Published in:
01-10-2020 | Editorial
PET imaging of glucose and fatty acid metabolism for NAFLD patients
Published in: Journal of Nuclear Cardiology | Issue 5/2020
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The paper presented in this issue of the Journal by Tang and colleagues illuminate the deficiency in our knowledge of the reciprocal metabolic relationship between liver and heart in health and disease.1 The results presented in this paper used a large number of previously acquired 18F-FDG PET studies to investigate the association between non-alcoholic fatty liver disease (NAFLD) (Figure 1A) and myocardial glucose uptake. Previous work published by Lee and colleagues in Metabolism,2 had found a significant correlation between NAFLD and vascular inflammation using 18F-FDG PET to measure maximum target-to-background uptake in the carotid arteries; however, the present study is the first to elicit through imaging the correlation between NAFLD and potential cardiac metabolic abnormalities. Patients with NAFLD have a high risk of related cardiovascular disease (CVD).3 It has been pointed out that the leading cause of death in NAFLD patients is CVD rather than liver-associated complications,4 of which only 5% of NAFLD patients die from liver-related diseases.518F-FGD PET is an important indicator of cardiac glucose metabolism and its alteration in the presence of disease; however, to systematically understand the relation between NAFLD and the risk of cardiovascular disease, other probes, in addition to 18FDG, should be used to study the complex and dynamic pathways of energy substrate metabolism in the heart in health and disease and their relationship to the metabolic pathways of other body organs.
Figure 1
A Non-alcoholic fatty liver disease (NAFLD) is the excessive accumulation of fat in the liver of people who consume very little or no alcohol. Fat deposits (white/clear round/oval spaces) and mild fibrosis (green) are shown in a micrograph tissue sample of nonalcoholic fatty liver disease. The tissue is stained with Masson's trichrome & Verhoeff stain. The hepatocytes stain red. Figure used under a Creative Commons Attribution-ShareAlike 3.0 Unported license (https://commons.wikimedia.org/wiki/File:Non-alcoholic_fatty_liver_disease1.jpg). B Liver has many functions in the body, including a major synthesize of very low density lipoproteins (VLDL) for cardiac lipoprotein-derived fatty acids. The ultra low-density lipoproteins (ULDL) called chylomicrons are from dietary fat. Adipose triglyceride lipase may play an important role in developing NAFLD. This figure was originally in Science 2011;332:1519, and reprinted with permission from AAAS. C Lipoprotein shown here as a micelle with a polar surface of phospholipid monolayer, free cholesterol, and apolipoproteins. The non-polar lipid core contains cholesterol esters, and triacylglycerides. Reprinted with permission from ShutterStock (ID: 246595399)
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