ESTIMATION OF INSULIN SENSITIVITY AND GLUCOSE CLEARANCE FROM MINIMAL MODEL - NEW INSIGHTS FROM LABELED IVGTT
ESTIMATION OF INSULIN SENSITIVITY AND GLUCOSE CLEARANCE FROM MINIMAL MODEL - NEW INSIGHTS FROM LABELED IVGTT
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DOI：
10.1152/ajpendo.1986.250.5.e591
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发表时间：
1986-05-01
影响因子：
--
通讯作者：
SACCA, L
中科院分区：
文献类型：
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作者：
COBELLI, C;PACINI, G;SACCA, L
葡萄糖消失的“最小模型”提供了静脉内葡萄糖耐量试验（IVGTT）的胰岛素敏感性和葡萄糖有效性的非侵入性估计。然而，该模型不允许葡萄糖生产与利用分离。为了克服这一局限性，将标记葡萄糖与冷葡萄糖一起沿着注射到6只正常狗中，并沿着胰岛素浓度监测冷葡萄糖和标记葡萄糖的时间过程。将修订的最小模型拟合到示踪剂数据以获得胰岛素敏感性的新测量。图形 **。= 6.41 .+-. 0.91 10-4 min-1. cntdot.μ U-1.cntdot. ml-1）和葡萄糖清除率分数。**图形 **。= 0.0092 .+-. 0.0009 min-1）。.**图形 **。与通过肝动脉-静脉差分技术获得的直接测量值进行比较，其得到的值为0.0097 ± 0.0097。0.0002，几乎等同于.**图形 **。从而验证模型估计。当从冷数据中识别原始最小模型时，我们获得SI = 4.52。1.39 SG = 0.042 ± 0.044。0.009. .**图形 **。和 **图形 **。分别与SI和SG不同。特别是SG高估了葡萄糖清除率分数约5倍。修正的最小模型产生葡萄糖处置参数。**图形 **。和 **图形 **。不受胰岛素和葡萄糖抑制葡萄糖产生的混杂效应的影响。标记IVGTT和修订的最小模型克服了冷IVGTT和原始最小模型固有的局限性，同时保持了测试的简单性。
The "minimal model" of glucose disappearance provides noninvasive estimates of insulin sensitivity and glucose effectiveness from an intravenous glucose tolerance test (IVGTT). However, this model does not allow the separation of glucose production from utilization. To overcome this limitation, labeled glucose ws injected along with cold glucose in six normal dogs, and both cold and labeled glucose time courses were monitored along with insulin concentration. A revised minimal model was fitted to tracer data to obtain new measures of insulin sensitivity .**GRAPHIC**. = 6.41 .+-. 0.91 10-4 min-1 .cntdot. .mu.U-1 .cntdot. ml-1) and fractional glucose clearance .**GRAPHIC**. = 0.0092 .+-. 0.0009 min-1). .**GRAPHIC**. was compared with a direct measure obtained by a hepatic arterial-venous difference technique, which yielded a value of 0.0097 .+-. 0.0002, virtually idential to .**GRAPHIC**. thereby validating the model estimate. When the original minimal model was identified from cold data, we obtained SI = 4.52 .+-. 1.39 and SG = 0.042 .+-. 0.009. .**GRAPHIC**. and .**GRAPHIC**. were different from SI and SG, respectively. In particular SG overestimates fractional glucose clearance by approximately five times. The revised minimal model yields glucose disposal parameters .**GRAPHIC**. and .**GRAPHIC**. that are not affected by the confounding effect of insulin and glucose inhibition of glucose production. Limitations inherent in cold IVGTT and original minimal model are overcome by labeled IVGTT and the revised minimal model, while test simplicity remains.