Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, ON, Canada.
Diabet Med. 2009 Dec;26(12):1198-203. doi: 10.1111/j.1464-5491.2009.02841.x.
Aims While the disposition index provides a useful measure of B-cell function, its calculation requires the performance of a frequently sampled intravenous glucose tolerance test (FSIVGTT). Recently, the demonstration of a hyperbolic relationship between indices of insulin secretion and insulin sensitivity derived from the oral glucose tolerance test (OGTT) has led to the introduction of two novel OGTT-based measures of B-cell function analogous to the disposition index: (i) the insulin secretion-sensitivity index-2 (ISSI-2) (defined as the ratio of the area-under-the-insulin-curve to the area-under-the-glucose curve, multiplied by the Matsuda index) and (ii) insulinogenic index (IGI)/fasting insulin. However, neither of these two measures has been directly compared with the disposition index. Methods Two hundred and thirteen non-diabetic children (122 boys, 91 girls) underwent both OGTT and FSIVGTT, allowing for the calculation of ISSI-2, IGI/fasting insulin and the disposition index. Results ISS1-2 and IGI/fasting insulin were strongly correlated with each other (r = 0.82, P < 0.0001). Both measures correlated with the disposition index, with ISSI-2 showing a modestly stronger association (ISSI-2: r = 0.24, P = 0.0003; IGI/fasting insulin: r = 0.21, P = 0.0022). Standardized linear regression analyses confirmed that the relationship between log ISSI-2 and the disposition index (standardized regression coefficient = 0.224, P = 0.001) was stronger than that between log IGI/fasting insulin and the disposition index (standardized regression coefficient = 0.166, P = 0.015). Conclusions The OGTT-derived measures ISSI-2 and IGI/fasting insulin exhibit modest correlations with the disposition index. These relationships require further assessment in other patient populations.
目的 尽管胰岛β细胞功能的处置指数提供了一种有用的衡量方法，但它的计算需要进行频繁采样的静脉葡萄糖耐量试验（FSIVGTT）。最近，口服葡萄糖耐量试验（OGTT）衍生的胰岛素分泌和胰岛素敏感性指数之间的双曲线关系的证明，导致了两种类似处置指数的新的基于 OGTT 的胰岛β细胞功能衡量方法的引入：（i）胰岛素分泌-敏感性指数-2（ISSI-2）（定义为胰岛素曲线下面积与血糖曲线下面积的比值，乘以 Matsuda 指数）和（ii）胰岛素原指数（IGI）/空腹胰岛素。然而，这两种方法都没有与处置指数进行直接比较。
方法 213 名非糖尿病儿童（男 122 名，女 91 名）同时进行 OGTT 和 FSIVGTT，允许计算 ISSI-2、IGI/空腹胰岛素和处置指数。
结果 ISS1-2 和 IGI/空腹胰岛素之间具有很强的相关性（r = 0.82，P < 0.0001）。这两种方法都与处置指数相关，其中 ISSI-2 具有稍强的相关性（ISSI-2：r = 0.24，P = 0.0003；IGI/空腹胰岛素：r = 0.21，P = 0.0022）。标准化线性回归分析证实，log ISSI-2 与处置指数之间的关系（标准化回归系数 = 0.224，P = 0.001）强于 log IGI/空腹胰岛素与处置指数之间的关系（标准化回归系数 = 0.166，P = 0.015）。
结论 OGTT 衍生的 ISSI-2 和 IGI/空腹胰岛素与处置指数具有适度的相关性。这些关系需要在其他患者群体中进一步评估。
