Nuclear medicine in the diagnosis of renal and coronary angiopathies in patients with type 2 diabetes and impaired glucose tolerance

Kharina DS1,2, Poletaeva TA1, Kondakov AK1,2, Mosin DYu1, Znamensky IA1,2
About authors

1 Central Clinical Hospital of RAS, Moscow, Russia

2 Pirogov Russian National Research Medical University, Moscow, Russia

Correspondence should be addressed: Dina Kharina
Litovsky bulvar, d. 1a, Moscow, Russia, 117593; ur.liam@ls.anidras

Received: 2016-11-25 Accepted: 2016-12-10 Published online: 2017-01-19

The number of patients suffering from diabetes mellitus (DM) is increasing necessitating the development of new strategies for early detection of the disease. Here, radionuclide imaging may be a promising diagnostic technique. We have conducted a retrospective analysis of medical records and scintigrams of patients with type 2 diabetes (n = 83) and impaired glucose tolerance (n = 52) to evaluate the effectiveness of dynamic renal scintigraphy and myocardial perfusion scintigraphy at rest (single-photon emission computed tomography, SPECT) in detecting coronary and renal angiopathies. The control group consisted of patients with normal levels of blood sugar. To evaluate the functional state of the renal parenchyma, we conducted a qualitative analysis of patients’ scintigrams and renographic curves; the glomerular filtration rate (GFR) was evaluated using Gates and Cockroft-Gault methods; myocardial scarring was evaluated using perfusion SPECT images synchronized with ECG. The functional activity of the renal parenchyma was shown to decrease significantly in patients with type 2 DM (Pearson’s chi- squared test was applied, p-value was 0.03). With Gates method applied, GFR in both experimental groups was significantly lower than in the controls (Mann-Whitney U was calculated; p-value was 0.0004 and 0.0002, respectively). In patients with type 2 DM, GFR was lower than in patients with impaired glucose tolerance (p = 0.0004). With Cockroft–Gault method applied, we observed the same GFR pattern; however, the difference between patients with impaired glucose tolerance and the controls was insignificant (p = 0.08). The correlation between GFR values obtained using different methods was moderate in all groups (Spearman’s rank correlation coefficient rs = 0.53, with p = 0.038).

Keywords: impaired glucose tolerance, diabetes mellitus, dynamic renal scintigraphy, myocardial perfusion scintigraphy