ENDOGENOUS GLUCOSE PRODUCTION DURING AN INTRAVENOUS GLUCOSE TOLERANCE TEST

最近，一种基于二室最小模型的新方法， 解卷积（deconvolution） J.Physiol.264E829-E841，1993; Comp. Meth. Prog. BioMed. 52 147-156，1997）已建议估计 来自标记的IVGTT数据的内源性葡萄糖产生（EGP）。 我们的目标 这里是将该EGP曲线与独立获得 采用参比方法，基于示踪剂与示踪剂比（TTR） 止血钳 胰岛素改良（0.03 U/kg体重输注超过5 分钟）[6，6 - 2 H2]葡萄糖标记的IVGTT（0.33 g/kg葡萄糖）。 在10个正常人中进行。 第二种示踪剂（[U-13 C]葡萄糖） 在测试期间也以可变方式输注，以便夹紧 内源性葡萄糖TTR。 TTR夹非常成功。 作为 结果，根据[U-13 C]葡萄糖数据重建的EGP谱， Steele的模型和Radziuk的模型几乎可以重叠，因此 确认了该方法的基本模型独立性。 的 解卷积获得的EGP曲线，计算自 [6，6 - 2 H2]葡萄糖数据，显示出显着的协议，获得 从TTR夹中取出 这两种配置文件之间的一些差异是 在估计的基础EGP和EGP的初始模式中注意到 抑制作用 还观察到高个体间变异性， 这两种方法在EGP恢复到基线时的差异性是 在恢复的时间和程度上都很高。 最后，我谨指出， 使用IVGTT的两室最小模型， 反卷积允许估计EGP的分布， 与用TTR钳独立获得的结果非常一致。

Recently, a new method based on a two compartment minimal model and deconvolution (Am. J. Physiol. 264 E829-E841, 1993; Comp. Meth. Prog. Biomed. 52 147-156, 1997) has been proposed to estimate endogenous glucose production (EGP) from labeled IVGTT data. Our aim here is to compare this EGP profile with that independently obtained with the reference method, based on the tracer to tracee ratio (TTR) clamp. An insulin modified (0.03 U/kg body weight infused over 5 minutes) [6,6-2H2]glucose labeled IVGTT (0.33 g/kg of glucose) was performed in ten normal subjects. A second tracer ([U-13C]glucose) was also infused during the test in a variable fashion, so as to clamp endogenous glucose TTR. The TTR clamp was quite successful. As a result, the EGP profile reconstructed from [U-13C]glucose data with Steele's and with Radziuk's models were almost superimposable, thus confirming the substantial model-independence of the method. The deconvolution-obtained EGP profile, calcula ted from [6,6-2H2]glucose data, showed remarkable agreement with that obtained from the TTR clamp. Some differences between the two profiles were noted in the estimated basal EGP and in the initial modalities of EGP inhibition. A high interindividual variability was also observed with both methods in the resumption of EGP to baseline; variability was high both in the timing and the extent of resumption. In conclusion, the use of the two compartment minimal model of the IVGTT and deconvolution allows the estimation of a profile of EGP which is in very good agreement with that independently obtained with a TTR clamp.