Measures of β-cell function during the oral glucose tolerance test, liquid mixed-meal test, and hyperglycemic clamp test
Measures of β-cell function during the oral glucose tolerance test, liquid mixed-meal test, and hyperglycemic clamp test
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DOI：
10.1016/j.jpeds.2007.11.044
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发表时间：
2008-05-01
影响因子：
5.1
通讯作者：
Arslanian, Silva A.
中科院分区：
文献类型：
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作者：
Bacha, Fida;Gungor, Neslihan;Arslanian, Silva A.
目的 评估源自口服葡萄糖耐量试验 (OGTT) 或混合餐（即 Boost）耐受试验的 β 细胞功能的临床有用测量值，以评估胰岛素分泌，并与金标准、高血糖钳 (Hyper-C) 试验进行比较。研究设计 通过 Hyper-C 测试测量胰岛素分泌。本研究旨在评估 OGTT 的 15 分钟和 30 分钟早期增量胰岛素/葡萄糖反应比率（Delta I-15/Delta G(15) 和 Delta I-30/Delta G(30)）与 Boost 测试与 Hyper-C 测试期间测量的胰岛素分泌（225 mg/dL）之间的相关性。使用C-肽评估相同的指数。共有 26 名儿童（14 名男性，12 名女性；平均年龄，9.9 +/- 0.2 岁；平均体重指数 = 22.1 +/- 1.2 kg/m(2)）接受了 2 小时 Hyper-C 测试 (225 mg/dL) 和 3 小时 OGTT 以及 Boost 测试，测量葡萄糖、胰岛素和 C 肽。 结果 Hvper-C- 和 OGTT 衍生的胰岛素分泌测量结果，15 分钟指数强于 30 分钟胰岛素分泌指数，C 肽水平强于胰岛素水平（第一相 C 肽与 OGTT 和 Boost、Delta C-15/Delta G(15) 相比，r = .7，P < .001）。 结论 在糖耐量正常的儿童中， OGTT 或 Boost 测试 15 分钟后测量的 C 肽而不是胰岛素水平提供了对 β 细胞功能的可靠估计，该功能与 Hyper-C 衍生的胰岛素分泌密切相关。
Objective To evaluate clinically useful measures of beta-cell function derived from the oral glucose tolerance test (OGTT) or mixed-meal (ie, Boost) tolerance test to assess insulin secretion in comparison with the gold standard, the hyperglycemic Clamp (Hyper-C) test.Study design We hypothesized that OGTT/Boost-derived measures are useful estimates of beta-cell function and correlate well with insulin secretion measured by the Hyper-C test. This study was designed to assess the correlation between the ratio of the early incremental insulin/glucose responses at 15 and 30 minutes (Delta I-15/Delta G(15) and Delta I-30/Delta G(30)) of the OGTT and the Boost test with insulin secretion measured during the Hyper-C test (225 mg/dL). The same indices were evaluated using C-peptide. A total of 26 children (14 males, 12 females; mean age, 9.9 +/- 0.2 years; mean body mass index = 22.1 +/- 1.2 kg/m(2)) underwent a 2-hour Hyper-C test (225 mg/dL) and 3-hour OGTT and Boost tests with measurements of glucose, insulin, and C-peptide.Results Correlations between Hvper-C- and OGTT-derived measures of insulin secretion were stronger for the 15-minute index than for the 30-minute index of insulin secretion and stronger for C-peptide levels than for insulin levels (r =.7, P < .001 for first-phase C-peptide vs both OGTT and Boost, Delta C-15/Delta G(15)).Conclusions In children with normal glucose tolerance, C-peptide rather than insulin level measured after 15 minutes of the OGTT or Boost test provides a reliable estimate of beta-cell function that correlates well with Hyper-C-derived insulin secretion.