocardial perfusion imaging. J Nucl Med. 1989;30:301–11. Wackers FJ, Berman DS, Maddahi J, et al. Technetium-99 m hexakis 2-methoxyisobutyl isonitrile: human biodistribution, dosimetry, safety, and preliminary comparison to thallium-201 myocardial perfusion imaging. J Nucl Med. 1989;30:301–11.
7.
Zurück zum Zitat Schalkwijk CG, Stehouwer CD. Vascular complications in diabetes mellitus: the role of endothelial dysfunction. Clin Sci (Lond). 2005;109:143–59. Schalkwijk CG, Stehouwer CD. Vascular complications in diabetes mellitus: the role of endothelial dysfunction. Clin Sci (Lond). 2005;109:143–59.
8.
Zurück zum Zitat Brownlee M, Viassara H, Cerami A. Nonenzymatic glycosylation and the pathogenesis of diabetic complications. Ann Intern Med. 1984;101:527–37. Brownlee M, Viassara H, Cerami A. Nonenzymatic glycosylation and the pathogenesis of diabetic complications. Ann Intern Med. 1984;101:527–37.
9.
Zurück zum Zitat Krishnan B, Babu S, Walker J, Walker AB, Pappachan JM. Gastrointestinal complications of diabetes mellitus. World J Diabetes. 2013;4(3):51–63. Krishnan B, Babu S, Walker J, Walker AB, Pappachan JM. Gastrointestinal complications of diabetes mellitus. World J Diabetes. 2013;4(3):51–63.
10.
Zurück zum Zitat Torbenson M, Chen YY, Brunt E, et al. Glycogenic hepatopathy: an underrecognized hepatic complication of diabetes mellitus. Am J Surg Pathol. 2006;30:508–13. Torbenson M, Chen YY, Brunt E, et al. Glycogenic hepatopathy: an underrecognized hepatic complication of diabetes mellitus. Am J Surg Pathol. 2006;30:508–13.
11.
Zurück zum Zitat Mitra V, Metcalf J. Functional anatomy and blood supply of the liver, Anaesth. Intensive Care Med. 2009;10(7):332–3. Mitra V, Metcalf J. Functional anatomy and blood supply of the liver, Anaesth. Intensive Care Med. 2009;10(7):332–3.
12.
Zurück zum Zitat Balci A, Karazincir S, Sumbas H, et al. Effects of diffuse fatty infiltration of the liver on portal vein flow hemodynamics. J Clin Ultrasound. 2008;36:134–40. Balci A, Karazincir S, Sumbas H, et al. Effects of diffuse fatty infiltration of the liver on portal vein flow hemodynamics. J Clin Ultrasound. 2008;36:134–40.
13.
Zurück zum Zitat Johnson DJ, Muhlbacher F, Wilmore DW. Measurement of hepatic blood flow. J Surg Res. 1985;39:470–81. Johnson DJ, Muhlbacher F, Wilmore DW. Measurement of hepatic blood flow. J Surg Res. 1985;39:470–81.
14.
Zurück zum Zitat Chundru S, Kalb B, Arif-Tiwari H, et al. MRI of diffuse liver disease: the common and uncommon etiologies. Diagn Interv Radiol. 2013;19(6):479–87. Chundru S, Kalb B, Arif-Tiwari H, et al. MRI of diffuse liver disease: the common and uncommon etiologies. Diagn Interv Radiol. 2013;19(6):479–87.
15.
Zurück zum Zitat Rijzewijk LJ, van der Meer RW, Lubberink M, et al. Liver fat content in type 2 diabetes: relationship with hepatic perfusion and substrate metabolism. Diabetes. 2010;59(11):2747–54. Rijzewijk LJ, van der Meer RW, Lubberink M, et al. Liver fat content in type 2 diabetes: relationship with hepatic perfusion and substrate metabolism. Diabetes. 2010;59(11):2747–54.
16.
Zurück zum Zitat Rausova Z, Chrenova J, Nuutila P, Iozzo P, Dedik L. System approach to modeling of liver glucose metabolism with physiologically interpreted model parameters outgoing from [18F]FDG concentrations measured by PET. Comput Methods Programs Biomed. 2012;107(2):347–56. Rausova Z, Chrenova J, Nuutila P, Iozzo P, Dedik L. System approach to modeling of liver glucose metabolism with physiologically interpreted model parameters outgoing from [18F]FDG concentrations measured by PET. Comput Methods Programs Biomed. 2012;107(2):347–56.
17.
Zurück zum Zitat Iozzo P, Jarvisalo MJ, Kiss J, et al. Quantification of liver glucose metabolism by positron emission tomography: validation study in pigs. Gastroenterology. 2007;132:531–42. Iozzo P, Jarvisalo MJ, Kiss J, et al. Quantification of liver glucose metabolism by positron emission tomography: validation study in pigs. Gastroenterology. 2007;132:531–42.
18.
Zurück zum Zitat Nuyts J, Dupont P, Van den Maegdenbergh V, et al. Study of the liver–heart artifact in emission tomography. J Nucl Med. 1995;36:133–9. Nuyts J, Dupont P, Van den Maegdenbergh V, et al. Study of the liver–heart artifact in emission tomography. J Nucl Med. 1995;36:133–9.
19.
Zurück zum Zitat Vitola JV, Brambatti JC, Caligaris F, et al. Exercise supplementation to dipyridamole prevents hypotension, improves electrocardiogram sensitivity, and increases heart-to-liver activity ratio on Tc-99 m sestamibi imaging. J Nucl Cardiol. 2001;8(6):652–9. Vitola JV, Brambatti JC, Caligaris F, et al. Exercise supplementation to dipyridamole prevents hypotension, improves electrocardiogram sensitivity, and increases heart-to-liver activity ratio on Tc-99 m sestamibi imaging. J Nucl Cardiol. 2001;8(6):652–9.
20.
Zurück zum Zitat Brock RW1, Dorman RB. Obesity, insulin resistance and hepatic perfusion. Microcirculation. 2007;14(4–5):339–47. Brock RW1, Dorman RB. Obesity, insulin resistance and hepatic perfusion. Microcirculation. 2007;14(4–5):339–47.
21.
Zurück zum Zitat Khimmaktong W, Petpiboolthai H, Panyarachun B, Anupunpisit V. Study of curcumin on microvasculature characteristic in diabetic rat’s liver as revealed by vascular corrosion cast/scanning electron microscope (SEM) technique. J Med Assoc Thai. 2012;95(5):133–41. Khimmaktong W, Petpiboolthai H, Panyarachun B, Anupunpisit V. Study of curcumin on microvasculature characteristic in diabetic rat’s liver as revealed by vascular corrosion cast/scanning electron microscope (SEM) technique. J Med Assoc Thai. 2012;95(5):133–41.
22.
Zurück zum Zitat Harrison SA, Brunt EM, Goodman ZD, Di Bisceglie AM. Diabetic hepatosclerosis: diabetic microangiopathy of the liver. Arch Pathol Lab Med. 2006;130(1):27–32. Harrison SA, Brunt EM, Goodman ZD, Di Bisceglie AM. Diabetic hepatosclerosis: diabetic microangiopathy of the liver. Arch Pathol Lab Med. 2006;130(1):27–32.
Metadaten
Titel
Evaluation of liver perfusion in diabetic patients using 99mTc-sestamibi
verfasst von
Assist. Prof. Hacer Şen
Yusuf Ziya Tan
Emine Binnetoğlu
Mehmet Aşik
Fahri Güneş
Gökhan Erbağ
Emine Gazi
Sibel Cevizci
Semra Özdemir
Erdem Akbal
Kubilay Ükinç
Publikationsdatum
01.01.2015
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 1-2/2015
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-014-0614-5

Weitere Artikel der Ausgabe 1-2/2015

Wiener klinische Wochenschrift 1-2/2015 Zur Ausgabe