Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, MN, USA.
Diabet Med. 2013 Jun;30(6):664-70. doi: 10.1111/dme.12189.
Carbohydrate metabolism in humans is regulated by insulin secretion from pancreatic β-cells and glucose disposal by insulin-sensitive tissues. Insulin facilitates glucose utilization in peripheral tissues and suppresses hepatic glucose production. Any defects in insulin action predispose an individual to glucose intolerance and Type 2 diabetes mellitus. Early detection of defects in insulin action could provide opportunities to prevent or delay progression of the disease state. There are different approaches to assess insulin action. Initial methods, such as peripheral insulin concentration and simple indices, have several limitations. Subsequently, researchers developed methodologies using intravenous glucose infusion to determine glucose fluxes. However, these methodologies are limited by being non-physiological. Newer, innovative techniques that have been developed are more sophisticated and physiological. By modelling glucose kinetics using isotope dilution techniques, several robust parameters can be obtained that are physiologically relevant and sound. This brief review summarizes most of the non-physiological and physiological methodologies used to measure the variables of insulin action.
人类的碳水化合物代谢受胰腺β细胞胰岛素分泌和胰岛素敏感组织葡萄糖处置的调节。胰岛素促进外周组织葡萄糖利用，抑制肝葡萄糖生成。任何胰岛素作用的缺陷都会使个体易患葡萄糖耐量受损和 2 型糖尿病。早期发现胰岛素作用的缺陷可能为预防或延迟疾病状态的进展提供机会。有不同的方法来评估胰岛素作用。最初的方法，如外周胰岛素浓度和简单的指数，有几个局限性。随后，研究人员开发了使用静脉内葡萄糖输注来确定葡萄糖通量的方法。然而，这些方法受到非生理的限制。新开发的、创新的技术更加复杂和具有生理意义。通过使用同位素稀释技术对葡萄糖动力学进行建模，可以获得一些与生理相关且合理的稳健参数。本综述总结了大多数用于测量胰岛素作用变量的非生理和生理方法。
