Increased cerebral FDG-PET uptake in type 1 diabetes patients with impaired awareness of hypoglycaemia
Por:
Sampedro, F, Stantonyonge, N, Martinez-Horta, S, Nan, N, Camacho, V, Chico, A
Publicada:
1 ene 2021
Ahead of Print:
1 nov 2020
Resumen:
Approximately 20% of type 1 diabetes (T1D) patients have an impaired awareness of hypoglyceamia (IAH). IAH represents a risk factor for severe and recurrent hypoglycaemic events, which can lead to brain damage. Because no effective treatments are currently available to prevent IAH in this population, characterising the set of brain alterations associated with IAH may reveal novel preclinical diagnostic or therapeutic strategies. Using state-of-the art neuroimaging techniques, we compared F-18-fluorodeoxyglucose-positron emission tomography (FDG-PET) uptake at rest between 10 T1D patients with IAH and nine patients with normal awareness of hypoglycaemia (NAH). T1D-IAH patients showed a pattern of increased FDG-PET uptake with respect to NAH patients (P < .05 corrected). Topographically, glucose metabolism was increased in the frontal and precuneus regions. Importantly, within the IAH group, this abnormal hypermetabolism correlated with IAH severity. This hypermetabolic state appeared to be unrelated to compensatory mechanisms as a result of reduced grey matter density or a neuroinflammatory state. We observed an abnormal increase in FDG-uptake in T1D patients with IAH in brain regions strongly related to cognition. Because this hypermetabolic state correlated with IAH severity, its biological characterisation could reveal new preventive or therapeutic strategies. A possible mechanism could be that glucose transport is increased in hypoglycaemia unawareness to compensate for recurrent hypoglycaemia, although this need to be confirmed in further research.
Filiaciones:
Sampedro, F:
Inst Invest Biomed St Pau IIB St Pau, Barcelona, Spain
Ctr Invest Red Enfermedades Neurodegenerat CIBERN, Madrid, Spain
Santa Creu & St Pau Hosp, Neurol Dept, Movement Disorders Unit, Barcelona, Spain
Stantonyonge, N:
Santa Creu & St Pau Hosp, Dept Endocrinol & Nutr, Mas Casanovas 90, Barcelona 08041, Spain
Univ Autonoma Barcelona UAB, Dept Med, Barcelona, Spain
Martinez-Horta, S:
Inst Invest Biomed St Pau IIB St Pau, Barcelona, Spain
Ctr Invest Red Enfermedades Neurodegenerat CIBERN, Madrid, Spain
Santa Creu & St Pau Hosp, Neurol Dept, Movement Disorders Unit, Barcelona, Spain
Nan, N:
Santa Creu & St Pau Hosp, Dept Biochem, Barcelona, Spain
Camacho, V:
Santa Creu & St Pau Hosp, Dept Nucl Med, Barcelona, Spain
Chico, A:
Santa Creu & St Pau Hosp, Dept Endocrinol & Nutr, Mas Casanovas 90, Barcelona 08041, Spain
Univ Autonoma Barcelona UAB, Dept Med, Barcelona, Spain
Inst Salud Carlos III, CIBER Bioengn Biomat & Nanotechnol CIBER BBN, Madrid, Spain
|