[胰岛素耐量试验。一种用于确定肥胖高雄激素女性胰岛素抵抗的有用测试]

[Insulin tolerance test. A useful test to determine insulin resistance in obese hyperandrogenic women].

作者信息

Sin T, Castillo T, Muñoz S, Candia M, López G, Calvillán M

机构信息

Unidad de Endocrinología, Facultad de Medicina, Universidad de Chile, Hospital San Juan de Dios.

出版信息

Rev Med Chil. 1996 Aug;124(8):931-7.

PMID:9196992

Abstract

BACKGROUND

Insulin tolerance test is a simple method to measure insulin resistance that has a good correlation with glucose clamp studies.

AIM

To use the insulin tolerance test to detect differences in insulin sensitivity between healthy and obese hyperandrogenic women and to correlate its results with those of the minimal model intravenous glucose tolerance test.

PATIENTS AND METHODS

Five healthy women aged 27 +/- 7 years old with a body mass index of 21 +/- 2 kg/m2 and six hyperandrogenic women aged 25 +/- 4 years old with a body mass index of 40 +/- 5 kg/m2 were studied after a 10 hours fast. For the insulin tolerance test 0.1 U/kg of crystalline insulin were injected intravenously and blood samples were drawn to measure glucose at -5,0,3,5,10 and 15 min. after the injection. Insulin resistance was calculated using the slope of descending blood glucose levels (SI1). For the intravenous glucose tolerance test, 29 blood glucose samples were obtained after an intravenous injection of 0.3 g glucose/kg followed by an injection of 0.02 U/kg of crystalline insulin. Insulin sensitivity (SI2) was calculated using Bergman's minimal model.

RESULTS

Healthy women had a SI1 of 0.58 (range 0.53-0.63) and a SI2 of 7.9 x 10(-4) x min-1/microU/ml (range 4.15-9.11). For hyperandrogenic women were 0.18 (range 0.06-0.29) and 0.9 x 10(-4) x min-1/microU/ml (range 0.46-1.79), respectively. Both methods had a positive correlation coefficient of 0.859 (p < 0.001).

CONCLUSIONS

Insulin tolerance test is a good method to measure insulin resistance and has a good correlation with the frequently sampled intravenous glucose tolerance test.

摘要

背景

胰岛素耐量试验是一种测量胰岛素抵抗的简单方法，与葡萄糖钳夹试验具有良好的相关性。

目的

使用胰岛素耐量试验检测健康女性与肥胖高雄激素血症女性之间胰岛素敏感性的差异，并将其结果与最小模型静脉葡萄糖耐量试验的结果进行关联。

患者和方法

对5名年龄为27±7岁、体重指数为21±2kg/m²的健康女性和6名年龄为25±4岁、体重指数为40±5kg/m²的高雄激素血症女性进行了10小时禁食后的研究。在胰岛素耐量试验中，静脉注射0.1U/kg的结晶胰岛素，并在注射后-5、0、3、5、10和15分钟采集血样以测量血糖。使用血糖水平下降斜率（SI1）计算胰岛素抵抗。在静脉葡萄糖耐量试验中，静脉注射0.3g葡萄糖/kg后再注射0.02U/kg的结晶胰岛素，然后采集29份血样。使用伯格曼最小模型计算胰岛素敏感性（SI2）。

结果

健康女性的SI1为0.58（范围0.53 - 0.63），SI2为7.9×10⁻⁴×min⁻¹/μU/ml（范围4.15 - 9.11）。高雄激素血症女性的SI1分别为0.18（范围0.06 - 0.29），SI2为0.9×10⁻⁴×min⁻¹/μU/ml（范围0.46 - 1.79）。两种方法的正相关系数为0.859（p < 0.001）。