|
|
||||||||
1 Metabolism Unit of the Consiglio Nazionale delle Ricerche Institute of Clinical Physiology and Department of Internal Medicine, University of Pisa, 56126 Pisa; and 2 Consiglio Nazionale delle Ricerche Institute of Systems Science and Biomedical Engineering, 35127 Padua, Italy
The traditional methods for the
assessment of insulin sensitivity yield only a single index,
not the whole dose-response curve information. This curve is typically
characterized by a maximally insulin-stimulated glucose clearance
(Clmax) and an insulin concentration at half-maximal
response (EC50). We developed an approach for estimating
the whole dose-response curve with a single in vivo test,
based on the use of tracer glucose and exogenous insulin administration
(two steps of 20 and 200 mU · min
1 · m
2,
100 min each). The effect of insulin on plasma glucose clearance was
calculated from non-steady-state data by use of a circulatory model of
glucose kinetics and a model of insulin action in which glucose clearance is represented as a Michaelis-Menten
function of insulin concentration with a delay
(t1/2). In seven nondiabetic subjects, the model
predicted adequately the tracer concentration: the model residuals were
unbiased, and their coefficient of variation was similar to the
expected measurement error (~3%), indicating that the
model did not introduce significant systematic errors. Lean (n = 4) and obese (n = 3) subjects had similar half-times for
insulin action (t1/2 = 25 ± 9 vs. 25 ± 8 min)
and maximal responses (Clmax = 705 ± 46 vs. 668 ± 259 ml · min
1 · m
2,
respectively), whereas EC50 was 240 ± 84 µU/ml in the
lean vs. 364 ± 229 µU/ml in the obese (P < 0.04). EC50 and the insulin sensitivity index (ISI, initial
slope of the dose-response curve), but not Clmax, were
related to body adiposity and fat distribution with r of
0.6-0.8 (P < 0.05). Thus, despite the small number
of study subjects, we were able to reproduce information
consistent with the literature. In addition, among the lean
individuals, t1/2 was positively related to the ISI
(r = 0.72, P < 0.02). We conclude that the
test here presented, based on a more elaborate representation of
glucose kinetics and insulin action, allows a reliable quantitation of
the insulin dose-response curve for whole body glucose utilization in a
single session of relatively short duration.
insulin sensitivity
This article has been cited by other articles:
![]() |
K. A. McAuley, J. I. Mann, J. G. Chase, T. F. Lotz, and G. M. Shaw Point: HOMA Satisfactory for the Time Being: HOMA: The best bet for the simple determination of insulin sensitivity, until something better comes along Diabetes Care, September 1, 2007; 30(9): 2411 - 2413. [Full Text] [PDF] |
||||
![]() |
J. F. Staub, E. Foos, B. Courtin, R. Jochemsen, and A. M. Perault-Staub A nonlinear compartmental model of Sr metabolism. I. Non-steady-state kinetics and model building Am J Physiol Regulatory Integrative Comp Physiol, March 1, 2003; 284(3): R819 - R834. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. Hovorka, F. Shojaee-Moradie, P. V. Carroll, L. J. Chassin, I. J. Gowrie, N. C. Jackson, R. S. Tudor, A. M. Umpleby, and R. H. Jones Partitioning glucose distribution/transport, disposal, and endogenous production during IVGTT Am J Physiol Endocrinol Metab, May 1, 2002; 282(5): E992 - E1007. [Abstract] [Full Text] [PDF] |
||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Visit Other APS Journals Online |