ENDOGENOUS GLUCOSE PRODUCTION DURING AN INTRAVENOUS GLUCOSE TOLERANCE TEST

最近，一种基于两室最小模型的新方法 和反褶积(Am.J.Physiol.264 E829-E841,1993；比较冰毒。 程序。生物医学。52147-156,1997)已被提议估计 来自标记的IVGTT数据的内源性葡萄糖产生(EGP)。我们的目标 下面是将该EGP配置文件与独立获得的配置文件进行比较 在参考方法中，基于示踪剂与被示踪物的比率(TTR) 夹子。改良胰岛素(0.03U/kg体重输注超过5 分钟)[6，6-2H2]葡萄糖标记的IVGTT(0.33g/kg葡萄糖)为 对10名正常受试者进行了测试。第二种示踪剂([U-13C]葡萄糖) 在测试过程中也以可变的方式注入，以便夹住 内源性葡萄糖TTR.Ttr夹相当成功。作为一名 结果，根据[U-13C]葡萄糖数据重建的EGP图谱 斯蒂尔和拉德齐克的模型几乎是可重叠的，因此 证实了该方法的实质模型无关性。这个 反褶积获得的EGP剖面，计算自 [6，6-2H2]葡萄糖数据与所获得的数据非常一致 从TTR夹具上取下。这两个配置文件之间的一些差异是 在估计的基本EGP和最初的EGP模式中注明 抑制力。还观察到了高度的个体间变异性 两种方法的EGP均恢复到基线水平；变异性均为 在恢复的时机和程度上都很高。总之， IVGTT和VGTT两室模型的应用 反褶积允许估计EGP的分布 与用TTR钳独立获得的结果非常吻合。

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.