Coates P A, Ollerton R L, Luzio S D, Ismail I S, Owens D R
Diabetes Research Unit, University of Wales College of Medicine, Cardiff.
Diabetes. 1993 Nov;42(11):1635-41. doi: 10.2337/diab.42.11.1635.
Recent work in healthy subjects, the aged, and subjects with gestational diabetes or drug-induced insulin resistance using minimal model analysis of the tolbutamide-modified frequently sampled intravenous glucose tolerance test suggested that a reduced sampling regimen of 12 time points produced unbiased and generally acceptable estimates of insulin sensitivity (SI) and glucose effectiveness (SG) compared with a full sampling schedule of 30 time points. We have used data from 26 insulin-modified frequently sampled intravenous glucose tolerance tests in 21 subjects with NIDDM to derive and compare estimates of SI and SG from the full sampling schedule (SI(30), SG(30)) with those estimated from the suggested 12 time points (SI(12), SG(12)) and those estimated with the addition of a 25-min time point (SI(13), SG(13)). Percentage relative errors were calculated relative to the corresponding 30 time-point values. A statistically significant bias of 15% (97% confidence interval from 7.4 to 25.6%, interquartile range 25%) was introduced by the estimation of SI(12) but not SI(13) (1%, 97% confidence interval from -9.4 to 9.3%, interquartile range 21%). Results for SG(12) (-12%, 97% confidence interval from -46.7 to 1.2%, interquartile range 49%) and SG(13) (-5%, 97% confidence interval from -27.8 to 6.8%, interquartile range 37%) were statistically equivocal. The precision of estimation of SI(12), SG(12), and SG(13) measured by the interquartile range of the percentage relative errors was poor. The precision of determination measured by the median minimal model coefficient of variation was 18, 29, and 27% for SI(30), SI(12), and SI(13) and 9, 11, and 11% for SG(30), SG(12), and SG(13), respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
最近，针对健康受试者、老年人以及患有妊娠期糖尿病或药物诱导性胰岛素抵抗的受试者，通过对甲苯磺丁脲改良的频繁采样静脉葡萄糖耐量试验进行最小模型分析发现，与30个时间点的完整采样方案相比，12个时间点的简化采样方案能得出无偏差且普遍可接受的胰岛素敏感性（SI）和葡萄糖有效性（SG）估计值。我们使用了21名非胰岛素依赖型糖尿病（NIDDM）受试者的26次胰岛素改良频繁采样静脉葡萄糖耐量试验数据，来推导并比较完整采样方案（SI(30)，SG(30)）、建议的12个时间点（SI(12)，SG(12)）以及增加一个25分钟时间点（SI(13)，SG(13)）所估计的SI和SG。计算相对于相应30个时间点值的相对误差百分比。SI(12)的估计引入了15%的统计学显著偏差（97%置信区间为7.4%至25.6%，四分位间距为25%），而SI(13)没有（1%，97%置信区间为-9.4%至9.3%，四分位间距为21%）。SG(12)（-12%，97%置信区间为-46.7%至1.2%，四分位间距为49%）和SG(13)（-5%，97%置信区间为-27.8%至6.8%，四分位间距为37%）的结果在统计学上不明确。通过相对误差百分比的四分位间距衡量，SI(12)、SG(12)和SG(13)的估计精度较差。通过中位数最小模型变异系数衡量的测定精度，SI(30)、SI(12)和SI(13)分别为18%、29%和27%，SG(30)、SG(12)和SG(13)分别为9%、11%和11%。（摘要截于250字）
