Validity of triple- and dual-tracer techniques to estimate glucose appearance.
Validity of triple- and dual-tracer techniques to estimate glucose appearance.
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DOI：
10.1152/ajpendo.00581.2011
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发表时间：
2012-06-15
期刊：
影响因子：
--
通讯作者：
Hovorka R
中科院分区：
文献类型：
--
作者：
Haidar A;Elleri D;Allen JM;Harris J;Kumareswaran K;Nodale M;Acerini CL;Wilinska ME;Jackson N;Umpleby AM;Evans ML;Dunger DB;Hovorka R
三示踪剂（TT）稀释技术已被提议为测量餐后血糖出现的金标准方法。然而，缺乏对独立标准的验证。我们解决了这个问题，并验证了更简单的双示踪剂（DT）技术。16例年轻1型糖尿病患者（年龄19.5 ± 3.8岁，BMI 23.4 ± 1.5 kg/m2，HbA 1c 8.7 ± 1.7%，糖尿病病程9.0 ± 6.9年，每日总胰岛素0.9 ± 0.2 U·kg-1·d-1，平均值± SD）接受了8小时内富含[U-13 C]葡萄糖的20%葡萄糖静脉输注，以达到餐后-类似于葡萄糖波动，而静脉注射胰岛素以达到类似于餐后的血浆胰岛素水平。以模拟预期内源性葡萄糖产生的方式输注预充[6，6 - 2 H2]葡萄糖，并以模拟标准餐中预期葡萄糖外观的方式输注[U-13 C; 1，2，3，4，5，6，6 - 2 H7]葡萄糖。用气相色谱-质谱法测定血浆葡萄糖浓度。静脉内葡萄糖输注作为一个独立的标准，并重建使用TT和DT技术与两室Radziuk/Mari模型和先进的随机计算方法。两种方法的输注和重建葡萄糖曲线之间的差异相似（均方根误差6.6 ± 1.9 vs. 8.0 ± 3.5 μmol·kg−1·min−1，TT vs. DT，P = NS，配对t检验）。TT技术在回收总葡萄糖输注方面更准确（100 ± 9和92 ± 12%; P = 0.02）。对于TT和DT技术，与平均葡萄糖输注曲线相关的均方根误差分别为2.5和3.3 μmol·kg-1·min-1。我们的结论是，TT和DT技术结合先进的计算方法可以准确地测量外源性葡萄糖的出现。TT技术往往略优于DT技术，但后者受益于降低实验和计算复杂性。
The triple-tracer (TT) dilution technique has been proposed to be the gold standard method to measure postprandial glucose appearance. However, validation against an independent standard has been missing. We addressed this issue and also validated the simpler dual-tracer (DT) technique. Sixteen young subjects with type 1 diabetes (age 19.5 ± 3.8 yr, BMI 23.4 ± 1.5 kg/m2, HbA1c 8.7 ± 1.7%, diabetes duration 9.0 ± 6.9 yr, total daily insulin 0.9 ± 0.2 U·kg−1·day−1, mean ± SD) received a variable intravenous 20% dextrose infusion enriched with [U-13C]glucose over 8 h to achieve postprandial-resembling glucose excursions while intravenous insulin was administered to achieve postprandial-resembling levels of plasma insulin. Primed [6,6-2H2]glucose was infused in a manner that mimicked the expected endogenous glucose production and [U-13C; 1,2,3,4,5,6,6-2H7]glucose was infused in a manner that mimicked the expected glucose appearance from a standard meal. Plasma glucose enrichment was measured by gas chromatography-mass spectrometry. The intravenous dextrose infusion served as an independent standard and was reconstructed using the TT and DT techniques with the two-compartment Radziuk/Mari model and an advanced stochastic computational method. The difference between the infused and reconstructed dextrose profile was similar for the two methods (root mean square error 6.6 ± 1.9 vs. 8.0 ± 3.5 μmol·kg−1·min−1, TT vs. DT, P = NS, paired t-test). The TT technique was more accurate in recovering the overall dextrose infusion (100 ± 9 and 92 ± 12%; P = 0.02). The root mean square error associated with the mean dextrose infusion profile was 2.5 and 3.3 μmol·kg−1·min−1 for the TT and DT techniques, respectively. We conclude that the TT and DT techniques combined with the advanced computational method can measure accurately exogenous glucose appearance. The TT technique tends to outperform slightly the DT technique, but the latter benefits from reduced experimental and computational complexity.
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影响因子：
--
作者：
MARI, A
通讯作者：
MARI, A
影响因子：
16.2
作者：
Pennant, Mary E.;Bluck, Leslie J. C.;Dunger, David B.
通讯作者：
Dunger, David B.
影响因子：
7.7
作者：
FERRANNINI, E;BJORKMAN, O;DEFRONZO, RA
通讯作者：
DEFRONZO, RA
影响因子：
3.5
作者：
Chase, HP;Saib, SZ;Garg, SK
通讯作者：
Garg, SK
影响因子：
7.7
作者：
STEELE, R;BJERKNES, C;ALTSZULER, N
通讯作者：
ALTSZULER, N