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短胰岛素耐量试验的可重复性

Reproducibility of the short insulin tolerance test.

作者信息

Hirst S, Phillips D I, Vines S K, Clark P M, Hales C N

机构信息

Metabolic Programming Group, Southampton General Hospital, UK.

出版信息

Diabet Med. 1993 Nov;10(9):839-42. doi: 10.1111/j.1464-5491.1993.tb00176.x.

Abstract

The short insulin tolerance test is a simple method of estimating insulin resistance by measuring the rate of fall of blood glucose following the intravenous administration of insulin. To determine its reproducibility, 18 healthy subjects underwent duplicate insulin tolerance tests separated by at least 1 week. Intravenous insulin (0.05 units kg-1) was administered into an antecubital vein and arterialized venous samples were obtained from a retrogradely cannulated vein on the dorsum of the hand on the same side. The test was terminated with an intravenous glucose injection 15 min after the administration of insulin. The mean whole blood glucose concentration fell from 4.6 mmol l-1 to 2.8 mmol l-1 while plasma insulin concentrations rose to supraphysiological levels and declined exponentially. The glucose disappearance rate (Kitt) calculated from the slope of the fall in log transformed blood glucose between 3 and 15 min after insulin injection ranged from 2.1 to 6.5 (mean 4.4) % min-1 during the first visit and 1.7 to 7.4 (mean 4.4) % min-1 during the second. The ratio of the within-subject to between-subject variance of the test was 0.24, the within-subject coefficient of variation was 13% and the between-subject coefficient of variation 26%. The short insulin tolerance test is reproducible and could be used to measure insulin resistance in large-scale epidemiological studies.

摘要

短胰岛素耐量试验是一种通过测量静脉注射胰岛素后血糖下降速率来评估胰岛素抵抗的简单方法。为确定其可重复性,18名健康受试者接受了至少间隔1周的两次重复胰岛素耐量试验。将静脉胰岛素(0.05单位/千克)注入肘前静脉,并从同侧手背逆行插管的静脉采集动脉化静脉血样。胰岛素注射15分钟后静脉注射葡萄糖终止试验。全血葡萄糖平均浓度从4.6毫摩尔/升降至2.8毫摩尔/升,而血浆胰岛素浓度升至超生理水平并呈指数下降。根据胰岛素注射后3至15分钟对数转换血糖下降斜率计算的葡萄糖消失率(Kitt)在首次试验期间为2.1至6.5(平均4.4)%/分钟,第二次试验期间为1.7至7.4(平均4.4)%/分钟。该试验的受试者内变异与受试者间变异之比为0.24,受试者内变异系数为13%,受试者间变异系数为26%。短胰岛素耐量试验具有可重复性,可用于大规模流行病学研究中测量胰岛素抵抗。

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