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1 Turku Positron Emission Tomography Center and 2 Lundberg Laboratory for Diabetes Research, Department of Internal Medicine, University of Gothenburg, 41345 Gothenburg, Sweden; and 3 Department of Medicine, University of Turku, F-20520 Turku, Finland
Quantitative
2-[18F]fluoro-2-deoxy-D-glucose
([18F]FDG) positron emission tomography (PET) has been
widely used to calculate glucose utilization in skeletal muscle.
FDG-PET results depend partly on the lumped constant (LC), which
accounts for the differences in the transport and phosphorylation
between [18F]FDG and glucose. In this study, we estimated
the LC for [18F]FDG directly in normal and in
insulin-resistant obese subjects by combining FDG PET with the
microdialysis technique. Eight obese [age 29.4 ± 1.0 yr, body
mass index (BMI) 33.6 ± 1.0 kg/m2] and eight
nonobese (age 25.0 ± 1.0 yr, BMI 23.1 ± 1.0 kg/m2) males were studied during euglycemic
hyperinsulinemia (1 mU · kg
1 · min
1 for 150 min). Muscle blood flow was measured using 15O-labeled
water and PET. Muscle [18F]FDG uptake
(rGUFDG) was calculated with Patlak graphic analysis. Interstitial glucose concentration of the quadriceps femoris muscle was
measured simultaneously with [18F]FDG scanning using
microdialysis. Muscle glucose uptake (by microdialysis,
rGUMD) was calculated by multiplying glucose extraction by
regional muscle blood flow. A significant correlation was found between
rGUMD and rGUFDG (r = 0.78, P < 0.01). The LC was determined as the ratio of the
rGUFDG to the rGUMD. The LC averaged 1.16 ± 0.16 and was similar in the obese and nonobese subjects (1.15 ± 0.11 vs. 1.16 ± 0.07, respectively, not significant). In
conclusion, the microdialysis technique can be reliably combined with
FDG PET to measure glucose uptake in skeletal muscle. Direct
measurements with these two independent techniques suggest an LC value
of 1.2 for [18F]FDG in human skeletal muscle during
insulin stimulation, and the LC appears not to be sensitive to insulin resistance.
glucose transport; glucose phosphorylation; insulin resistance; microdialysis; positron emission tomography
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