Chronic Kidney Disease Is Associated with Increased Glucose Uptake-Associated Metabolic Activity of Visceral Adipose and Subcutaneous Adipose Tissue in Gout Patients.

Objective: We evaluate the ¹⁸F-Fluorodeoxyglucose (¹⁸F-FDG) PET standardized uptake value (SUV) by PET/CT in visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) in patients with and without gout. Additionally, we investigate whether glucose uptake in these tissues predicts the progression of chronic kidney disease (CKD).

Methods: We used ICD-10 codes from the University of California San Diego patient database to identify patients with gout and controls, forming a cohort of individuals who underwent PET/CT scans. The mean VAT and SAT SUVmax were measured using PET/CT and adjusted for potential confounders using inverse probability weighting analysis. We also employed multivariable linear regression to analyze changes in estimated glomerular filtration rate (eGFR) after PET/CT.

Results: The study included 221 patients, with 120 diagnosed with gout. After the inverse probability of weighting adjustment, the mean VAT and SAT SUVmax were higher in patients with gout (mean VAT SUVmax: β=0.09, 95% CI=0.04 to 0.15; mean SAT SUVmax: β=0.06, 95% CI=0.01 to 0.12). Additionally, in gout patients with CKD stage 3 or higher, higher mean VAT and SAT SUVmax were associated with decreased eGFR in the five years following PET/CT (mean VAT SUVmax: β=-1.76, 95% CI=-3.50 to -0.01; mean SAT SUVmax: β=-2.97, 95% CI=-5.61 to -0.32) CONCLUSIONS: Elevated glucose uptake-associated metabolic activity in both VAT and SAT was observed in gout patients, which may contribute to CKD progression among patients with both gout and CKD.