Insulin sensitivity by oral glucose minimal models: validation against clamp.
Measuring insulin sensitivity in the presence of physiological changes in glucose and insulin concentrations, e.g., during a meal or OGTT, is important to better understand insulin resistance in a variety of metabolic conditions. Recently, two oral minimal models have been proposed to measure overall insulin sensitivity (S(I)) and its selective effect on glucose disposal (S(I)*) from oral tests. S(I) and S(I)* have been successfully validated against multiple tracer meal estimates, but validation against euglycemic hyperinsulinemic clamp estimates is lacking. Here, we do so in 21 subjects who underwent both a multiple-tracer OGTT and a labeled euglycemic hyperinsulinemic clamp. Correlation between minimal-model S(I), S(I) and corresponding clamp estimates S(I)(*clamp), S(I)(*clamp) was satisfactory, respectively r = 0.81, P < 0.001, and r = 0.71, P < 0.001. S(I) was significantly lower than S(I)(clamp) (8.08 +/- 0.89 vs. 13.66 +/- 1.69 10(-4) dl.kg(-1).min(-1) per microU/ml, P = 0.0002), whereas S(I) and S(I)(*clamp) were very similar (8.17 +/- 1.59 vs. 8.84 +/- 1.39 10(-4) dl.kg(-1).min(-1) per microU/ml, P = 0.52). These results add credibility to the oral minimal-model method as a simple and reliable physiological tool to estimate S(I) and S(I)*, also in large-scale clinical trials.
Dalla Man
Chiara
C
Dept. of Information Engineering, University of Padova, Via Gradenigo 6/B, I-35131 Padua, Italy.
Yarasheski
Kevin E
KE
Caumo
Andrea
A
Robertson
Heather
H
Toffolo
Gianna
G
Polonsky
Kenneth S
KS
Cobelli
Claudio
C
D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D005260:Female; D015309:Glucose Clamp Technique; D018149:Glucose Intolerance; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood* / Q000494:pharmacology*; D008297:Male; D008433:Mathematics; D008954:Models, Biological; D015203:Reproducibility of Results
D001786:Blood Glucose; D007328:Insulin