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使用从最小模型分析获得的代理变量和参考五分位数来测定马的胰岛素敏感性和胰腺β细胞反应性。

Use of proxies and reference quintiles obtained from minimal model analysis for determination of insulin sensitivity and pancreatic beta-cell responsiveness in horses.

作者信息

Treiber Kibby H, Kronfeld David S, Hess Tanja M, Boston Ray C, Harris Pat A

机构信息

Department of Animal and Poultry Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061-0306, USA.

出版信息

Am J Vet Res. 2005 Dec;66(12):2114-21. doi: 10.2460/ajvr.2005.66.2114.

Abstract

OBJECTIVE

To develop proxies calculated from basal plasma glucose and insulin concentrations that predict insulin sensitivity (SI; L.min(-1) x mU(-1)) and beta-cell responsiveness (ie, acute insulin response to glucose [AIRg]; mU/L x min(-1)) and to determine reference quintiles for these and minimal model variables.

ANIMALS

1 laminitic pony and 46 healthy horses.

PROCEDURE

Basal plasma glucose (mg/dL) and insulin (mU/L) concentrations were determined from blood samples obtained between 8:00 AM and 9:00 AM. Minimal model results for 46 horses were compared by equivalence testing with proxies for screening SI and pancreatic beta-cell responsiveness in humans and with 2 new proxies for screening in horses (ie, reciprocal of the square root of insulin [RISQI] and modified insulin-to-glucose ratio [MIRG]).

RESULTS

Best predictors of SI and AIRg were RISQI (r = 0.77) and MIRG (r = 0.75) as follows: SI = 7.93(RISQI) - 1.03 and AIRg = 70.1(MIRG) - 13.8, where RISQI equals plasma insulin concentration(-0.5) and MIRG equals [800 - 0.30(plasma insulin concentration 50)(2)]/(plasma glucose concentration - 30). Total predictive powers were 78% and 80% for RISQI and MIRG, respectively. Reference ranges and quintiles for a population of healthy horses were calculated nonparametrically.

CONCLUSIONS AND CLINICAL RELEVANCE

Proxies for screening SI and pancreatic beta-cell responsiveness in horses from this study compared favorably with proxies used effectively for humans. Combined use of RISQI and MIRG will enable differentiation between compensated and uncompensated insulin resistance. The sample size of our study allowed for determination of sound reference range values and quintiles for healthy horses.

摘要

目的

开发根据基础血浆葡萄糖和胰岛素浓度计算得出的指标,以预测胰岛素敏感性(SI;L·min⁻¹·mU⁻¹)和β细胞反应性(即对葡萄糖的急性胰岛素反应[AIRg];mU/L·min⁻¹),并确定这些指标及最小模型变量的参考五分位数。

动物

1匹患蹄叶炎的小马和46匹健康马匹。

方法

从上午8:00至9:00采集的血样中测定基础血浆葡萄糖(mg/dL)和胰岛素(mU/L)浓度。通过等效性检验,将46匹马的最小模型结果与用于筛查人类胰岛素敏感性和胰腺β细胞反应性的指标以及两种用于马匹筛查的新指标(即胰岛素平方根倒数[RISQI]和改良胰岛素与葡萄糖比值[MIRG])进行比较。

结果

SI和AIRg的最佳预测指标分别为RISQI(r = 0.77)和MIRG(r = 0.75),如下所示:SI = 7.93(RISQI) - 1.03,AIRg = 70.1(MIRG) - 13.8,其中RISQI等于血浆胰岛素浓度⁻⁰·⁵,MIRG等于[800 - 0.30(血浆胰岛素浓度⁵⁰)²]/(血浆葡萄糖浓度 - 30)。RISQI和MIRG的总预测能力分别为78%和80%。采用非参数方法计算了健康马群的参考范围和五分位数。

结论及临床意义

本研究中用于筛查马匹胰岛素敏感性和胰腺β细胞反应性的指标与有效用于人类的指标相比具有优势。联合使用RISQI和MIRG将能够区分代偿性和失代偿性胰岛素抵抗。我们研究的样本量允许确定健康马匹合理的参考范围值和五分位数。

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