Krudys Kevin M, Greenbaum Carla J, Pihoker Catherine, Vicini Paolo
Department of Bioengineering, Resource Facility for Population Kinetics, University of Washington, PO Box 355061, Seattle, WA 98195, USA.
Metabolism. 2008 Apr;57(4):445-7. doi: 10.1016/j.metabol.2007.10.001.
Insulin resistance plays an important role during various stages of the type 1 diabetes mellitus disease process. Unfortunately, many of the techniques used to measure insulin sensitivity are experimentally laborious and time-consuming and are thus impractical for larger clinical and population studies. Therefore, in this study, we obtain estimates of insulin sensitivity from a simpler experiment, the oral glucose tolerance test (OGTT), and compare them with those from a frequently sampled intravenous glucose tolerance test (FSIGT) in a population of subjects defined as having early type 1 diabetes mellitus (abnormal 2-hour glucose on OGTT) and a group of healthy controls. A total of 19 subjects were studied. Eight antibody-positive first- or second-degree relatives of patients with type 1 diabetes mellitus and 11 healthy controls underwent both a 3-hour OGTT and an insulin-modified FSIGT on separate days. Indices of insulin sensitivity (SI) were estimated from the recently derived oral glucose minimal model and the original minimal model of glucose kinetics for the OGTT and FSIGT, respectively. Estimates of SI from the OGTT correlated closely with those from the FSIGT in both early type 1 diabetes mellitus (rs=0.76, P = .04) and healthy control (rs = 0.67, P = .03) populations. This preliminary study demonstrates the usefulness of OGTT-derived estimates of insulin sensitivity in an early type 1 diabetes mellitus population. Given the simplicity of the OGTT relative to the traditional methods of measuring SI, the oral glucose minimal model may be appropriate for large population studies and clinical trials.
胰岛素抵抗在1型糖尿病疾病进程的各个阶段都起着重要作用。不幸的是，许多用于测量胰岛素敏感性的技术在实验上既费力又耗时，因此对于更大规模的临床和人群研究来说并不实用。因此，在本研究中，我们从一个更简单的实验——口服葡萄糖耐量试验（OGTT）中获得胰岛素敏感性的估计值，并将其与一组被定义为患有早期1型糖尿病（OGTT两小时血糖异常）的受试者以及一组健康对照者通过频繁采样静脉葡萄糖耐量试验（FSIGT）获得的估计值进行比较。总共研究了19名受试者。8名1型糖尿病患者的抗体阳性一级或二级亲属以及11名健康对照者在不同日期分别进行了3小时的OGTT和胰岛素改良FSIGT。分别从最近推导的口服葡萄糖最小模型和葡萄糖动力学原始最小模型中估计OGTT和FSIGT的胰岛素敏感性指数（SI）。在早期1型糖尿病患者群体（rs = 0.76，P = 0.04）和健康对照者群体（rs = 0.67，P = 0.03）中，OGTT得出的SI估计值与FSIGT得出的估计值密切相关。这项初步研究证明了OGTT得出的胰岛素敏感性估计值在早期1型糖尿病患者群体中的有用性。鉴于OGTT相对于传统SI测量方法的简便性，口服葡萄糖最小模型可能适用于大规模人群研究和临床试验。
