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Am J Physiol Endocrinol Metab (October 1, 2002). doi:10.1152/ajpendo.00499.2001
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Articles in PresS, published online ahead of print October 1, 2002
Am J Physiol Endocrinol Metab, 10.1152/ajpendo.00499.2001
Submitted on November 6, 2001
Accepted on September 27, 2002

THE HOT IVGTT TWO-COMPARTMENT MINIMAL MODEL: AN IMPROVED VERSION

Gianna Toffolo1 and Claudio Cobelli1*

1 Department of Information Engineering, University of Padova, Padova, Italy

* To whom correspondence should be addressed. E-mail: cobelli{at}dei.unipd.it.

The two-compartment minimal model (2CMM) interpretation of a labelled IVGTT is a powerful tool to assess glucose metabolism in a single individual. It has been reported that a derived 2CMM parameter describing the proportional effect of glucose on insulin-independent glucose disposal can take physiologically unplausible negative values. In addition, precision of 2CMM parameter estimates is sometimes not satisfactory. Here we resolve the above issues by presenting an improved version of 2CMM which relies on a new assumption on the constant component Rd0 of insulin-independent glucose disposal. Here Rd0 is not fixed to 1mgkg-1 min-1 but instead is expressed as a fraction of steady state glucose disposal. The new 2CMM is identified on the same stable labelled IVGTT data base on which the original 2CMM was formulated. A more reliable insulin-independent glucose disposal portrait is obtained while that of insulin action remains unchanged. The new 2CMM also improves the precision with which model parameters and metabolic indexes are estimated.




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