Bartlette Kai, Carreau Anne-Marie, Xie Danielle, Garcia-Reyes Yesenia, Rahat Haseeb, Pyle Laura, Nadeau Kristen J, Cree-Green Melanie, Diniz Behn Cecilia
Department of Applied Mathematics and Statistics, Colorado School of Mines, Golden, CO, 80401, USA.
Division of Endocrinology, Department of Pediatrics, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, 80045, USA.
Metabol Open. 2021 Jan 7;9:100078. doi: 10.1016/j.metop.2021.100078. eCollection 2021 Mar.
The Oral Minimal Model (OMM), a differential-equations based mathematical model of glucose-insulin dynamics, utilizes data from a frequently sampled oral glucose tolerance test (OGTT) to quantify insulin sensitivity ( ). OMM-based estimates of can detect differences in insulin resistance (IR) across population groups and quantify effects of clinical or behavioral interventions. These estimates of have been validated in healthy adults using data from OGTTs with durations from 2 to 7 h. However, data demonstrating how protocol duration affects estimates in highly IR populations such as adolescents with obesity are limited.
A 6-h frequently sampled OGTT was performed in adolescent females with obesity. Two, 3-, and 4- hour implementations of OMM assuming an exponentially-decaying rate of glucose appearance beyond measured glucose concentrations were compared to the 6-h implementation. A 4- hour OMM implementation with truncated data (4h Tr) was also considered.
Data from 68 participants were included (age 15.8 ± 1.2 years, BMI 35.4 ± 5.6 kg/m). Although values were highly correlated for all implementations, they varied with protocol duration (2h: 2.86 ± 3.31, 3h: 2.55 ± 2.62, 4h: 2.81 ± 2.59, 4h tr: 3.13 ± 3.14, 6h: 3.06 ± 2.85 x 10 dl/kg/min per U/ml). estimates based on 2 or 3 h of data underestimated values, whereas 4-h estimates more closely approximated 6-h values.
These results suggest that OGTT protocol duration should be considered when implementing OMM to estimate in adolescents with obesity and other IR populations.
口服最小模型（OMM）是一种基于微分方程的葡萄糖 - 胰岛素动力学数学模型，它利用频繁采样的口服葡萄糖耐量试验（OGTT）数据来量化胰岛素敏感性（ ）。基于OMM的 估计值能够检测不同人群组之间胰岛素抵抗（IR）的差异，并量化临床或行为干预的效果。这些 估计值已在健康成年人中使用持续时间为2至7小时的OGTT数据得到验证。然而，关于方案持续时间如何影响肥胖青少年等高胰岛素抵抗人群中 估计值的数据有限。
对肥胖青少年女性进行了6小时频繁采样的OGTT。将假设葡萄糖出现速率呈指数衰减（超出测量的葡萄糖浓度）的OMM的两小时、三小时和四小时实施方案与六小时实施方案进行比较。还考虑了具有截断数据的四小时OMM实施方案（4h Tr）。
纳入了68名参与者的数据（年龄15.8±1.2岁，BMI 35.4±5.6 kg/m）。尽管所有实施方案的 值高度相关，但它们随方案持续时间而变化（2小时：2.86±3.31，3小时：2.55±2.62，4小时：2.81±2.59，4小时tr：3.13±3.14，6小时：3.06±2.85 x 10 dl/kg/min per U/ml）。基于2或3小时数据的 估计值低估了 值，而4小时的 估计值更接近6小时的 值。
这些结果表明，在对肥胖青少年和其他胰岛素抵抗人群实施OMM来估计 时，应考虑OGTT方案的持续时间。
