Bayesian two-compartment and classic single-compartment minimal models: comparison on insulin modified IVGTT and effect of experiment reduction.
Bayesian two-compartment and classic single-compartment minimal models: comparison on insulin modified IVGTT and effect of experiment reduction.
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贝叶斯二室与经典单室最小模型：胰岛素改良IVGTT比较及实验减少效果。
DOI：
10.1109/tbme.2003.819850
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发表时间：
2003
期刊：
影响因子：
--
通讯作者：
Cobelli,Claudio
中科院分区：
文献类型：
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作者：
Callegari,Tiziano;Caumo,Andrea;Cobelli,Claudio
描述静脉内葡萄糖耐量试验（IVGTT）的血浆葡萄糖和胰岛素浓度的模型允许无创的成本有效的方法来估计表征葡萄糖-胰岛素控制系统的效率的重要指标，即，葡萄糖有效性（S/sub G/）和胰岛素敏感性（S/sub I/）。为了克服经典的单室最小模型（1CMM）的葡萄糖动力学的一些局限性，最近提出了一个两室贝叶斯最小模型（2CBMM）的标准IVGTT。本研究旨在评估2CBMM描述胰岛素改良IVGTT（IM-IVGTT）的能力，IM-IVGTT是首选方案，因为它允许研究胰岛素缺乏状态。研究了全长IM-IVGTT（240 min）和简化版本（90 min）。13名正常人IM-IVGTT（240 min）的最大后验识别结果与标准IVGTT的结果一致，即，与1CMM相比，S/sub G/降低42%（P<0.002），S/sub I/增加13%（P<0.006）。当从IM-IVGTT（90分钟）中识别时，2CBMM不仅提供了S/sub G/和S/sub I/估计值低46%（P<0.002）和41%与1CMM组比较P<0.002，但似乎也克服了240分钟的一些限制，基于识别，可能是因为最小模型无法正确解释发生在糖尿病患者中的高血糖激素反应而出现的。IM-IVGTT的第二部分。
Models describing plasma glucose and insulin concentration of an intravenous glucose tolerance test (IVGTT) allow a noninvasive cost-effective approach to estimate important indexes characterizing the efficiency of glucose-insulin control system, i.e., glucose effectiveness (S/sub G/) and insulin sensitivity (S/sub I/). To overcome some limitations of the classic single compartment minimal model (1CMM) of glucose kinetics , a two-compartment Bayesian minimal model (2CBMM) has been recently proposed for the standard IVGTT. This study aims to assess 2CBMM ability to describe the insulin-modified IVGTT (IM-IVGTT) which is the protocol of choice since it allows one to study insulinopenic states. Both a full-length IM-IVGTT (240 min) as well as a reduced version (90 min) of it are studied. Results of the maximum a posteriori identification of IM-IVGTT (240 min) in 13 normals agree with those of standard IVGTT, i.e., a 42% decrease (P<0.002) of S/sub G/ and a 13% increase (P<0.006) of S/sub I/ with respect to 1CMM. When identified from IM-IVGTT (90 min), 2CBMM not only provides S/sub G/ and S/sub I/ estimates 46% lower (P<0.002) and 41% higher (P<0.002) than 1CMM ones respectively, but also seems to overcome some limitations of the 240 min-based identification that probably arise because the minimal model is unable to properly account for the hyperglycemic hormonal response taking place in the second half of IM-IVGTT.