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Basset-Sagarminaga J, van de Weijer T, Iozzo P, Schrauwen P, Schrauwen-Hinderling V. Advances and challenges in measuring hepatic glucose uptake with FDG PET: implications for diabetes research. Diabetologia 2024; 67:407-419. [PMID: 38099962 DOI: 10.1007/s00125-023-06055-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/10/2023] [Indexed: 02/06/2024]
Abstract
The liver plays a crucial role in the control of glucose homeostasis and is therefore of great interest in the investigation of the development of type 2 diabetes. Hepatic glucose uptake (HGU) can be measured through positron emission tomography (PET) imaging with the tracer [18F]-2-fluoro-2-deoxy-D-glucose (FDG). HGU is dependent on many variables (e.g. plasma glucose, insulin and glucagon concentrations), and the metabolic state for HGU assessment should be chosen with care and coherence with the study question. In addition, as HGU is influenced by many factors, protocols and measurement conditions need to be standardised for reproducible results. This review provides insights into the protocols that are available for the measurement of HGU by FDG PET and discusses the current state of knowledge of HGU and its impairment in type 2 diabetes. Overall, a scanning modality that allows for the measurement of detailed kinetic information and influx rates (dynamic imaging) may be preferable to static imaging. The combination of FDG PET and insulin stimulation is crucial to measure tissue-specific insulin sensitivity. While the hyperinsulinaemic-euglycaemic clamp allows for standardised measurements under controlled blood glucose levels, some research questions might require a more physiological approach, such as oral glucose loading, with both advantages and complexities relating to fluctuations in blood glucose and insulin levels. The available approaches to address HGU hold great potential but await more systematic exploitation to improve our understanding of the mechanisms underlying metabolic diseases. Current findings from the investigation of HGU by FDG PET highlight the complex interplay between insulin resistance, hepatic glucose metabolism, NEFA levels and intrahepatic lipid accumulation in type 2 diabetes and obesity. Further research is needed to fully understand the underlying mechanisms and potential therapeutic targets for improving HGU in these conditions.
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Affiliation(s)
- Jeremy Basset-Sagarminaga
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, the Netherlands
| | - Tineke van de Weijer
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, the Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Patricia Iozzo
- Institute of Clinical Physiology, National Research Council (CNR), Pisa, Italy
| | - Patrick Schrauwen
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, the Netherlands
| | - Vera Schrauwen-Hinderling
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, the Netherlands.
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands.
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany.
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Tonda K, Iwabuchi Y, Shiga T, Owaki Y, Fujita A, Nakahara T, Sakurai R, Shimizu A, Yamada Y, Okada M, Jinzaki M. Impact of patient characteristic factors on the dynamics of liver glucose metabolism: Evaluation of multiparametric imaging with dynamic whole-body 18 F-fluorodeoxyglucose-positron emission tomography. Diabetes Obes Metab 2023; 25:3521-3528. [PMID: 37589247 DOI: 10.1111/dom.15247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 07/20/2023] [Accepted: 07/30/2023] [Indexed: 08/18/2023]
Abstract
AIMS To assess the impact of various patient characteristics on the dynamics of liver glucose metabolism using automated multiparametric imaging with whole-body dynamic 18 F-fluorodeoxyglucose (FDG)-positron emission tomography (PET). MATERIALS AND METHODS We retrospectively enrolled 540 patients who underwent whole-body dynamic FDG-PET. Three quantitative indices representing hepatic glucose metabolism [mean standardized uptake value normalized by lean body mass (SULmean), metabolic glucose rate (kinetic index) and distribution volume (DV)] were measured from multiparametric PET images produced automatically based on the Patlak plot model. Patient characteristics including age, sex, body mass index, fasting time, blood glucose level, and the presence of diabetes mellitus (DM) or hepatic steatosis (HS) were collected. We examined the correlations between the characteristic factors and three quantitative indices using multiple regression analysis. RESULTS The success rate of kinetic analysis using multiparametric PET imaging was 93.3% (504/540). Hepatic SULmean was significantly correlated with age (p < .001), sex (p < .001) and blood glucose level (p = .002). DV was significantly correlated with age (p = .033), sex (p < .001), body mass index (p = .002), fasting time (p = .043) and the presence of HS (p = .002). The kinetic index was significantly correlated with age (p < .001) and sex (p = .004). In the comparison of the healthy, DM and HS groups, patients with DM had a significantly increased SULmean, whereas patients with HS had a significantly decreased DV. CONCLUSIONS Our results showed that liver glucose metabolism was influenced by various patient characteristic factors. Multiparametric FDG-PET imaging can be used to analyse the kinetics of liver glucose metabolism in routine clinical practice.
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Affiliation(s)
- Kai Tonda
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Yu Iwabuchi
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Tohru Shiga
- Advanced Clinical Research Center, Fukushima Global Medical Science Center, Fukushima Medical University, Fukushima, Japan
| | - Yoshiki Owaki
- Office of Radiation Technology, Keio University Hospital, Tokyo, Japan
| | - Arashi Fujita
- Office of Radiation Technology, Keio University Hospital, Tokyo, Japan
| | - Takehiro Nakahara
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Ryosuke Sakurai
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Atsushi Shimizu
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Yoshitake Yamada
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Masahiro Okada
- Department of Radiology, Nihon University School of Medicine, Tokyo, Japan
| | - Masahiro Jinzaki
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
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da Luz FAC, Nascimento CP, Marinho EDC, Felicidade PJ, Antonioli RM, de Araújo RA, Silva MJB. Survival differences between women and men in the non-reproductive cancers: Results from a matched analysis of the surveillance, epidemiology, and end-results program. Front Public Health 2023; 10:1076682. [PMID: 36684979 PMCID: PMC9853080 DOI: 10.3389/fpubh.2022.1076682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 12/15/2022] [Indexed: 01/09/2023] Open
Abstract
Background Men with non-reproductive cancers have a discrepant outcome compared to women. However, they differ significantly in the incidence of cancer type and characteristics. Methods Patients with single primary cancer who were 18 years or older and whose data were gathered and made accessible by the Surveillance, Epidemiology, and End Results (SEER) program were included in this retrospective analysis. Kaplan-Meier curves and Cox regression before and after propensity score matching were performed to analyze the risk survival by sex. Results Among the 1,274,118 patients included [median (range) age, 65 year (18-85+) years; 688,481 (54.9%) male]. The median follow-up was 21 months (0-191). Substantial improvements in survival were observed for both sexes during the years of inclusion analyzed, with no difference between them, reaching a reduction of almost 17% of deaths in 2010, and of almost 28% in 2015, compared to 2004. The women had a median survival of 74 months and overall mortality of 48.7%. Males had a median survival of 30 months (29.67-30.33) with an overall mortality of 56.2%. The PSM showed a reduced difference (6 months shorter median survival and 2.3% more death in men), but no change in hazards was observed compared to the unmatched analysis [adjusted HR: 0.888 (0.864-0.912) vs. 0.876 (0.866-0.886) in unmatched]. Conclusions The discrepancy in survival between men and women is not explained only by the incidence of more aggressive and more advanced cancers in the former.
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Affiliation(s)
- Felipe Andrés Cordero da Luz
- Center for Cancer Prevention and Research, Uberlandia Cancer Hospital, Umuarama, Uberlândia, Minas Gerais, Brazil,Laboratory of Tumor Biomarkers and Osteoimmunology, Department of Immunology, Institute of Biomedical Sciences, Federal University of Uberlandia, Umuarama, Uberlândia, Minas Gerais, Brazil,*Correspondence: Felipe Andrés Cordero da Luz ✉; ✉
| | - Camila Piqui Nascimento
- Center for Cancer Prevention and Research, Uberlandia Cancer Hospital, Umuarama, Uberlândia, Minas Gerais, Brazil
| | - Eduarda da Costa Marinho
- Center for Cancer Prevention and Research, Uberlandia Cancer Hospital, Umuarama, Uberlândia, Minas Gerais, Brazil
| | - Pollyana Júnia Felicidade
- Center for Cancer Prevention and Research, Uberlandia Cancer Hospital, Umuarama, Uberlândia, Minas Gerais, Brazil
| | - Rafael Mathias Antonioli
- Center for Cancer Prevention and Research, Uberlandia Cancer Hospital, Umuarama, Uberlândia, Minas Gerais, Brazil
| | - Rogério Agenor de Araújo
- Center for Cancer Prevention and Research, Uberlandia Cancer Hospital, Umuarama, Uberlândia, Minas Gerais, Brazil,Laboratory of Tumor Biomarkers and Osteoimmunology, Department of Immunology, Institute of Biomedical Sciences, Federal University of Uberlandia, Umuarama, Uberlândia, Minas Gerais, Brazil,Medical Faculty, Federal University of Uberlandia, Umuarama, Uberlândia, Minas Gerais, Brazil
| | - Marcelo José Barbosa Silva
- Laboratory of Tumor Biomarkers and Osteoimmunology, Department of Immunology, Institute of Biomedical Sciences, Federal University of Uberlandia, Umuarama, Uberlândia, Minas Gerais, Brazil
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The spatiotemporal dynamics of lung cancer: 30-year trends of epidemiology across 204 countries and territories. BMC Public Health 2022; 22:987. [PMID: 35578216 PMCID: PMC9109351 DOI: 10.1186/s12889-022-13281-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 04/22/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND It has been established that lung cancer is the leading cause of all cancer deaths. This study sought to analyze the epidemiological trends of lung cancer over the past 30 years worldwide. METHODS Estimates, including the global, regional, national prevalence, incidence, and years lived with disability (YLDs) of lung cancer from 1990 to 2019, were extracted from the Global Burden of Disease Study 2019 to assess the spatiotemporal dynamics in cases and age-standardized rates (ASR). The estimated annual percentage change (EAPC) was calculated to evaluate the variation in ASR. Besides, estimates of age-sex specific prevalence, decomposition analysis for incident cases, and correlation analysis of the EAPC were conducted in our study. RESULTS Globally, the ASR of lung cancer prevalence, incidence and YLDs in 2019 were 38.84/100,000 persons, 27.66/100,000 persons, and 6.62/100,000 persons, respectively. Over the past 30 years, the ASR of incidence (EAPC = -0.09) decreased, although that of prevalence (EAPC = 0.51) and YLDs (EAPC = 0.03) increased. The global prevalence counts was greater in males than females at all age groups and increased with age, peaking in the 65-69 age group for both sexes. The increase in incidence was mainly attributed to population aging. For YLDs, EAPC was negatively correlated with the human development index (p = 0.0008) and ASR (p < 0.0001) in 1990 across nation-level units. CONCLUSIONS Lung cancer remains a major public health issue globally, warranting the implementation of scientific and effective measures in different countries and territories to control it.
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Haupt S, Caramia F, Klein SL, Rubin JB, Haupt Y. Sex disparities matter in cancer development and therapy. Nat Rev Cancer 2021; 21:393-407. [PMID: 33879867 PMCID: PMC8284191 DOI: 10.1038/s41568-021-00348-y] [Citation(s) in RCA: 124] [Impact Index Per Article: 41.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/08/2021] [Indexed: 12/12/2022]
Abstract
Curing cancer through precision medicine is the paramount aim of the new wave of molecular and genomic therapies. Currently, whether patients with non-reproductive cancers are male or female according to their sex chromosomes is not adequately considered in patient standard of care. This is a matter of consequence because there is growing evidence that these cancer types generally initiate earlier and are associated with higher overall incidence and rates of death in males compared with females. Gender, in contrast to sex, refers to a chosen sexual identity. Hazardous lifestyle choices (notably tobacco smoking) differ in prevalence between genders, aligned with disproportionate cancer risk. These add to underlying genetic predisposition and influences of sex steroid hormones. Together, these factors affect metabolism, immunity and inflammation, and ultimately the fidelity of the genetic code. To accurately understand how human defences against cancer erode, it is crucial to establish the influence of sex. Our Perspective highlights evidence from basic and translational research indicating that including genetic sex considerations in treatments for patients with cancer will improve outcomes. It is now time to adopt the challenge of overhauling cancer medicine based on optimized treatment strategies for females and males.
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Affiliation(s)
- Sue Haupt
- Tumor Suppression and Cancer Sex Disparity Laboratory, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia.
| | - Franco Caramia
- Tumor Suppression and Cancer Sex Disparity Laboratory, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Sabra L Klein
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Joshua B Rubin
- Department of Pediatrics and Neuroscience, Washington University School of Medicine, St Louis, MO, USA
| | - Ygal Haupt
- Tumor Suppression and Cancer Sex Disparity Laboratory, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia.
- Department of Biochemistry and Molecular Biology, Monash University, Melbourne, Victoria, Australia.
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Otomi Y, Otsuka H, Shono N, Onishi H, Mitsuhashi R, Matsuzaki S, Takaoka Y, Enomoto H, Sakamoto Y, Sasahara M, Abe T, Shinya T, Harada M. A reduced physiological 18F-fluorodeoxyglucose uptake in the brain and liver caused by malignant lymphoma being deprived of the tracer. THE JOURNAL OF MEDICAL INVESTIGATION 2021; 68:181-185. [PMID: 33994467 DOI: 10.2152/jmi.68.181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Purpose : To investigate whether or not the physiological brain and liver FDG uptake are decreased in patients with highly accelerated glycolysis lesions. Methods : We retrospectively analyzed 51 patients with malignant lymphoma. We compared the FDG uptake in the brain and liver of the patients with that in a control group. In 24 patients with a complete response (CR) or partial response (PR) to treatment, we compared the brain and liver uptake before and after treatment. Results : The maximum standardized uptake value (SUVmax) and total glycolytic volume (TGV) of the brain as well as the SUVmax and mean standardized uptake value (SUVmean) of the liver in malignant lymphoma patients were 13.1 ± 2.3, 7386.3 ± 1918.4, 3.2 ± 0.5, and 2.3 ± 0.4, respectively ; in the control group, these values were 14.9 ± 2.4, 8566.2 ± 1659.5, 3.4 ± 0.4, and 2.5 ± 0.3, respectively. The SUVmax and TGV of the brain and the SUVmean of the liver in malignant lymphoma patients were significantly lower than the control group. The SUVmax and TGV of the brain after treatment were significantly higher than before treatment. Both the SUVmax and SUVmean of liver after treatment were higher than before treatment, but not significant. Conclusion : A decreased physiological brain and liver FDG uptake is caused by highly accelerated lesion glycolysis. J. Med. Invest. 68 : 181-185, February, 2021.
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Affiliation(s)
- Yoichi Otomi
- Department of Radiology, Tokushima University Hospital, Tokushima, Japan
| | - Hideki Otsuka
- Department of Radiology, Tokushima University Hospital, Tokushima, Japan
| | - Nahomi Shono
- Department of Radiology, Tokushima University Hospital, Tokushima, Japan
| | - Hajime Onishi
- Department of Radiology, Tsurugi Municipal Handa Hospital, Tokushima, Japan
| | - Ryota Mitsuhashi
- Department of Radiology, Tokushima University Hospital, Tokushima, Japan
| | - Saya Matsuzaki
- Department of Radiology, Tokushima University Hospital, Tokushima, Japan
| | - Yukiko Takaoka
- Department of Radiology, Tokushima University Hospital, Tokushima, Japan
| | - Hideaki Enomoto
- Department of Radiology, Tokushima University Hospital, Tokushima, Japan
| | - Yuko Sakamoto
- Department of Radiology, Tokushima University Hospital, Tokushima, Japan
| | - Mihoko Sasahara
- Department of Radiology, Tokushima University Hospital, Tokushima, Japan
| | - Takashi Abe
- Department of Radiology, Nagoya University Hospital, Aichi, Japan
| | - Takayoshi Shinya
- Department of Radiology, Tokushima University Hospital, Tokushima, Japan
| | - Masafumi Harada
- Department of Radiology, Tokushima University Hospital, Tokushima, Japan
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Ishihara K, Inamura N, Tani A, Shima D, Kuramochi A, Nonaka T, Oneda H, Nakamura Y. Contribution of Solid Food to Achieve Individual Nutritional Requirement during a Continuous 438 km Mountain Ultramarathon in Female Athlete. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105153. [PMID: 34067992 PMCID: PMC8152256 DOI: 10.3390/ijerph18105153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 05/08/2021] [Accepted: 05/10/2021] [Indexed: 02/08/2023]
Abstract
Background: Races and competitions over 100 miles have recently increased. Limited information exists about the effect of multiday continuous endurance exercise on blood glucose control and appropriate intake of food and drink in a female athlete. The present study aimed to examine the variation of blood glucose control and its relationship with nutritional intake and running performance in a professional female athlete during a 155.7 h ultramarathon race with little sleep. Methods: We divided the mountain course of 438 km into 33 segments by timing gates and continuously monitored the participant’s glucose profile throughout the ultramarathon. The running speed in each segment was standardized to the scheduled required time-based on three trial runs. Concurrently, the accompanying runners recorded the participant’s food and drink intake. Nutrient, energy, and water intake were then calculated. Results: Throughout the ultramarathon of 155.7 h, including 16.0 h of rest and sleep, diurnal variation had almost disappeared with the overall increase in blood glucose levels (25–30 mg/dL) compared with that during resting (p < 0.0001). Plasma total protein and triglyceride levels were decreased after the ultramarathon. The intake of protein and fat directly or indirectly contributed to maintaining blood glucose levels and running speed as substrates for gluconeogenesis or as alternative sources of energy when the carbohydrate intake was at a lower recommended limit. The higher amounts of nutrient intakes from solid foods correlated with a higher running pace compared with those from liquids and gels to supply carbohydrates, protein, and fat. Conclusion: Carbohydrate, protein, and fat intake from solid foods contributed to maintaining a fast pace with a steady, mild rise in blood glucose levels compared with liquids and gels when female runner completed a multiday continuous ultramarathon with little sleep.
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Affiliation(s)
- Kengo Ishihara
- Department of Food Sciences and Human Nutrition, Faculty of Agriculture, Ryukoku University, Shiga 520-2194, Japan; (N.I.); (A.T.); (D.S.); (A.K.); (Y.N.)
- Correspondence: ; Tel.: +81-77-599-5601 (ext. 2011)
| | - Naho Inamura
- Department of Food Sciences and Human Nutrition, Faculty of Agriculture, Ryukoku University, Shiga 520-2194, Japan; (N.I.); (A.T.); (D.S.); (A.K.); (Y.N.)
| | - Asuka Tani
- Department of Food Sciences and Human Nutrition, Faculty of Agriculture, Ryukoku University, Shiga 520-2194, Japan; (N.I.); (A.T.); (D.S.); (A.K.); (Y.N.)
| | - Daisuke Shima
- Department of Food Sciences and Human Nutrition, Faculty of Agriculture, Ryukoku University, Shiga 520-2194, Japan; (N.I.); (A.T.); (D.S.); (A.K.); (Y.N.)
| | - Ai Kuramochi
- Department of Food Sciences and Human Nutrition, Faculty of Agriculture, Ryukoku University, Shiga 520-2194, Japan; (N.I.); (A.T.); (D.S.); (A.K.); (Y.N.)
| | | | | | - Yasuyuki Nakamura
- Department of Food Sciences and Human Nutrition, Faculty of Agriculture, Ryukoku University, Shiga 520-2194, Japan; (N.I.); (A.T.); (D.S.); (A.K.); (Y.N.)
- Department of Public Health, Shiga University of Medical Science, Shiga 520-2192, Japan
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Haupt S, Haupt Y. Cancer and Tumour Suppressor p53 Encounters at the Juncture of Sex Disparity. Front Genet 2021; 12:632719. [PMID: 33664771 PMCID: PMC7920968 DOI: 10.3389/fgene.2021.632719] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 01/26/2021] [Indexed: 12/12/2022] Open
Abstract
There are many differences in cancer manifestation between men and women. New understanding of the origin of these point to fundamental distinctions in the genetic code and its demise. Tumour suppressor protein p53 is the chief operating officer of cancer defence and critically acts to safeguard against sustained DNA damaged. P53 cannot be ignored in cancer sex disparity. In this review we discuss the greater prevalence and associated death rates for non-reproductive cancers in males. The major tumour suppressor protein p53, encoded in the TP53 gene is our chosen context. It is fitting to ask why somatic TP53 mutation incidence is estimated to be disproportionately higher among males in the population for these types of cancers compared with females? We scrutinised the literature for evidence of predisposing genetic and epigenetic alterations that may explain this sex bias. Our second approach was to explore whether redox activity, either externally imposed or inherent to males and females, may define distinct risks that could contribute to the clear cancer sex disparities.
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Affiliation(s)
- Sue Haupt
- Tumor Suppression Laboratory, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia.,Department of Clinical Pathology, University of Melbourne, Parkville, VIC, Australia
| | - Ygal Haupt
- Tumor Suppression Laboratory, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia.,Department of Clinical Pathology, University of Melbourne, Parkville, VIC, Australia.,Department of Biochemistry and Molecular Biology, Monash University, Melbourne, VIC, Australia
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Li X, Wang L, Zhang L, Tang F, Wei X. Application of Multimodal and Molecular Imaging Techniques in the Detection of Choroidal Melanomas. Front Oncol 2021; 10:617868. [PMID: 33634026 PMCID: PMC7902045 DOI: 10.3389/fonc.2020.617868] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 12/16/2020] [Indexed: 02/05/2023] Open
Abstract
Choroidal melanomas are the most common ocular malignant tumors worldwide. The onset of such tumors is insidious, such that affected patients often have no pain or obvious discomfort during early stages. Notably, enucleation is required for patients with a severe choroidal melanoma, which can seriously impact their quality of life. Moreover, choroidal melanomas metastasize early, often to the liver; this eventually causes affected patients to die of liver failure. Therefore, early diagnosis of choroidal melanomas is extremely important. Unfortunately, an early choroidal melanoma is easily confused with a choroidal nevus, which is the most common benign tumor of the eye and does not often require surgical treatment. This review discusses recent advances in the use of multimodal and molecular imaging to identify choroidal melanomas and choroidal nevi, detect early metastasis, and diagnose patients with choroidal melanomas.
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Affiliation(s)
- Xuying Li
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Lixiang Wang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Li Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Fei Tang
- Department of Ophthalmology, ShangjinNanfu Hospital, Chengdu, China
| | - Xin Wei
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China.,Department of Ophthalmology, ShangjinNanfu Hospital, Chengdu, China
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10
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Keramida G, Peters AM. FDG PET/CT of the non‐malignant liver in an increasingly obese world population. Clin Physiol Funct Imaging 2020; 40:304-319. [DOI: 10.1111/cpf.12651] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 05/11/2020] [Accepted: 06/04/2020] [Indexed: 12/19/2022]
Affiliation(s)
- Georgia Keramida
- Department of Nuclear Medicine Royal Brompton and HarefieldNHS Foundation Trust London UK
| | - A. Michael Peters
- Department of Nuclear Medicine King’s College HospitalNHS Foundation Trusts London UK
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11
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Application of Continuous Glucose Monitoring for Assessment of Individual Carbohydrate Requirement during Ultramarathon Race. Nutrients 2020; 12:nu12041121. [PMID: 32316458 PMCID: PMC7230511 DOI: 10.3390/nu12041121] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 04/12/2020] [Accepted: 04/14/2020] [Indexed: 02/08/2023] Open
Abstract
Background: The current study intended to evaluate the feasibility of the application of continuous glucose monitoring to guarantee optimal intake of carbohydrate to maintain blood glucose levels during a 160-km ultramarathon race. Methods: Seven ultramarathon runners (four male and three female) took part in the study. The glucose profile was monitored continuously throughout the race, which was divided into 11 segments by timing gates. Running speed in each segment was standardized to the average of the top five finishers for each gender. Food and drink intake during the race were recorded and carbohydrate and energy intake were calculated. Results: Observed glucose levels ranged between 61.9–252.0 mg/dL. Average glucose concentration differed from the start to the end of the race (104 ± 15.0 to 164 ± 30.5 SD mg/dL). The total amount of carbohydrate intake during the race ranged from 0.27 to 1.14 g/kg/h. Glucose concentration positively correlated with running speeds in segments (P < 0.005). Energy and carbohydrate intake positively correlated with overall running speed (P < 0.01). Conclusion: The present study demonstrates that continuous glucose monitoring could be practical to guarantee optimal carbohydrate intake for each ultramarathon runner.
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Abstract
Aim To compare weight, lean body mass and body surface area for calculation of standardised uptake value (SUV) in fluorine-18-fluorodeoxyglucose PET/computed tomography, taking sex into account. Patients and methods This was a retrospective study of 161 (97 men) patients. Maximum standardised uptake value (SUVmax) and mean standardised uptake value (SUVmean) were obtained from a 3-cm region of interest over the right lobe of the liver and scaled to weight, scaled to lean body mass (SUL) and scaled to body surface area (SUA). Mean hepatic computed tomography density was used to adjust SUVmean for hepatic fat (SUVFA). Hepatic SUV indices were divided by SUV from left ventricular cavity, thereby, eliminating whole body metric, to obtain a surrogate of blood fluorine-18-fluorodeoxyglucose clearance into liver, and multiplied by blood glucose to give a surrogate of hepatic glucose uptake rate (mSUV). Results SULmax, SUAmax and all scaled to weight indices correlated strongly with weight. SULmean, SULFA, SUAmean and SUAFA, however, correlated weakly or not at all with weight, nor with their corresponding whole body metric in men or women, but correlated strongly when the sexes were combined into one group. This was the result of sex differences in SUL (greater in men) and SUA (greater in women). There was, however, no sex difference in mSUV. Conclusion Weight is unsuitable for calculating SUV. SUL and SUA are also inappropriate as maxima but appropriate as mean and fat-adjusted values. However, SUL is recommended for both sexes because SUA is influenced by both body fat and weight. Sex differences in SUL and SUA give rise to misleading correlations when sexes are combined into one group.
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Keiding S, Sørensen M, Frisch K, Gormsen LC, Munk OL. Quantitative PET of liver functions. AMERICAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING 2018; 8:73-85. [PMID: 29755841 PMCID: PMC5944823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 04/12/2018] [Indexed: 06/08/2023]
Abstract
Improved understanding of liver physiology and pathophysiology is urgently needed to assist the choice of new and upcoming therapeutic modalities for patients with liver diseases. In this review, we focus on functional PET of the liver: 1) Dynamic PET with 2-deoxy-2-[18F]fluoro-D-galactose (18F-FDGal) provides quantitative images of the hepatic metabolic clearance Kmet (mL blood/min/mL liver tissue) of regional and whole-liver hepatic metabolic function. Standard-uptake-value (SUV) from a static liver 18F-FDGal PET/CT scan can replace Kmet and is currently used clinically. 2) Dynamic liver PET/CT in humans with 11C-palmitate and with the conjugated bile acid tracer [N-methyl-11C]cholylsarcosine (11C-CSar) can distinguish between individual intrahepatic transport steps in hepatic lipid metabolism and in hepatic transport of bile acid from blood to bile, respectively, showing diagnostic potential for individual patients. 3) Standard compartment analysis of dynamic PET data can lead to physiological inconsistencies, such as a unidirectional hepatic clearance of tracer from blood (K1; mL blood/min/mL liver tissue) greater than the hepatic blood perfusion. We developed a new microvascular compartment model with more physiology, by including tracer uptake into the hepatocytes from the blood flowing through the sinusoids, backflux from hepatocytes into the sinusoidal blood, and re-uptake along the sinusoidal path. Dynamic PET data include information on liver physiology which cannot be extracted using a standard compartment model. In conclusion, SUV of non-invasive static PET with 18F-FDGal provides a clinically useful measurement of regional and whole-liver hepatic metabolic function. Secondly, assessment of individual intrahepatic transport steps is a notable feature of dynamic liver PET.
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Affiliation(s)
- Susanne Keiding
- Department of Nuclear Medicine and PET Centre, Aarhus University HospitalAarhus, Denmark
- Department of Hepatology and Gastroenterology, Aarhus University HospitalAarhus, Denmark
| | - Michael Sørensen
- Department of Nuclear Medicine and PET Centre, Aarhus University HospitalAarhus, Denmark
- Department of Hepatology and Gastroenterology, Aarhus University HospitalAarhus, Denmark
| | - Kim Frisch
- Department of Nuclear Medicine and PET Centre, Aarhus University HospitalAarhus, Denmark
| | - Lars C Gormsen
- Department of Nuclear Medicine and PET Centre, Aarhus University HospitalAarhus, Denmark
| | - Ole Lajord Munk
- Department of Nuclear Medicine and PET Centre, Aarhus University HospitalAarhus, Denmark
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Keramida G, Peters AM. Fasting hepatic glucose uptake is higher in men than women. Physiol Rep 2018; 5:5/11/e13174. [PMID: 28583989 PMCID: PMC5471426 DOI: 10.14814/phy2.13174] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 01/04/2017] [Accepted: 01/12/2017] [Indexed: 01/12/2023] Open
Abstract
Differences in glucose metabolism between men and women have previously been reported. Our purpose was to determine if there is a gender difference in fasting hepatic glucose uptake (MRglu). Fifty‐five patients (44 men, 11 women) referred for routine PET/CT using the glucose tracer 2‐deoxy‐2‐[F‐18]fluoro‐D‐glucose (FDG), mainly for cancer, had dynamic imaging for 30 min immediately following injection. Hepatic FDG clearance (mL/min/100 mL) was measured as gradient divided by intercept from Patlak–Rutland graphical analysis using a volume of interest over the abdominal aorta to record input function. Hepatic MRglu was obtained by multiplication of clearance by blood glucose concentration. Hepatic steatosis was diagnosed as CT density ≤40 HU. Mean (standard deviation) hepatic MRglu in 44 men was 2.30 (1.14) μmol/min/100 mL, significantly higher than in 11 women in whom it was 1.07 (1.35) μmol/min/100 mL (P = 0.003). CT density was 52 (12) HU in women compared with 45 (9) HU in men (P = 0.04), but there was no significant difference in blood glucose, BMI, or prevalence of recent chemotherapy (within 6 months preceding PET/CT). When patients were subdivided into those without hepatic steatosis (31 men/9 women), those without evidence of FDG‐avid malignancy on PET/CT (15/6), and those without either (11/5), gender differences in hepatic MRglu remained highly significant, but there were no significant differences in CT density, blood glucose, BMI, or recent chemotherapy history. Despite this being a population of clinically referred patients, the results strongly suggest that fasting hepatic MRglu is higher in men than in women.
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Affiliation(s)
- Georgia Keramida
- Clinical Imaging Sciences Centre, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - A Michael Peters
- Division of Clinical and Laboratory Investigation, Brighton and Sussex Medical School, Brighton, United Kingdom
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