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1 Department of Systems Analysis and Informatics, University of Rome-La Sapienza, Rome, Italy
2 Institute of Systems Analysis and Computer Science, CNR, Rome, Italy
3 Liver Unit, Bambino Gesù Hospital, Rome, Italy
4 Institute of Internal Medicine, Catholic University, Rome, Italy
* To whom correspondence should be addressed. E-mail: salinari{at}dis.uniroma1.it.
There is experimental evidence that a source of fatty acids (FAs) either exogenous or endogenous is necessary to support normal insulin secretion. Therefore, FAs co-modulate the glucose-induced pancreatic insulin secretion. To assess the role of FAs, sixteen morbidly obese non-diabetic patients and healthy volunteers were studied. The controls and the obese subjects, before and after diet-induced weight loss, spent 24 h in a calorimetric chamber, where they consumed standardized meals. Hourly blood samples were drawn from a central venous catheter for the measurement of glucose, C-peptide, and non-esterified fatty acids (NEFA) concentrations. Insulin sensitivity was measured (as the M value) by euglycemic hyperinsulinemic clamp. In the present study we propose a mathematical model, in which insulin secretion rate (ISR) is expressed as a function of both plasma glucose and NEFA concentrations. Model parameters, obtained by fitting the individual experimental data of plasma C-peptide concentration, gave an estimated ISR comparable to that obtained by the deconvolution method. To evaluate the performance of the model in an experimental condition in which incretin effect was minimized, previous data on insulin secretion following a butter load and subsequent hyperglycemic clamp were reanalyzed. This model of nutrient-stimulated insulin secretion is the first attempt to represent in a simple way the interaction glucose-NEFA in the regulation of insulin secretion in the β-cell and explains, at least in part, the "potentiation factor" used in previous models to account for other control factors different from glucose after either an intravenous infusion of glucose or a mixed meal.
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