Multi-organ glucose metabolism alterations in diabetes mellitus: a total-body 18F-FDG PET/CT study

作者：Minghua Wang, Minghua Wang, Lubing Sun, Yaping Wu, Junting Liang, Junting Liang, Nan Meng, Yichun Jiao, Xipeng Yue, Xipeng Yue, Jingjing Lv, Lili Yu, Tao Sun, Meiyun Wang, Meiyun Wang, C.-L. Chen · 发表于：EJNMMI Research · 年份：2026 · DOI：10.1186/s13550-026-01418-8 · 研究领域：Medical Imaging Techniques and Applications、Metabolism, Diabetes, and Cancer、Parathyroid Disorders and Treatments

BACKGROUND: Diabetes mellitus (DM) is associated with systemic metabolic disturbances across multiple organs. Total-body 18F-fluorodeoxyglucose (F-FDG) PET/CT enables simultaneous quantification of glucose metabolism in numerous organs. This study aimed to characterize multi-organ 18F-FDG uptake patterns in type 2 DM patients compared with healthy controls and to explore associations with clinical variables including brain volume. RESULTS: Compared with controls, DM patients exhibited significantly lower SULmean in brain (− 15.3%, P < 0.001), left ventricular myocardium (− 12.7%, P < 0.001), and skull (− 9.8%, P = 0.003), and higher SULmean in subcutaneous adipose tissue (+ 18.2%, P = 0.004). Differences remained significant after multivariable adjustment. Brain volume showed moderate positive correlations with SUL values across multiple organs (r = 0.44–0.63, P < 0.01), and these associations remained significant after adjustment. DM duration negatively correlated with brain and skull SULmean (r = − 0.33 to − 0.46, P < 0.05). CONCLUSIONS: Type 2 DM is characterized by selective glucose hypometabolism in high-energy-demand organs and compensatory adipose activation. Independent associations with brain volume and disease duration suggest potential imaging biomarkers for diabetic complications using total-body PET/CT.