Beard J C, Bergman R N, Ward W K, Porte D
Diabetes. 1986 Mar;35(3):362-9. doi: 10.2337/diab.35.3.362.
Although the minimal-model-based insulin sensitivity index (S1) can be estimated from the results of a simple 180-min intravenous glucose tolerance test (IVGTT), its relationship to widely accepted but technically more difficult clamp-based techniques has not been resolved in humans. Therefore we measured S1 by standard IVGTT, modified IVGTT, and clamp methods in 10 nondiabetic men with %IBW of 109 +/- 12 (mean +/- SD). In the euglycemic clamp studies, insulin was infused to bring insulin levels (IRI) from basal, 8 +/- 4 microU/ml, to plateaus of 21 +/- 5 and 35 +/- 6 microU/ml. S1[clamp], measured as the increase in glucose (G) clearance per increase in IRI [delta INF/(delta IRI X G)], averaged 0.29 +/- 0.09 ml/kg X min per microU/ml. In the IVGTT studies, 300 mg/kg G was given as an i.v. bolus, and G and IRI were measured for 180 min; in the modified (mod) IVGTT, tolbutamide (300-500 mg) was given i.v. 20 min after the G to observe the effect of an IRI peak on G removal after G level was free of initial "mixing" effects. The S1 estimated by computer did not differ significantly between standard [(6.9 +/- 3.4) X 10(-4) min-1 per microU/ml] and modified [(6.7 +/- 3.5) X 10(-4) min-1 per microU/ml] tests, indicating no bias due to the differing insulin patterns and levels. There was a strong positive correlation between S1 (mod IVGTT) and S1(clamp): r = 0.84; N = 10; P less than 0.002. The correlation between S1(standard IVGTT) and S1(clamp) was 0.54, suggesting the modified test is less "noisy." Nonetheless, in eight euglycemic women with a wider range of adiposity, S1(standard IVGTT) has been significantly correlated with %IBW (r = -0.72) and basal IRI (r = -0.84). The correlation between S1 measures by clamp and IVGTT methods provides one step toward validation of the minimal model for studies of insulin action in man.
尽管基于最小模型的胰岛素敏感性指数（S1）可通过简单的180分钟静脉葡萄糖耐量试验（IVGTT）结果进行估算，但其与广泛接受但技术上更复杂的钳夹技术之间的关系在人体中尚未明确。因此，我们采用标准IVGTT、改良IVGTT和钳夹方法，对10名体重百分比（%IBW）为109±12（均值±标准差）的非糖尿病男性进行了S1测量。在正常血糖钳夹研究中，输注胰岛素使胰岛素水平（IRI）从基础值8±4微单位/毫升升至平台期的21±5微单位/毫升和35±6微单位/毫升。以每单位IRI增加时葡萄糖（G）清除率的增加量[δINF/(δIRI×G)]来衡量的S1[钳夹]，平均为0.29±0.09毫升/千克×分钟/微单位/毫升。在IVGTT研究中，静脉推注给予300毫克/千克的G，并测量180分钟内的G和IRI；在改良（mod）IVGTT中，在给予G后20分钟静脉注射甲苯磺丁脲（300 - 500毫克），以观察在G水平消除初始“混合”效应后IRI峰值对G清除的影响。计算机估算的标准试验[(6.9±3.4)×10⁻⁴分钟⁻¹/微单位/毫升]和改良试验[(6.7±3.5)×10⁻⁴分钟⁻¹/微单位/毫升]之间的S1无显著差异，表明胰岛素模式和水平不同并无偏差。S1（改良IVGTT）与S1（钳夹）之间存在强正相关：r = 0.84；N = 10；P < 0.002。S1（标准IVGTT）与S1（钳夹）之间的相关性为0.54，表明改良试验的“噪声”较小。尽管如此，在8名肥胖程度范围更广的正常血糖女性中，S1（标准IVGTT）与%IBW（r = -0.72）和基础IRI（r = -0.84）显著相关。钳夹法和IVGTT法测量的S1之间的相关性为在人体胰岛素作用研究中验证最小模型迈出了一步。
