Meneilly G S, Elliott T
Department of Medicine, University of British Columbia, Vancouver, Canada.
J Am Geriatr Soc. 1998 Jan;46(1):88-91. doi: 10.1111/j.1532-5415.1998.tb01019.x.
The euglycemic glucose clamp technique is the gold standard for the measurement of insulin sensitivity in older adults, whereas the hyperglycemic glucose clamp technique is used to assess insulin release. The objective of this study was to evaluate the ability of the hyperglycemic glucose clamp technique to assess insulin sensitivity and insulin release in older people.
Healthy older controls (n = 26, age 72 +/- 1) and older non-insulin-dependent diabetes mellitus (NIDDM) patients (n = 35, age 75 +/- 1) underwent a 2-hour hyperglycemic glucose clamp study (glucose 5.4 mM above basal) and a 3-hour euglycemic clamp study (insulin infusion rate 40 mU/m2/min). The average glucose infusion rate (last 30 minutes) of each clamp was divided by the average insulin value (last 30 minutes). This value was then divided by the average plasma glucose value to give glucose clearance per plasma insulin concentration.
In control subjects (Eug: 0.80 +/- .05 mL/kg/min/pM; Hyper: 0.88 +/- .07 mL/kg/min/pM, P = .357) and NIDDM patients (Eug: 0.48 +/- .03 mL/kg/min/pM; Hyper: 0.42 +/- .03 mL/kg/min/pM, P = .162), glucose clearance values were similar whether calculated from the euglycemic or the hyperglycemic clamp. The correlation between glucose clearance values derived from the euglycemic and hyperglycemic clamp was excellent in normal controls (r = .76, P < .001) and patients with NIDDM (r = .71, P < .001).
We conclude that the hyperglycemic glucose clamp technique can reliably assess both insulin release and insulin sensitivity in older people.
正常血糖葡萄糖钳夹技术是测量老年人胰岛素敏感性的金标准，而高血糖葡萄糖钳夹技术则用于评估胰岛素释放。本研究的目的是评估高血糖葡萄糖钳夹技术评估老年人胰岛素敏感性和胰岛素释放的能力。
健康老年对照组（n = 26，年龄72±1岁）和老年非胰岛素依赖型糖尿病（NIDDM）患者（n = 35，年龄75±1岁）接受了一项2小时的高血糖葡萄糖钳夹研究（血糖比基础值高5.4 mM）和一项3小时的正常血糖钳夹研究（胰岛素输注速率40 mU/m2/min）。将每个钳夹的平均葡萄糖输注速率（最后30分钟）除以平均胰岛素值（最后30分钟）。然后将该值除以平均血浆葡萄糖值，以得出每单位血浆胰岛素浓度的葡萄糖清除率。
在对照组（正常血糖钳夹：0.80±0.05 mL/kg/min/pM；高血糖钳夹：0.88±0.07 mL/kg/min/pM，P = 0.357）和NIDDM患者（正常血糖钳夹：0.48±0.03 mL/kg/min/pM；高血糖钳夹：0.42±0.03 mL/kg/min/pM，P = 0.162）中，无论从正常血糖钳夹还是高血糖钳夹计算，葡萄糖清除率值均相似。正常对照组（r = 0.76，P < 0.001）和NIDDM患者（r = 0.71，P < 0.001）中，正常血糖钳夹和高血糖钳夹得出的葡萄糖清除率值之间的相关性极佳。
我们得出结论，高血糖葡萄糖钳夹技术可以可靠地评估老年人的胰岛素释放和胰岛素敏感性。
