| Objective:Voxel–based analysis of the regional cerebral glucose metabolism in patients with prediabetes by fluorine–18 fluorodeoxyglucose positron emission tomography(18F–FDG PET).Materials and methods:Totally 105 patients underwent 18F–FDG whole body PET/CT scan from April 2010 to May 2015 were analyzed retrospectively,including 60 males and 45 females,aged 36–59years,average(46.0 ± 4.9)years.According to the Standards of Medical Care in Diabetes 2015 of American Diabetes Association,the patients were divided into prediabetes group,high blood glucose levels group(HBGL group)and low blood glucose levels group(LBGL group),which prediabetes group of 35 patients,male 20 cases,female 15 cases,average(47.4 ± 3.9)years,fasting blood glucose(6.1 ± 0.3)mmol / L,BMI(26 ± 3)Kg / m2,HBGL group of 35 patients,20 males and females 15 cases,average(45.7 ± 5.3)years,fasting blood glucose(5.3 ± 0.1)mmol / L,BMI(25 ± 2)Kg / m2,LBGL group of 35 patients,20 males and 15 cases female,average(45.0 ± 5.3)years,fasting blood glucose(4.8 ± 0.1)mmol / L,BMI(25 ± 3)Kg / m2.The differences of glucose metabolism of brain among the three groups were assessed by Statistical Parametric Mapping12(SPM12)based on the Matlab platform,and compared with the imaging by using t test.The age and BMI of all included were as a covariate involved in statistical analysis.The probability statistical threshold was set at P <0.01(uncorrected),the effective range of the threshold value was set to 50 k voxels.The resulting differences in brain areas were projected onto three–dimensional image of the brain orientation.Use Xjview software to location the significantly(P <0.01)voxel,then output MNI brain region coordinates and difference voxel value.And remove the coordinates of the brain region which was corresponding to the white matter.Among the three groups age and BMI data were compared by one–way ANOVA,P <0.05 was considered statistically significant.Two sets of data in SPM12 software were compared using two independent sample t test,P <0.01(uncorrected)and k ?50 voxel was considered statistically significant.Results:1.In the one–way ANOVA analysis,the age result among prediabetes group,high blood glucose levels group and low blood glucose levels group was F=1.491,P=0.230,and the BMI rusult among the three groups was F=1.491,P=0.230.It shows no significant difference(P> 0.05)among the three groups of age and BMI.2.Compared with the LBGL group,statistical parametric mapping showed that the HBGL group had no clusters(P<0.01,uncorrected,k?50 voxels).3.Compared with the HBGL group,the Prediabetes group had significantly lower brain glucose metabolism in left middle frontal gyrus(Brodmann area 47),left inferior frontal gyrus(Brodmann area 45),right middle frontal gyrus(Brodmann area 10)and right inferior frontal gyrus(Brodmann area 45?Brodmann area 47)(P<0.01,uncorrected,k?50 voxels.4.Compared with the LBGL group,the Prediabetes group had significantly lower brain glucose metabolism in left middle frontal gyrus(Brodmann area 47),left inferior frontal gyrus(Brodmann area 9?Brodmann area 45?Brodmann area 47)and right middle frontal gyrus(Brodmann area 10)(P<0.01,uncorrected,k?50 voxels).Conclusion:Compared with the HBGL group,the Prediabetes group had significantly lower brain glucose metabolism in left middle frontal gyrus,left inferior frontal gyrus,right middle frontal gyrus and right inferior frontal gyrus;Compared with the LBGL group,the Prediabetes group had significantly lower brain glucose metabolism in left middle frontal gyrus,left inferior frontal gyrus and right middle frontal gyrus.The decline of glucose metabolism were found in partial cerebral regions of patients under prediabetic stage which shows the abnormal cerebral metabolism can be observed in prediabetes. |
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