Validation of [18F]fluorodeoxyglucose and positron emission tomography (PET) for the measurement of intestinal metabolism in pigs, and evidence of intestinal insulin resistance in patients with morbid obesity

H Honka, J Mäkinen, J C Hannukainen, M Tarkia, V Oikonen, M Teräs, V Fagerholm, T Ishizu, A Saraste, C Stark, T Vähäsilta, P Salminen, A Kirjavainen, M Soinio, A Gastaldelli, J Knuuti, P Iozzo, P Nuutila

Research output: Contribution to journalArticleScientificpeer-review

37 Citations (Scopus)

Abstract

AIMS/HYPOTHESIS: The role of the intestine in the pathogenesis of metabolic diseases is gaining much attention. We therefore sought to validate, using an animal model, the use of positron emission tomography (PET) in the estimation of intestinal glucose uptake (GU), and thereafter to test whether intestinal insulin-stimulated GU is altered in morbidly obese compared with healthy human participants.

METHODS: In the validation study, pigs were imaged using [(18)F]fluorodeoxyglucose ([(18)F]FDG) and the image-derived data were compared with corresponding ex vivo measurements in tissue samples and with arterial-venous differences in glucose and [(18)F]FDG levels. In the clinical study, GU was measured in different regions of the intestine in lean (n = 8) and morbidly obese (n = 8) humans at baseline and during euglycaemic hyperinsulinaemia.

RESULTS: PET- and ex vivo-derived intestinal values were strongly correlated and most of the fluorine-18-derived radioactivity was accumulated in the mucosal layer of the gut wall. In the gut wall of pigs, insulin promoted GU as determined by PET, the arterial-venous balance or autoradiography. In lean human participants, insulin increased GU from the circulation in the duodenum (from 1.3 ± 0.6 to 3.1 ± 1.1 μmol [100 g](-1) min(-1), p < 0.05) and in the jejunum (from 1.1 ± 0.7 to 3.0 ± 1.5 μmol [100 g](-1) min(-1), p < 0.05). Obese participants failed to show any increase in insulin-stimulated GU compared with fasting values (NS).

CONCLUSIONS/INTERPRETATION: Intestinal GU can be quantified in vivo by [(18)F]FDG PET. Intestinal insulin resistance occurs in obesity before the deterioration of systemic glucose tolerance.

Original languageEnglish
Pages (from-to)893-900
Number of pages8
JournalDiabetologia
Volume56
Issue number4
DOIs
Publication statusPublished - Apr 2013
MoE publication typeA1 Journal article-refereed

Keywords

  • Adult
  • Animals
  • Arteries/pathology
  • Female
  • Fluorodeoxyglucose F18
  • Gastrointestinal Tract/metabolism
  • Glucose/pharmacokinetics
  • Humans
  • Insulin Resistance
  • Intestinal Mucosa/metabolism
  • Male
  • Middle Aged
  • Obesity, Morbid/metabolism
  • Positron-Emission Tomography/methods
  • Random Allocation
  • Swine
  • Veins/pathology

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