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An empirical index of insulin sensitivity from short IVGTT: validation against the minimal model and glucose clamp indices in patients with different clinical characteristics

På svenska

Author

  • A. Tura
  • S. Sbrignadello
  • E. Succurro
  • Leif Groop
  • G. Sesti
  • G. Pacini

Summary, in English

Aims/hypothesis Minimal model analysis for insulin sensitivity has been validated against the glucose clamp and is an accepted method for estimating insulin sensitivity from IVGTT. However minimal model analysis requires a 3 h test and relevant expertise to run the mathematical model. The aim of this study was to suggest a simple predictor of minimal model analysis index using only 1 h IVGTT. Methods We studied participants with different clinical characteristics who underwent 3 h regular (n=336) or insulin-modified (n=160) IVGTT, or 1 h IVGTT and euglycaemic-hyperinsulinaemic clamp (n=247). Measures of insulin sensitivity were insulin sensitivity index estimated by minimal model analysis ( SI) and the mean glucose infusion rate (clamp) (M). A calculated S-I (CSI) predictor, CSI alpha x K-G/(Delta AUC(INS)/T), was suggested, based on the calculation of the rate of glucose disappearance K-G and the suprabasal AUC of insulin concentration Delta AUC(INS) over T=40 min. For all the participants, a was assumed equal to the regression line slope between K-G/(Delta AUC(INS)/T) and S-I in control participants. Results CSI and S-I showed high correlation (R-2=0.68-0.96) and regression line slopes of approximately one in the majority of groups. CSI tended to overestimate S-I in type 2 diabetic participants, but results were more reliable when CSI was computed with insulin-modified rather than regular IVGTT. CSI showed behaviours similar to S-I as regards relationships with BMI, acute insulin response and sex. CSI showed good correlation with M (R-2=0.82). Conclusions/interpretation A short test can achieve a good approximation of minimal model analysis and clamp insulin sensitivity. The importance of a method such as CSI is that it allows analysis of IVGTT datasets with samples limited to 1 h.

Publishing year

2010

Language

English

Pages

144-152

Publication/Series

Diabetologia

Volume

53

Issue

1

Document type

Journal article

Publisher

Springer

Topic

  • Endocrinology and Diabetes

Keywords

  • Insulin resistance
  • Glucose tolerance
  • Insulin action
  • intravenous glucose tolerance test
  • One hour

Status

Published

Research group

  • Genomics, Diabetes and Endocrinology

ISBN/ISSN/Other

  • ISSN: 1432-0428