Assessment of β-cell function in humans, simultaneously with insulin sensitivity and hepatic extraction, from intravenous and oral glucose tests
Assessment of β-cell function in humans, simultaneously with insulin sensitivity and hepatic extraction, from intravenous and oral glucose tests
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DOI：
10.1152/ajpendo.00421.2006
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发表时间：
2007-07-01
影响因子：
5.1
通讯作者：
Rizza, Robert
中科院分区：
文献类型：
--
作者：
Cobelli, Claudio;Toffolo, Gianna Maria;Rizza, Robert
由于其与胰岛素作用和肝脏胰岛素提取的复杂相互作用，在生理条件下对人类胰岛素分泌的评估一直是一个挑战。在生理条件下使用一种简单的方法同时评估P细胞功能、胰岛素敏感性和肝脏胰岛素提取的可能性很有吸引力，因为它有可能为糖尿病和非糖尿病患者的空腹和餐后糖代谢的调节提供新的见解。从这个角度出发，我们回顾了一些数据，这些数据表明，口服葡萄糖耐量试验(OGTT)或膳食试验在解释口服P细胞最小模型时能够实现这一目标。我们首先使用成熟的静脉最小模型来强调口服最小模型是如何发展的，以及口头评估如何与静脉葡萄糖耐量测试(IVGTT)平行。我们还指出了这两种方法在评估P细胞分泌级联的不同方面的能力方面的独特之处。我们回顾了口腔模型同时测量胰岛素敏感性和肝脏胰岛素提取的能力，从而使其能够定量描述P细胞功能、肝脏胰岛素提取和胰岛素作用之间的复杂关系。此外，204名受试者(54名年轻人和159名老年人)的数据被用来说明这些不同的方法如何提供关于人类P细胞功能调节的互补但不同的见解。
Assessment of insulin secretion in humans under physiological conditions has been a challenge because of its complex interplay with insulin action and hepatic insulin extraction. The possibility of simultaneously assessing P-cell function, insulin sensitivity, and hepatic insulin extraction under physiological conditions using a simple protocol is appealing, since it has the potential to provide novel insights regarding the regulation of fasting and postprandial glucose metabolism in diabetic and nondiabelie humans. In this Perspective, we review data indicating that an oral glucose tolerance test (OGTT) or a meal test is able to accomplish this goal when interpreted with the oral P-cell minimal model. We begin by using the well-established intravenous minimal model to highlight how the oral minimal model was developed and how the oral assessment parallels that of an intravenous glucose tolerance test (IVGTT). We also point out the unique aspects of both approaches in relation to their ability to assess different aspects of the P-cell secretory cascade. We review the ability of the oral model to concurrently measure insulin sensitivity and hepatic insulin extraction, thereby enabling it to quantitatively portray the complex relationship among P-cell function, hepatic insulin extraction, and insulin action. In addition, data from 204 individuals (54 young and 159 elderly) who underwent both IVGTT and meal tolerance tests are used to illustrate how these different approaches provide complementary but differing insights regarding the regulation of P-cell function in humans.