Lin Jiunn-Diann, Hseih Chang Hsun, Liu Chuan Chieh, Lian Wei-Cheng, Wu Chung-Ze, Hsu Chun-Hsien, Pei Dee, Hsia Te-Lin, Chen Yen-Lin
Division of Endocrinology, Department of Internal Medicine, Shuang Ho Hospital, School of Medicine, Taipei Medical University, Taipei, ROC.
Endocr J. 2014;61(8):789-96. doi: 10.1507/endocrj.ej13-0510. Epub 2014 May 28.
Decreased insulin sensitivity (IS) and impaired insulin secretion are major pathological features of type 2 diabetes (T2DM). The product of these factors is the disposition index (DI). We aimed to develop an equation for predicting DI. We enrolled 167 participants in our study. We randomly assigned 126 (75%) of the participants to the study group, whose data would be used to build the equation for estimating the DI. The remaining 41 participants comprised the external validation group. A frequently sampled intravenous glucose-tolerance test was performed for all participants, and the IS, the glucose sensitivity, the acute insulin response to the glucose load, and the DI were determined. Three factors were selected from multiple linear regression analysis, and we constructed the equation log (DI) = 2.449 - 0.113 × fasting plasma glucose + 0.046 × body mass index - 0.612 × high-density lipoprotein cholesterol. Using this equation, the calculated log (DI) significantly correlated with the measured log (DI) in the external validation group (r = 0.428, p = 0.007). By using the equation based on the demographic data and measurements of metabolic syndrome components, the DI could be predicted with acceptable accuracy (r = 0.428). Because of the relationships between the MetS and demographic parameters, this method of predicting DI may help further clinicians' understanding of the underlying pathological mechanisms in T2DM.
胰岛素敏感性(IS)降低和胰岛素分泌受损是2型糖尿病(T2DM)的主要病理特征。这些因素的乘积就是处置指数(DI)。我们旨在建立一个预测DI的方程。我们招募了167名参与者进行研究。我们将126名(75%)参与者随机分配到研究组,其数据将用于构建估算DI的方程。其余41名参与者组成外部验证组。对所有参与者进行了频繁采样的静脉葡萄糖耐量试验,并测定了IS、葡萄糖敏感性、对葡萄糖负荷的急性胰岛素反应和DI。从多元线性回归分析中选择了三个因素,我们构建了方程log(DI)=2.449 - 0.113×空腹血糖 + 0.046×体重指数 - 0.612×高密度脂蛋白胆固醇。使用这个方程,在外部验证组中计算得到的log(DI)与测量得到的log(DI)显著相关(r = 0.428,p = 0.007)。通过使用基于人口统计学数据和代谢综合征组分测量值的方程,可以以可接受的准确性预测DI(r = 0.428)。由于代谢综合征与人口统计学参数之间的关系,这种预测DI的方法可能有助于临床医生进一步了解T2DM的潜在病理机制。