Indies of insulin action, disposal, and secretion derived from fasting samples and clamps in normal glucose-tolerant black and white children
Indies of insulin action, disposal, and secretion derived from fasting samples and clamps in normal glucose-tolerant black and white children
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DOI：
10.2337/diacare.25.11.2081
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发表时间：
2002-11-01
期刊：
影响因子：
16.2
通讯作者：
Yanovski, JA
中科院分区：
文献类型：
--
作者：
Uwaifo, GI;Fallon, EM;Yanovski, JA
研究设计与方法：31名儿童(平均BMI 25.1+/-4.9 kg/m(2)，平均年龄8.7+/-1.4岁，15名女孩和16名男孩，12名黑人和19名白人)接受了正常血糖和高血糖钳夹2-6周的胰岛素敏感性指数(SI)和高血糖钳夹(SI)。结果：QUICI与Eug钳制指数(SI)相关性最好(r=0.69，P<；0.05)，与Eug钳制指数(SI)相关性最好(r=0.69，P<；0.05)，与Eug钳(SI)相关性更强(r=0.45，P<；0.05)或HOMA-IR(r=-0.51，P<；0.05)。空腹胰岛素和胰岛素分泌指数与第一次稳态胰岛素分泌有较好的相关性(r‘s为0.79~0.86，P<；0.05)，而HOMA-B%相关性较差(r=0.69~0.72，P<；0.05)。空腹C肽/胰岛素比值与胰岛素钳夹代谢率无明显相关性。ISI-FFA与钳夹获得的游离脂肪酸抑制程度无关。结论在这个不同的儿科队列中，快速、空腹胰岛素和胰岛素生成指数都与相应的钳夹衍生的胰岛素敏感性和分泌指数密切相关。这些结果，如果在相似的不同人群中重复，表明基于禁食样本的估计可以用来对儿童队列中胰岛素分泌的顺序和敏感性进行排序。
OBJECTIVE - To validate fasting indices of insulin sensitivity and secretion in a diverse pediatric population against gold standard estimates from euglycemic and hyperglycemic clamps.RESEARCH DESIGN AND METHODS - A total of 31 children (mean BMI 25.1 +/- 4.9 kg/m(2), mean age 8.7 +/- 1.4 years, 15 girls and 16 boys, 12 black and 19 white) underwent euglycemic and hyperglycemic clamps 2-6 weeks apart to derive insulin sensitivity indices (SI (Eug clamp) and SI (Hyper clamp)). Fasting samples were used to derive the homeostasis model assessment of insulin resistance index (HOMA-IR), HOMA of percent beta-cell function (HOMA-B%), quantitative insulin sensitivity check index (QUICKI), insulinogenic index, antilipolytic insulin sensitivity index (ISI-FFA), and C-peptide-to-insulin ratio.RESULTS - The QUICKI correlated best with SI (Eug clamp) (r = 0.69, P < 0.05) and had greater correlations to SI (Eug clamp) than did either SI (Hyper clamp) (r = 0.45, P < 0.05) or the HOMA-IR (r = -0.51, P < 0.05). Both fasting insulin and the insulinogenic index correlated well with first- an steady-phase insulin secretion (r's from 0.79 to 0.86, P < 0.05) HOMA-B% was not as highly correlated (r = 0.69-0.72, P < 0.05). Fasting C-peptide-to-insulin ratio was not significantly correlated with clamp-derived metabolic clearance rate of insulin. ISI-FFA was, not correlated with the degree of free fatty acid suppression obtained from the clamps.CONCLUSIONS - The QUICKI, fasting insulin, and the insulinogenic index all closely correlate with corresponding clamp-derived indices of insulin sensitivity and secretion in this diverse pediatric cohort. These results, if replicated in similarly diverse populations, suggest that estimates based on fasting samples can be used to rank order insulin secretion and sensitivity in pediatric cohorts.