[Measurement of insulin sensitivity using the somatostatin-insulin-glucose test. Importance of the determination of plasma free fatty acids and insulin clearance].
Insulin sensitivity was determined in normal subjects and in subjects with possible insulin-resistance by simultaneous infusion of somatostatin, insulin and glucose. C peptide, growth hormone and glucagon were decreased by somatostatin in all subjects. Steady-state blood glucose was 2.84 mM (mean) in normal subjects and between 11 and 15 mM in the other subjects (p less than 0.01), indicating severe insulin resistance. Steady state plasma insulin was 50 mU/l (mean) in control subjects, but was markedly lower in one of the subjects with insulin-resistance and higher in the other two subjects, suggesting abnormalities in insulin clearance in these subjects. An index of insulin sensitivity taking into account these variable insulin levels was decreased in the insulin-resistant subjects (21 to 61, vs 117 to 251; p less than 0.01). Insulin-resistant subjects had increased basal levels of plasma free fatty acids (p less than 0.01) which failed to decrease during the test as in control subjects, suggesting abnormal metabolic regulation. In contrast, blood ketone bodies were normal in the basal state and decreased similarly in all subjects during the test, suggesting that hepatic ketogenesis does not resist to insulin.
D000328:Adult; D000368:Aged; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D005934:Glucagon / Q000097:blood; D005947:Glucose; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D010477:Perfusion; D013004:Somatostatin
D005230:Fatty Acids, Nonesterified; D007328:Insulin; D013004:Somatostatin; D005934:Glucagon; D005947:Glucose
Measure de la sensibilité à l'insuline par le test somatostatine-insuline-glucose. Intérêt de la mesure des acides gras libres plasmatiques et de la clairance de l'insuline.