Determinants of (18)F-NaF uptake in femoral arteries in patients with type 2 diabetes mellitus

BACKGROUND: The goal of this study was to investigate the potential determinants of (18)F-NaF uptake in femoral arteries as a marker of arterial calcification in patients with type 2 diabetes and a history of arterial disease. METHODS AND RESULTS: The study consisted of participants of a randomized controlled trial to investigate the effect of vitamin K2 (NCT02839044). In this prespecified analysis, subjects with type 2 diabetes and known arterial disease underwent full body (18)F-NaF PET/CT. Target-to-background ratio (TBR) was calculated by dividing the mean SUV(max) from both superficial femoral arteries by the SUV(mean) in the superior vena cava (SVC) and calcium mass was measured on CT. The association between (18)F-NaF TBR and cardiovascular risk factors was investigated using uni- and multivariate linear regression corrected for age and sex. In total, 68 patients (mean age: 69 ± 8 years; male: 52) underwent (18)F-NaF PET/CT. Higher CT calcium mass, total cholesterol, and HbA1c were associated with higher (18)F-NaF TBR after adjusting. CONCLUSION: This study shows that several modifiable cardiovascular risk factors (total cholesterol, triglycerides, HbA1c) are associated with femoral (18)F-NaF tracer uptake in patients with type 2 diabetes. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s12350-020-02099-z) contains supplementary material, which is available to authorized users.