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Am J Physiol Endocrinol Metab 280: E2-E10, 2001;
0193-1849/01 $5.00
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Vol. 280, Issue 1, E2-E10, January 2001

Quantitative indexes of beta -cell function during graded up&down glucose infusion from C-peptide minimal models

Gianna Toffolo1, Elena Breda1, Melissa K. Cavaghan2, David A. Ehrmann2, Kenneth S. Polonsky3, and Claudio Cobelli1

1 Department of Electronics and Informatics, University of Padova, 35131 Padova, Italy; 2 Department of Medicine, The University of Chicago, Chicago, Illinois 60637; and 3 Department of Medicine, Washington University School of Medicine, St Louis, Missouri 63110

Availability of quantitative indexes of insulin secretion is important for definition of the alterations in beta -cell responsivity to glucose associated with different physiopathological states. This is presently possible by using the intravenous glucose tolerance test (IVGTT) in conjunction with the C-peptide minimal model. However, the secretory response to a more physiological slowly increasing/decreasing glucose stimulus may uncover novel features of beta -cell function. Therefore, plasma C-peptide and glucose data from a graded glucose infusion protocol (seven 40-min periods of 0, 4, 8, 16, 8, 4, and 0 mg · kg-1 · min-1) in eight normal subjects were analyzed by use of a new model of insulin secretion and kinetics. The model assumes a two-compartment description of C-peptide kinetics and describes the stimulatory effect on insulin secretion of both glucose concentration and the rate at which glucose increases. It provides in each individual the insulin secretion profile and three indexes of pancreatic sensitivity to glucose: Phi s, Phi d, and Phi b, related, respectively, to the control of insulin secretion by the glucose level (static control), the rate at which glucose increases (dynamic control), and basal glucose. Indexes (means ± SE) were Phi s = 18.8 ± 1.8 (109 min-1), Phi d = 222 ± 30 (109), and Phi b = 5.2 ± 0.4 (109 min-1). The model also allows one to quantify the beta -cell times of response to increasing and decreasing glucose stimulus, equal to 5.7 ± 2.2 (min) and 17.8 ± 2.0 (min), respectively. In conclusion, the graded glucose infusion protocol, interpreted with a minimal model of C-peptide secretion and kinetics, provides a quantitative assessment of pancreatic function in an individual. Its application to various physiopathological states should provide novel insights into the role of insulin secretion in the development of glucose intolerance.

insulin secretion; beta -cell sensitivity; mathematical model; kinetics


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