Differences between the tolbutamide-boosted and the insulin-modified minimal model protocols
Differences between the tolbutamide-boosted and the insulin-modified minimal model protocols
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DOI：
10.2337/diabetes.46.7.1167
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发表时间：
1997-07-01
期刊：
影响因子：
7.7
通讯作者：
Bergman, RN
中科院分区：
文献类型：
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作者：
Saad, MF;Steil, GM;Bergman, RN
在35名非糖尿病受试者（年龄38 ± 2岁，BMI 27.2 ± 0.9 kg/m2）中，将胰岛素修饰的频繁采样静脉葡萄糖耐量试验（FSIGTT）和最小模型分析（MINMOD）与甲苯磺丁脲方案和葡萄糖钳夹进行比较。每例受试者接受两次FSIGTT，一次使用甲苯磺丁脲（300 mg），另一次使用胰岛素（0.03 U/kg）和正常血糖高胰岛素钳夹（40 mU.m（-2）.min（-1））。从每个FSIGTT用MINMOD和从钳夹确定胰岛素敏感性。两种FSIGTT的胰岛素敏感性指数（S-I）显著相关（r = 0.77，P < 0.001），但S-I（胰岛素）比S-I（甲苯磺丁脲）低29 ± 4%。SI（胰岛素）和SI（甲苯磺丁脲）均与S-I（钳夹）呈显著相关（r = 0.70和0.71，P < 0.001）。以相同单位（dl/min/mu U/ml）表示，S-I（甲苯磺丁脲）比S-I（钳夹）平均低13 +/- 6%（4.51 +/- 0.40 vs. 5.36 +/- 0.36 x 10（-2），P = 0.009），而S-I（胰岛素）低44 +/- 4%。S-G（甲苯磺丁脲）和S-G（胰岛素）无差异（1.88 +/- 0.10 vs. 2.01 +/- 0.09 x 10（-2）min（-1），P = 0.167），且显著相关（r = 0.50，P = 0.002）。因此，来自两个方案的胰岛素敏感性估计彼此显著相关并且与钳夹显著相关。然而，它们在数量上是不一致的，可能是由于胰岛素作用的胰岛素递送途径饱和度和/或甲苯磺丁脲诱导的胰岛素原释放的差异。从这两个MINMOD方案中获得的数据不具有直接可比性，在任何单一的横断面或纵向研究中必须使用相同的方案。
The insulin-modified frequently sampled intravenous glucose tolerance test (FSIGTT) with minimal model analysis (MINMOD) was compared with the tolbutamide protocol and the glucose clamp in 35 nondiabetic subjects (age 38 +/- 2 years [mean +/- SE], BMI 27.2 +/- 0.9 kg/m(2)). Each subject underwent two FSIGTTs, one with tolbutamide (300 mg) and the other with insulin (0.03 U/kg) and a euglycemic hyperinsulinemic clamp (40 mU.m(-2).min(-1)). Insulin sensitivity was determined from each FSIGTT with MINMOD and from the clamp. Insulin sensitivity indexes (S-I) from the two FSIGTTs were significantly correlated (r = 0.77, P < 0.001), but S-I(insulin) was 29 +/- 4% lower than S-I(tolbutamide). Both SI(insulin) and SI(tolbutamide) correlated significantly with S-I(clamp) (r = 0.70 and 0.71, P < 0.001 for each). Expressed in the same units (dl/min per mu U/ml), S-I(tolbutamide) Was On average 13 +/- 6% lower than S-I(clamp) (4.51 +/- 0.40 vs. 5.36 +/- 0.36 x 10(-2), P = 0.009), whereas S-I(insulin) was 44 +/- 4% lower. S-G(tolbutamide) and S-G(insulin) were not different (1.88 +/- 0.10 vs. 2.01 +/- 0.09 x 10(-2) min(-1), P = 0.167) and were significantly correlated (r = 0.50, P = 0.002). Thus, insulin sensitivity estimates from both protocols correlate significantly with each other and with the clamp. They are quantitatively discrepant, however, possibly due to differences in the route of insulin delivery saturation of insulin action, and/or tolbutamide-induced proinsulin release. Data obtained from these two MINMOD protocols are not directly comparable, and the same protocol must be used in any single cross-sectional or longitudinal study.