Brain Glucose Metabolism in Health, Obesity, and Cognitive Decline—Does Insulin Have Anything to Do with It? A Narrative Review
Imaging brain glucose metabolism with fluorine-labelled fluorodeoxyglucose ([<sup>18</sup>F]-FDG) positron emission tomography (PET) has long been utilized to aid the diagnosis of memory disorders, in particular in differentiating Alzheimer’s disease (AD) from other neurological conditio...
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doaj-b7aedf47fd16441c8f46110c317621d42021-04-06T23:03:30ZengMDPI AGJournal of Clinical Medicine2077-03832021-04-01101532153210.3390/jcm10071532Brain Glucose Metabolism in Health, Obesity, and Cognitive Decline—Does Insulin Have Anything to Do with It? A Narrative ReviewEleni Rebelos0Juha O. Rinne1Pirjo Nuutila2Laura L. Ekblad3Turku PET Centre, University of Turku and Turku University Hospital, 20520 Turku, FinlandTurku PET Centre, University of Turku and Turku University Hospital, 20520 Turku, FinlandTurku PET Centre, University of Turku and Turku University Hospital, 20520 Turku, FinlandTurku PET Centre, University of Turku and Turku University Hospital, 20520 Turku, FinlandImaging brain glucose metabolism with fluorine-labelled fluorodeoxyglucose ([<sup>18</sup>F]-FDG) positron emission tomography (PET) has long been utilized to aid the diagnosis of memory disorders, in particular in differentiating Alzheimer’s disease (AD) from other neurological conditions causing cognitive decline. The interest for studying brain glucose metabolism in the context of metabolic disorders has arisen more recently. Obesity and type 2 diabetes—two diseases characterized by systemic insulin resistance—are associated with an increased risk for AD. Along with the well-defined patterns of fasting [<sup>18</sup>F]-FDG-PET changes that occur in AD, recent evidence has shown alterations in fasting and insulin-stimulated brain glucose metabolism also in obesity and systemic insulin resistance. Thus, it is important to clarify whether changes in brain glucose metabolism are just an epiphenomenon of the pathophysiology of the metabolic and neurologic disorders, or a crucial determinant of their pathophysiologic cascade. In this review, we discuss the current knowledge regarding alterations in brain glucose metabolism, studied with [<sup>18</sup>F]-FDG-PET from metabolic disorders to AD, with a special focus on how manipulation of insulin levels affects brain glucose metabolism in health and in systemic insulin resistance. A better understanding of alterations in brain glucose metabolism in health, obesity, and neurodegeneration, and the relationships between insulin resistance and central nervous system glucose metabolism may be an important step for the battle against metabolic and cognitive disorders.https://www.mdpi.com/2077-0383/10/7/1532brain glucose uptakepositron emission tomographyinsulin sensitivityAlzheimer’s disease |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Eleni Rebelos Juha O. Rinne Pirjo Nuutila Laura L. Ekblad |
spellingShingle |
Eleni Rebelos Juha O. Rinne Pirjo Nuutila Laura L. Ekblad Brain Glucose Metabolism in Health, Obesity, and Cognitive Decline—Does Insulin Have Anything to Do with It? A Narrative Review Journal of Clinical Medicine brain glucose uptake positron emission tomography insulin sensitivity Alzheimer’s disease |
author_facet |
Eleni Rebelos Juha O. Rinne Pirjo Nuutila Laura L. Ekblad |
author_sort |
Eleni Rebelos |
title |
Brain Glucose Metabolism in Health, Obesity, and Cognitive Decline—Does Insulin Have Anything to Do with It? A Narrative Review |
title_short |
Brain Glucose Metabolism in Health, Obesity, and Cognitive Decline—Does Insulin Have Anything to Do with It? A Narrative Review |
title_full |
Brain Glucose Metabolism in Health, Obesity, and Cognitive Decline—Does Insulin Have Anything to Do with It? A Narrative Review |
title_fullStr |
Brain Glucose Metabolism in Health, Obesity, and Cognitive Decline—Does Insulin Have Anything to Do with It? A Narrative Review |
title_full_unstemmed |
Brain Glucose Metabolism in Health, Obesity, and Cognitive Decline—Does Insulin Have Anything to Do with It? A Narrative Review |
title_sort |
brain glucose metabolism in health, obesity, and cognitive decline—does insulin have anything to do with it? a narrative review |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2021-04-01 |
description |
Imaging brain glucose metabolism with fluorine-labelled fluorodeoxyglucose ([<sup>18</sup>F]-FDG) positron emission tomography (PET) has long been utilized to aid the diagnosis of memory disorders, in particular in differentiating Alzheimer’s disease (AD) from other neurological conditions causing cognitive decline. The interest for studying brain glucose metabolism in the context of metabolic disorders has arisen more recently. Obesity and type 2 diabetes—two diseases characterized by systemic insulin resistance—are associated with an increased risk for AD. Along with the well-defined patterns of fasting [<sup>18</sup>F]-FDG-PET changes that occur in AD, recent evidence has shown alterations in fasting and insulin-stimulated brain glucose metabolism also in obesity and systemic insulin resistance. Thus, it is important to clarify whether changes in brain glucose metabolism are just an epiphenomenon of the pathophysiology of the metabolic and neurologic disorders, or a crucial determinant of their pathophysiologic cascade. In this review, we discuss the current knowledge regarding alterations in brain glucose metabolism, studied with [<sup>18</sup>F]-FDG-PET from metabolic disorders to AD, with a special focus on how manipulation of insulin levels affects brain glucose metabolism in health and in systemic insulin resistance. A better understanding of alterations in brain glucose metabolism in health, obesity, and neurodegeneration, and the relationships between insulin resistance and central nervous system glucose metabolism may be an important step for the battle against metabolic and cognitive disorders. |
topic |
brain glucose uptake positron emission tomography insulin sensitivity Alzheimer’s disease |
url |
https://www.mdpi.com/2077-0383/10/7/1532 |
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