SIMULTANEOUS ASSESSMENT OF INSULIN-SECRETION AND INSULIN SENSITIVITY USING A HYPERGLYCEMIC CLAMP
SIMULTANEOUS ASSESSMENT OF INSULIN-SECRETION AND INSULIN SENSITIVITY USING A HYPERGLYCEMIC CLAMP
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DOI：
10.1210/jc.75.2.379
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发表时间：
1992-08-01
影响因子：
5.8
通讯作者：
GERICH, J
中科院分区：
文献类型：
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作者：
MITRAKOU, A;VUORINENMARKKOLA, H;GERICH, J
高血糖钳夹是评估胰岛素分泌的既定方法，通常仅用于此目的。为了确定它是否也可以用来评估胰岛素敏感性，我们比较了22名非肥胖志愿者(体重指数为23.9±0.6 kg/m2)和20名肥胖者(体重指数为30.8±1.3 kg/m2)在正常血糖和高血糖钳夹实验中获得的胰岛素敏感性指数(ISI)。在高血糖(0.088+/-0.011)和正常血糖(0.050+/-0.005)钳夹实验中，肥胖组的ISI值(微摩尔/公斤·分钟/微摩尔)均显著低于非肥胖组(分别为0.179+/-0.024和0.096+/-0.009，P均<0.01)。尽管高血糖钳夹组的ISI值始终高于正常血糖钳夹组(0.137+/-0.016比0.075+/-0.007；P<；0.001)，但两者高度相关(r=0.84P<；0.0001)。此外，当这些指数转换为清除率，从而校正葡萄糖对葡萄糖处置的质量作用效应时，用高血糖钳夹获得的值(0.0137+/-0.0016毫升/公斤)。M in/pm o l)与正常血糖钳夹所获得的结果(0.0142+/-0.0013 m L/kg)在统计学上相同。由截距为0，斜率为1.03的回归方程表示。因此，我们得出结论，高血糖钳夹和正常血糖钳夹可获得类似的胰岛素敏感性估计值，并且，在适当的条件下，高血糖钳夹技术可用于在一次实验中评估同一个体的胰岛素敏感性和胰岛素分泌。
A hyperglycemic clamp is an established method to assess insulin secretion and is generally used only for this purpose. To determine whether it could also be used to assess insulin sensitivity, we compared insulin sensitivity indices (ISI) obtained during euglycemic and hyperglycemic clamp experiments in 22 nonobese volunteers (body mass index, 23.9 +/- 0.6 kg/m2) and in 20 obese individuals (body mass index, 30.8 +/- 1.3 kg/M2) matched for age and gender. The ISI values (micromoles per kg-min/pmol) of the obese group assessed during hyperglycemic (0.088 +/- 0.011) and euglycemic (0.050 +/- 0.005) clamp experiments were both significantly lower than the ISI of the nonobese group assessed in hyperglycemic and euglycemic clamp experiments (0.179 +/- 0.024 and 0.096 +/- 0.009, respectively; both P < 0.01). Although the ISI values obtained with hyperglycemic clamps were consistently greater than those obtained with euglycemic clamp (0.137 +/- 0.016 vs. 0.075 +/- 0.007; P < 0.001), they were highly correlated (r = 0.84; P < 0.0001). Moreover, when these indices were converted to clearance rates, thereby correcting for the mass action effects of glucose on glucose disposal, the values obtained with the hyperglycemic clamp (0.0137 +/- 0.0016 mL/kg . min/pmol) were statistically identical to those obtained with the euglycemic clamp (0.0142 +/- 0.0013 mL/kg . min/pmol), as indicated by a regression equation having an intercept of 0 and a slope (1.03) not different from 1. We, therefore, conclude that the hyperglycemic clamp and the euglycemic clamp yield comparable estimates of insulin sensitivity and that, under appropriate conditions, the hyperglycemic clamp technique may be used to assess both insulin sensitivity and insulin secretion in the same individual in a single experiment.