The use of technetium-99m hexamethylpropylene amine oxime lung scintigraphy in the detection of subclinical lung injury in patients with noninsulin-dependent diabetes mellitus

Abstract

The aims of this study were to evaluate subclinical pulmonary injury in patients with noninsulin-dependent diabetes mellitus (NIDDM) who showed normal chest radiograph and pulmonary function test results by using technetium-99 hexamethylpropylene amine oxime (Tc-99m-HMPAO) scintigraphy and to investigate the relationship between Tc-99m-HMPAO lung uptake and duration of diabetes, glycemic control, and the presence of diabetes-related microvascular complications. A total of 40 patients with NIDDM (19 men, 21 women; age 56.5 ± 6.8 years; duration of diabetes: 13.1 ± 6.7 years) were included in this study. The pulmonary vascular damage was represented as lung/liver uptake ratios (L/L ratios) calculated by Tc-99m-HMPAO lung scintigraphy. Results were compared with those of age-matched controls. The L/L ratio was 0.36 ± 0.07 in normal controls and 0.51 ± 0.16 in patients with NIDDM. The L/L ratio was significantly higher in NIDDM patients than in the control group (P=0.002). No correlation was observed between L/L ratio and the presence of diabetic complications, glycemic control, and diabetes duration. Tc-99m-HMPAO lung scintigraphy is a sensitive and an objective method for the detection of subclinical lung injury in NIDDM patients. Tc-99m-HMPAO lung uptake serves as an indicator of pulmonary injury due to diabetes, regardless of diabetes age, glycemic control, and the presence of other diabetes-related microvascular complications.