Imaging diagnosis of insulin resistence by metabolic imaging of myocardium and skeletal muscle using F-18 fluorodeoxyglucose PET.

胰岛素抵抗是糖尿病发病的重要原因之一，是判断糖尿病分期的重要指标。糖尿病、高甘油三酯血症、高血压（每种疾病均存在胰岛素抵抗）患者表达胰岛素抵抗的全身葡萄糖处置率（GDR，胰岛素钳夹时的全身葡萄糖利用率）较低，骨骼肌葡萄糖代谢与GDR和胰岛素抵抗密切相关。心肌糖代谢与GDR相关，但不像骨骼肌那么强烈。曲格列酮改善不依赖血清游离脂肪酸的非胰岛素依赖型糖尿病患者骨骼肌糖代谢，改善全身胰岛素抵抗。因此，本研究表明F-18 FDG PET可用于骨骼肌糖代谢，FDG PET作为GDR可用于评价胰岛素抵抗，F-18 FDG PET可用于评价糖尿病或其他疾病的胰岛素抵抗以及评价口服药物对胰岛素抵抗的改善。糖尿病引起的动脉粥样硬化是一个非常重要的问题。我们的研究表明，高血糖而不是胰岛素抵抗与非胰岛素依赖型糖尿病患者的冠状动脉血流储备有关。本研究表明，降糖治疗可改善非胰岛素依赖型糖尿病患者的冠状动脉血流储备。本研究表明，在降脂治疗后，高胆固醇血症患者弥漫性冠状动脉粥样硬化引起的心肌血管舒张功能受损得到改善。

Insulin resistence is one of the important cause of diabetes mellitus and it is important to evaluate the stage of diabetes mellitus. Whole body glucose dispoasal rate (GDR, whole body glucose utilization rate while insulin clamp) which express insulin resistence was low in patients with diabetes mellitus, hypertriglyceridemia, hypertention (in each disease, there is insulin resistence) and glucose metabolism of skeletal muscle was strongly related to GDR and insulin resistence.And myocardial glucose metabolism was related to GDR, though not so strongly as skeletal muscle.Troglitazone improved skeletal muscle glucose metabolism of patients with non-insulin dependent diabetes mellitus independent from serum FFA and improved whole body insulin resistence.Like this, this study showed that skeletal muscle glucose metabolism was quatified by F-18 FDG PET and insulin resistence was able to be evaluated by FDG PET as GDR and F-18 FDG PET was useful for the evaluation of insulin resistence of diabetes mellitus or other disease and the evaluation of improvement of insulin resistence by oral medicine.Atherosclerosis by diabetes mellitus is very important problem. Our study showed that hyperglycemia rather than insulin resistence is related to coronary flow reserve in patients with non-insulin dependent diabetes mellitus. This study showed that blood glucose lowering therapy improved coronary flow reserve in petients with non-insulin dependent diabetes mellitus.And this study showed the improvement of impaired myocardial vasodilation due to diffuse coronary atherosclerosis in hypercholesterolemics after lipid-lowering therapy.