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静脉胰岛素耐量试验是一种用于筛查普通人群胰岛素抵抗及相关异常情况的准确方法。

The intravenous insulin tolerance test is an accurate method for screening a general population for insulin resistance and related abnormalities.

作者信息

Graci S, Baratta R, Degano C, Luppa A, Vigneri R, Frittitta L, Trischitta V

机构信息

Institute of Internal Medicine, Endocrine and Metabolic Disease, University of Catania, Italy.

出版信息

J Endocrinol Invest. 1999 Jun;22(6):472-5. doi: 10.1007/BF03343592.

Abstract

To verify whether the short intravenous insulin tolerance test (ITT) (a safe, reproducible, inexpensive, rapid and easy to perform measurement of insulin sensitivity) is a suitable test for insulin resistance screening in a general population, we measured in 60 non diabetic subjects, either non-obese (no.=40) or obese (BMI>28, no.=20) the K of glucose disappearance from plasma after ITT (K(ITT)), plasma glucose (PG) and insulin (IRI) both fasting (FPG, FIRI) and at 120 min of OGTT (PG- 120, IRI- 120), and also triglycerides (Tg), cholesterol (Chol) and blood pressure (BP). Subjects were subdivided into quartiles according to K(ITT) values. Average FPG, PG-120, FIRI, IRI-120, Tg and Chol values were progressively increased, and average HDL/Chol was progressively decreased from quartile 1 (the most insulin sensitive) to 4 (the most insulin resistant) (p<0.05, by 1-way ANOVA test). Also BP was increased in the insulin resistant patients, but statistical significance was not reached. Three or more of the studied parameters (FPG and/or PG-120, FIRI and/or IRI-120, Tg, HDL/Chol, mean BP) were altered (below the worst 25 degree percentile) in 64% of subjects from quartile 4; none of the subjects in quartile 1 was affected by such a cluster of alterations. K(ITT) values < or =4.8 identified the cluster of insulin resistance related alterations with an accuracy of 82% (sensitivity=83.3%, specificity=80.5%). In healthy subjects with a wide range of BMI the ITT is a reliable procedure for screening for the cluster of metabolic alterations related to insulin resistance.

摘要

为验证短程静脉胰岛素耐量试验(ITT)(一种安全、可重复、廉价、快速且易于实施的胰岛素敏感性测量方法)是否适用于普通人群的胰岛素抵抗筛查,我们对60名非糖尿病受试者进行了测量,其中非肥胖者(n = 40),肥胖者(BMI>28,n = 20),测量了ITT后血浆葡萄糖消失率(K(ITT))、空腹血浆葡萄糖(PG)和胰岛素(IRI)即空腹血糖(FPG,FIRI)以及口服葡萄糖耐量试验(OGTT)120分钟时的情况(PG - 120,IRI - 120),还测量了甘油三酯(Tg)、胆固醇(Chol)和血压(BP)。根据K(ITT)值将受试者分为四分位数。从第1四分位数(胰岛素最敏感)到第4四分位数(胰岛素抵抗最强),平均FPG、PG - 120、FIRI、IRI - 120、Tg和Chol值逐渐升高,平均高密度脂蛋白胆固醇比值(HDL/Chol)逐渐降低(通过单因素方差分析,p<0.05)。胰岛素抵抗患者的血压也升高,但未达到统计学显著性。在第4四分位数的受试者中,64%的受试者有三个或更多研究参数(FPG和/或PG - 120、FIRI和/或IRI - 120、Tg、HDL/Chol、平均血压)发生改变(低于最差的25百分位数);第1四分位数的受试者均未受此类改变群的影响。K(ITT)值≤4.8识别胰岛素抵抗相关改变群的准确率为82%(敏感性 = 83.3%,特异性 = 80.5%)。在BMI范围广泛的健康受试者中,ITT是筛查与胰岛素抵抗相关的代谢改变群的可靠方法。

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