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Am J Physiol Endocrinol Metab 273: E1024-E1032, 1997;
0193-1849/97 $5.00
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Vol. 273, Issue 5, E1024-E1032, November 1997

MODELING IN PHYSIOLOGY
The hot IVGTT two-compartment minimal model: indexes  of glucose effectiveness and insulin sensitivity

Paolo Vicini1, Andrea Caumo2, and Claudio Cobelli1

1 Department of Electronics and Informatics, University of Padova, 35131 Padua; and 2 Scientific Institute San Raffaele, 20132 Milan, Italy

A two-compartment minimal model (2CMM) has been proposed [A. Caumo and C. Cobelli. Am. J. Physiol. 264 (Endocrinol. Metab. 27): E829-E841, 1993] to describe intravenous glucose tolerance test (IVGTT) labeled (hereafter hot) glucose kinetics. This model, at variance with the one-compartment minimal model (1CMM), allows the estimation of a plausible profile of glucose production. The aim of this study is to show that the 2CMM also allows the assessment of insulin sensitivity (S2*I), glucose effectiveness (S2*G), and plasma clearance rate (PCR). The 2CMM was identified on stable-isotope IVGTTs performed in normal subjects (n = 14). Results were (means ± SE) S2*G = 0.85 ± 0.14 ml · kg-1 · min-1, PCR = 2.02 ± 0.14 ml · kg-1 · min-1, and S2*I = 13.83 ± 2.54 × 10-2 ml · kg-1 · min-1 · µU-1 · ml. The 1CMM was also identified; glucose effectiveness and insulin sensitivity indexes were S*GV = 1.36 ± 0.08 ml · kg-1 · min-1 and S*I V = 12.98 ± 2.21 × 10-2 ml · kg-1 · min-1 · µU-1 · ml, respectively, where V is the 1CMM glucose distribution volume. S*GV was lower than PCR and higher than S2*G and did not correlate with either [r = 0.45 (NS) and r = 0.50 (NS), respectively], whereas S*IV was not different from and was correlated with S2*I (r = 0.95; P < 0.001). S*G compares well (r = 0.78; P < 0.001) with PCR normalized by the 2CMM total glucose distribution volume. In conclusion, the 2CMM is a powerful tool to assess glucose metabolism in vivo.

intravenous glucose tolerance test; tracer kinetics; plasma clearance rate


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