Dalla Man Chiara, Yarasheski Kevin E, Caumo Andrea, Robertson Heather, Toffolo Gianna, Polonsky Kenneth S, Cobelli Claudio
Dept. of Information Engineering, University of Padova, Via Gradenigo 6/B, I-35131 Padua, Italy.
Am J Physiol Endocrinol Metab. 2005 Dec;289(6):E954-9. doi: 10.1152/ajpendo.00076.2005. Epub 2005 Jul 12.
Measuring insulin sensitivity in the presence of physiological changes in glucose and insulin concentrations, e.g., during a meal or OGTT, is important to better understand insulin resistance in a variety of metabolic conditions. Recently, two oral minimal models have been proposed to measure overall insulin sensitivity (S(I)) and its selective effect on glucose disposal (S(I)) from oral tests. S(I) and S(I) have been successfully validated against multiple tracer meal estimates, but validation against euglycemic hyperinsulinemic clamp estimates is lacking. Here, we do so in 21 subjects who underwent both a multiple-tracer OGTT and a labeled euglycemic hyperinsulinemic clamp. Correlation between minimal-model S(I), S(I) and corresponding clamp estimates S(I)(*clamp), S(I)(*clamp) was satisfactory, respectively r = 0.81, P < 0.001, and r = 0.71, P < 0.001. S(I) was significantly lower than S(I)(clamp) (8.08 +/- 0.89 vs. 13.66 +/- 1.69 10(-4) dl.kg(-1).min(-1) per microU/ml, P = 0.0002), whereas S(I) and S(I)(clamp) were very similar (8.17 +/- 1.59 vs. 8.84 +/- 1.39 10(-4) dl.kg(-1).min(-1) per microU/ml, P = 0.52). These results add credibility to the oral minimal-model method as a simple and reliable physiological tool to estimate S(I) and S(I), also in large-scale clinical trials.
在葡萄糖和胰岛素浓度发生生理变化时（例如在进餐期间或口服葡萄糖耐量试验期间）测量胰岛素敏感性，对于更好地理解各种代谢状况下的胰岛素抵抗至关重要。最近，有人提出了两种口服简易模型，用于通过口服试验测量总体胰岛素敏感性（S(I)）及其对葡萄糖处置的选择性作用（S(I)*）。S(I)和S(I)*已针对多种示踪剂餐估计值成功进行了验证，但缺乏针对正常血糖高胰岛素钳夹估计值的验证。在此，我们对21名同时进行了多示踪剂口服葡萄糖耐量试验和标记的正常血糖高胰岛素钳夹试验的受试者进行了验证。简易模型的S(I)、S(I)与相应钳夹估计值S(I)(*clamp)、S(I)(*clamp)之间的相关性分别令人满意，r = 0.81，P < 0.001，以及r = 0.71，P < 0.001。S(I)显著低于S(I)(clamp)（8.08 +/- 0.89对13.66 +/- 1. .69 10(-4) dl.kg(-1).min(-1) 每微单位/毫升，P = 0.0002），而S(I)和S(I)(*clamp)非常相似（8.17 +/- 1.59对8.84 +/- 1.39 10(-4) dl.kg(-1).min(-1) 每微单位/毫升，P = 0.52）。这些结果为口服简易模型方法作为一种简单可靠的生理工具来估计S(I)和S(I)*增添了可信度，在大规模临床试验中也是如此。
