Int J Sports Med 2005; 26(9): 727-731
DOI: 10.1055/s-2005-837458
Physiology & Biochemistry

© Georg Thieme Verlag KG Stuttgart · New York

In Vivo Measurements of Glucose Uptake in Human Achilles Tendon During Different Exercise Intensities

J. Hannukainen1 , K. K. Kalliokoski1 , 5 , P. Nuutila1 , 2 , T. Fujimoto1 , 4 , J. Kemppainen1 , T. Viljanen1 , M. S. Laaksonen1 , R. Parkkola3 , J. Knuuti1 , M. Kjær 5
  • 1Turku PET Centre, University of Turku, Turku, Finland
  • 2Department of Medicine, University of Turku, Turku, Finland
  • 3Department of Diagnostic Radiology, Turku University Central Hospital, Turku, Finland
  • 4Department of Medicine and Science in Sports and Exercise, Graduate School of Medicine, University of Tohoku, Sendai, Japan
  • 5Sports Medicine Research Unit, Bispebjerg Hospital, Copenhagen, Denmark
Further Information

Publication History

Accepted after revision: October 31, 2004

Publication Date:
15 March 2005 (online)

Abstract

Muscular contraction and loading of adjacent tendons has been demonstrated to cause increased blood flow and metabolic activity in the peritendinous region. However, it is poorly known to what extent the human tendon itself takes up glucose during exercise. Thus, the purpose of this study was to measure tendon glucose uptake with increasing exercise intensity and to compare it to muscle glucose uptake at the same intensities. Eight young men were examined on three separate days during which they performed 35 min of cycling at 30, 55 and 75 % of V·O2max, respectively. Glucose uptake was measured directly by positron emission tomography (PET) with 2-[18F]fluoro-2-deoxyglucose ([18F]FDG). [18F]FDG was injected after 10 min of exercise that was continued for a further 25 min after the injection. PET scanning of the thigh and Achilles region was performed after the exercise. Glucose uptake of the Achilles tendon (AT) remained unchanged (7.1 ± 1.5, 6.6 ± 1.1, and 6.0 ± 1.1 µmol · kg-1 · min-1) with the increasing workload, although the glucose uptake in m. quadriceps femoris simultaneously clearly increased (48 ± 35, 120 ± 35, and 152 ± 74 µmol · kg-1 · min-1, p < 0.05). In conclusion, the AT takes up glucose during exercise but in significantly smaller amounts than the skeletal muscle does. Furthermore, glucose uptake in the AT is not increased with the increasing exercise intensity. This may be partly explained by the cycle ergometry exercise used in the present study, which probably causes only a little increase in strain to the AT with increasing exercise intensity.

References

  • 1 Alenius S, Ruotsalainen U. Bayesian image reconstruction for emission tomography based on median root prior.  Eur J Nuc Med. 1997;  24 258-265
  • 2 Boushel R, Langberg H, Green S, Skovgaard D, Bülow J, Kjær M. Blood flow and oxygenation in peritendinous tissue and calf muscle during dynamic exercise in humans.  J Physiol. 2000;  524 305-313
  • 3 Boushel R, Langberg H, Olesen J, Nowak M, Simonsen L, Bülow J, Kjær M. Regional blood flow during exercise in humans measured by near-infrared spectroscopy and indocyanine green.  J Appl Physiol. 2000;  89 1868-1878
  • 4 Clark M G, Clerk L H, Newman J MB, Rattigan S. Interaction between metabolism and flow in tendon and muscle.  Scand J Med Sci Sports. 2000;  10 338-345
  • 5 Fujimoto T, Kemppainen J, Kalliokoski K K, Nuutila P, Ito M, Knuuti J. Skeletal muscle glucose uptake response to exercise in trained and untrained men.  Med Sci Sports Exerc. 2003;  35 777-783
  • 6 Gallagher B M, Ansari A, Atkins H, Casella V, Christman D R, Fowler J S, Ido T, MacGregor R R, Som P, Wan C N, Wolf A P, Kuhl D E, Reivich M. Radiopharmaceuticals XXXVII. 18 F-labeled 2-deoxy-2-fluoro-d-glucose as a radiopharmaceutical for measuring regional myocardial glucose metabolism in vivo: tissue distribution and imaging studies in animals.  J Nucl Med. 1977;  18 990-996
  • 7 Goodyear L, Kahn B. Exercise, glucose transport and insulin sensitivity.  Ann Rev Med. 1998;  49 235-261
  • 8 Gregor R J, Komi P V, Järvinen M. Achilles tendon forces during cycling.  Int J Sports Med. 1987;  8 9-14
  • 9 Hamacher K, Coenen H H, Stocklin G. Efficient stereospecific synthesis of no carrier-added 2-[18 F]-fluoro-2-deoxy-D-glucose using aminopolyether supported nucleophilic substitution.  J Nuc Med. 1986;  27 235-238
  • 10 Józsa L, Bálint J B, Réffy A, Demel Z. Histochemical and ultrastructural study of adult human tendon.  Acta Histochem. 1979;  65 250-257
  • 11 Kelley D E, Williams K V, Price J C, Goodpaster B. Determination of the lumped constant for [18 F] fluorodeoxyglucose in human skeletal muscle.  J Nucl Med. 1999;  40 1798-1804
  • 12 Kemppainen J, Fujimoto T, Kalliokoski K K, Viljanen T, Nuutila P, Knuuti J. Myocardial and skeletal muscle glucose uptake during exercise.  J Physiol. 2002;  542 403-412
  • 13 Koivunen-Niemelä T. Imaging of the Achilles Tendon. Diagnostic Evaluation of Sonography and Magnetic Resonance Imaging. Turku; Doctoral Dissertation, Annales Universitatis Turkuensis (D 190) 1995
  • 14 Kvist M, Józsa L, Järvinen M, Kvist H. Chronic Achilles paratenonitis in athletes: a histological and histochemical study.  Pathology. 1987;  19 1-11
  • 15 Langberg H, Skovgaard D, Karamouzis M, Bülow J, Kjær M. Metabolism and inflammatory mediators in the peritendinous space measured by microdialysis during intermittent isometric exercise in humans.  J Physiol. 1999;  515 919-927
  • 16 Lepers R, Hausswrith C, Maffiuletti N, Brisswalter J, van Hoecke J. Evidence of neuromuscular fatigue after prolonged cycling exercise.  Med Sci Sports Exerc. 2000;  32 1880-1886
  • 17 Maggs D G, Borg W P, Sherwin R S. Microdialysis techniques in the study of brain and skeletal muscle.  Diabetologia. 1997;  40 75-82
  • 18 Marbach E P, Weil M H. Rapid enzymatic measurement of blood lactate and puruvate. Use and significance of metaphosphoric acid as a common percipitant.  Clin Chem. 1967;  13 314-325
  • 19 Newman J MB, Steen J T, Clark M G. Vessels supplying septa and tendons as functional shunts in perfused rat hindlimb.  Microvasc Res. 1997;  54 49-57
  • 20 Nuutila P, Raitakari M, Laine H, Kirvelä O, Takala T, Utriainen T, Mäkimattila S, Pitkänen O-P, Ruotsalainen U, Ida H, Knuuti J, Yki-Järvinen H. Role of blood flow in regulating insulin-stimulated glucose uptake in humans.  J Clin Invest. 1996;  97 1741-1747
  • 21 Nuutila P, Peltoniemi P, Oikonen V, Larmola K, Kemppainen J, Takala T O, Sipilä H, Oksanen A, Ruotsalainen U, Bolli G B, Yki-Järvinen H. Enhanced stimulation of glucose uptake by insulin increases exercise-stimulated glucose uptake in skeletal muscle in humans: Studies using (15O)-oxygen, (15O)-water, (18F)-fluoro-deoxy-glucose and positron emission tomography.  Diabetes. 2000;  49 1084-1091
  • 22 Peltoniemi P, Lönnroth P, Laine H, Oikonen V, Tolvanen T, Grönroos T, Strindberg L, Knuuti J, Nuutila P. Determination of lumped constant for (18F)-fluoro-deoxy-glucose in skeletal muscle of obese and nonobese humans.  Am J Physiol. 2000;  279 1122-1130
  • 23 Sokoloff L, Reivich M, Kennedy C, Rosiers M H, Patlak C S, Pettigrew K D, Sakurada O, Shinohara M. The (14C)deoxyglucose method for the measurement of local cerebral glucose utilization: theory, procedure, and normal values in the conscious and anaesthetized albino rat.  J Neurochem. 1977;  28 897-916
  • 24 Virtanen K A, Peltoniemi P, Marjamäki P, Asola M, Strindberg L, Parkkola R, Huupponen R, Knuuti J, Lonnroth P, Nuutila P. Human adipose tissue glucose uptake determined using [(18)F]-fluoro-deoxy-glucose ([(18)F]FDG) and PET in combination with microdialysis.  Diabetologia. 2001;  44 2171-2179

J. Hannukainen

Turku PET Centre

P. O. Box 52

20521 Turku

Finland

Phone: + 38523132798

Fax: + 35 8 22 31 81 91

Email: jarna.hannukainen@tyks.fi