Two-hour postload plasma glucose and pigment epithelium-derived factor levels are markers of coronary artery inflammation in type 2 diabetic patients

  • Nobuhiro TaharaEmail author
  • Yoshikazu Nitta
  • Munehisa Bekki
  • Atsuko Tahara
  • Shoko Maeda-Ogata
  • Yoichi Sugiyama
  • Akihiro Honda
  • Sachiyo Igata
  • Tomohisa Nakamura
  • Jiahui Sun
  • Seiji Kurata
  • Kiminori Fujimoto
  • Toshi Abe
  • Takanori Matsui
  • Sho-ichi Yamagishi
  • Yoshihiro Fukumoto
Original Article



We have previously found that pioglitazone attenuates inflammation in the left main trunk of coronary artery (LMT), evaluated as target-to-background ratio (TBR) by 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) in patients with impaired glucose tolerance or type 2 diabetes.


We assessed which clinical variables could predict the change in TBR in the LMT after 4-month add-on therapy with oral hypoglycemic agents (OHAs).


A total of 38 type 2 diabetic patients with carotid atherosclerosis who had already received OHAs except for pioglitazone was enrolled. At baseline and 4 months after add-on therapy with pioglitazone or glimepiride, all patients underwent 75 g oral glucose tolerance test, blood chemistry analysis, and FDG-PET/CT.


Fasting plasma glucose, 30-, 60-, 90-, 120-minutes postload plasma glucose, HbA1c, and LMT-TBR values were significantly decreased by add-on therapy, whereas high-density lipoprotein-cholesterol and adiponectin levels were increased. Increased serum levels of pigment epithelium-derived factor (PEDF), a marker of insulin resistance and non-use of aspirin at baseline could predict the favorable response of LMT-TBR to add-on therapy. Moreover, Δ120-minutes postload plasma glucose and ΔPEDF were independent correlates of ΔLMT-TBR.


Our present study suggests that 120-minutes postload plasma glucose and PEDF values may be markers and potential therapeutic targets of coronary artery inflammation in type 2 diabetic patients.

Clinical Trial Registration

URL: Unique identifier: NCT00722631.

Graphic Abstract

New markers for diabetes and CAD is on the horizon! Two-hour postload plasma glucose and pigment epithelium derived factor are markers of coronary artery inflammation in type 2 diabetic patients.


Coronary artery inflammation FDG-PET insulin resistance 75 g OGTT PEDF 



Cardiovascular disease


Computed tomography




Positron emission tomography


Target-to-background ratio

75 g OGTT

75 g oral glucose tolerance test


Oral hypoglycemic agents


Pigment epithelium-derived factor


Left main trunk of coronary artery


TBR in the LMT



We thank Mami Nakayama, Miho Nakao-Kogure, Katsue Shiramizu, Miyuki Nishikata, Yuri Nishino, Makiko Kiyohiro (Kurume University), and Kouichi Nitta (Hitachi Ltd., Tokyo, Japan) for their technical assistance.


This study was supported in part by research grants from the Kimura Memorial Foundation (to YN, MB, AT, SM, AH and TN), the Grant-in-Aid for Scientific Research C (17K09564 and 17K08968) from the Japan Society for the Promotion of Science (JSPS KAKENHI), Tokyo, Japan (to NT and SY). Yoichi Sugiyama, Sachiyo Igata, Jiahui Sun, Seiji Kurata, Kiminori Fujimoto, Toshi Abe, Takanori Matsui, and Yoshihiro Fukumoto have nothing to disclose.

Supplementary material

12350_2019_1842_MOESM1_ESM.ppt (662 kb)
Supplementary material 1 (PPT 664 kb)


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Copyright information

© American Society of Nuclear Cardiology 2019

Authors and Affiliations

  • Nobuhiro Tahara
    • 1
    Email author
  • Yoshikazu Nitta
    • 1
  • Munehisa Bekki
    • 1
  • Atsuko Tahara
    • 1
  • Shoko Maeda-Ogata
    • 1
  • Yoichi Sugiyama
    • 1
  • Akihiro Honda
    • 1
  • Sachiyo Igata
    • 1
  • Tomohisa Nakamura
    • 1
  • Jiahui Sun
    • 1
  • Seiji Kurata
    • 2
  • Kiminori Fujimoto
    • 2
  • Toshi Abe
    • 2
  • Takanori Matsui
    • 3
  • Sho-ichi Yamagishi
    • 4
  • Yoshihiro Fukumoto
    • 1
  1. 1.Division of Cardiovascular Medicine, Department of MedicineKurume University School of MedicineKurumeJapan
  2. 2.Department of RadiologyKurume University School of MedicineKurumeJapan
  3. 3.Department of Pathophysiology and Therapeutics of Diabetic Vascular ComplicationsKurume University School of MedicineKurumeJapan
  4. 4.Division of Diabetes, Metabolism, and Endocrinology, Department of MedicineShowa University School of MedicineTokyoJapan

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