用~（18）F-FDG观察脂肪肝患者肝脏葡萄糖摄取变化

目的：通过PET/CT检查观察脂肪肝患者肝脏及其他组织对18F脱氧葡萄糖（18F-FDG）摄入变化,探讨脂肪肝与糖脂代谢的相关性。方法：36例做PET/CT的健康和2型糖尿病男性患者,分为对照组（n=18例）;脂肪肝组（n=9例）;糖尿病脂肪肝组（n=9例）。常规测血糖、血脂及肝肾功能。PET/CT测肝脏CT值和肝脏、肾皮质,骨骼肌组织18F-FDG的最大标准摄入值（SUVmax）及平均标准摄入值（SUVmean）。结果：1.糖尿病脂肪肝组的TG显著高于单纯脂肪肝组和正常对照组,P=0.0003,0.0000。单纯脂肪肝组的TG亦显著高于正常对照组,P=0.028。2.糖尿病脂肪肝组的肝脏18F-FDG的SUVmean和SUVmax显著高于正常对照组的SUVmean和SUVmax,P=0.0054,0.0133。单纯脂肪肝组的肝脏SUVmean和SUVmax亦高于正常对照组,但比较无统计学差异。脑皮质、肾皮质和骨骼肌组织的18F-FDG的SUVmean和SUVmax三组间比较无显著性差异。3.Spearman相关性分析发现FBG与TG显著正相关（r=0.59919,P=0.0004）;FBG和TG与肝脏的CT值显著负相关（r=-0．55625，P=0．0004；r=-0．45739，P=0．0097）。结论：脂肪肝与空腹血糖和甘油三酯升高显著相关。脂肪肝及2型糖尿病脂肪肝患者肝脏对葡萄糖摄取增高。

^18F-FDG Assessment of Hepatic Glucose Uptake in Nonalcoholic Fatty Liver Disease Patients

Objective：To examine liver glucose uptake in nonalcoholic fatty liver disease（NAFLD）by using 18F-FDG and positron emission tomography and to approach the relationship between NAFLD and metabolic disorders of glucose and lipids.Methods： Thirty-six male subjects were divided in three groups： control（n=18）;NAFLD（n=9）;NAFLD with diabetes（n=9）.Blood glucose and liver and kidney function were conventionally tested.Liver CT value was tested by computerised tomography scan.18F-FDG uptake in liver, brain, kidney and muscle was semi-quantitatively measured using the maximum and mean standardized uptake value（SUVmax and SUVmean）. Results： 1. Serum Iriglyceride （TG）level was significantly higher in the NAFLD with diabetes group compared with the control and NAFLD group（ p=0.0003,0.0000 ）. And TG level in NAFLD group was higher compared with the control group（P=0.028）. 2. 1SF -FDG liver mean and maximum standardized uptake value was significantly increased in NAFLD with diabetes as compared to control group （p=0.0054;0.0133）. ISF -FDG liver uptake was high in NAFLD group but not significantly different from control group. There was no significant difference in ~SF -FDG brain, kidney and muscle tissues uptake among the three groups. 3. In spearman correlation analyses, FBG was correlated well with Serum triglyceride（TG） value （r=0.59919, p=0.0004）. FBG and TG were negatively correlated with liver CT value （r=-0.55625,p =0.0004; r= -0.45739,p = 0.0097, respectively）. Conclusions： The data suggest that non-alcoholic fatty liver disease has been associated with metabolic disorders, including high triglyceride and fasting blood glucose. In vivo in men with non-alcoholic fatty liver disease and diabetes, liver glucose uptake is enhanced.