Assessment of β-cell function in humans, simultaneously with insulin sensitivity and hepatic extraction, from intravenous and oral glucose tests

被引:246
作者
Cobelli, Claudio
Toffolo, Gianna Maria
Dalla Man, Chiara
Campioni, Marco
Denti, Paolo
Caumo, Andrea
Butler, Peter
Rizza, Robert
机构
[1] Univ Padua, Dept Informat Engn, I-35131 Padua, Italy
[2] Ist Sci San Raffaele, I-20132 Milan, Italy
[3] Univ Calif Los Angeles, David Geffen Sch Med, Larry Hillblom Islet Res Ctr, Los Angeles, CA USA
[4] Mayo Clin & Mayo Fdn, Dept Internal Med, Div Endocrinol Diabet Metab & Nutr, Rochester, MN 55905 USA
来源
AMERICAN JOURNAL OF PHYSIOLOGY-ENDOCRINOLOGY AND METABOLISM | 2007年 / 293卷 / 01期
关键词
glucose tolerance; disposition index; oral glucose tolerance test; meal; intravenous glucose tolerance test;
D O I
10.1152/ajpendo.00421.2006
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Assessment of insulin secretion in humans under physiological conditions has been a challenge because of its complex interplay with insulin action and hepatic insulin extraction. The possibility of simultaneously assessing P-cell function, insulin sensitivity, and hepatic insulin extraction under physiological conditions using a simple protocol is appealing, since it has the potential to provide novel insights regarding the regulation of fasting and postprandial glucose metabolism in diabetic and nondiabelie humans. In this Perspective, we review data indicating that an oral glucose tolerance test (OGTT) or a meal test is able to accomplish this goal when interpreted with the oral P-cell minimal model. We begin by using the well-established intravenous minimal model to highlight how the oral minimal model was developed and how the oral assessment parallels that of an intravenous glucose tolerance test (IVGTT). We also point out the unique aspects of both approaches in relation to their ability to assess different aspects of the P-cell secretory cascade. We review the ability of the oral model to concurrently measure insulin sensitivity and hepatic insulin extraction, thereby enabling it to quantitatively portray the complex relationship among P-cell function, hepatic insulin extraction, and insulin action. In addition, data from 204 individuals (54 young and 159 elderly) who underwent both IVGTT and meal tolerance tests are used to illustrate how these different approaches provide complementary but differing insights regarding the regulation of P-cell function in humans.
引用
收藏
页码:E1 / E15
页数:15
相关论文
共 64 条
[1]   A subset of 50 secretory granules in close contact with L-type Ca2+ channels accounts for first-phase insulin secretion in mouse β-cells [J].
Barg, S ;
Eliasson, L ;
Renström, E ;
Rorsman, P .
DIABETES, 2002, 51 :S74-S82
[2]   Two years of treatment with dehydroepiandrosterone does not improve insulin secretion, insulin action, or postprandial glucose turnover in elderly men or women [J].
Basu, Rita ;
Dalla Man, Chiara ;
Campioni, Marco ;
Basu, Ananda ;
Nair, K. Sree ;
Jensen, Michael D. ;
Khosla, Sundeep ;
Klee, George ;
Toffolo, Gianna ;
Cobelli, Claudio ;
Rizza, Robert A. .
DIABETES, 2007, 56 (03) :753-766
[3]   Effects of age and sex on postprandial glucose metabolism - Differences in glucose turnover, insulin secretion, insulin action, and hepatic insulin extraction [J].
Basu, Rita ;
Man, Chiara Dalla ;
Campioni, Marco ;
Basu, Ananda ;
Klee, George ;
Toffolo, Gianna ;
Cobelli, Claudio ;
Rizza, Robert A. .
DIABETES, 2006, 55 (07) :2001-2014
[4]   QUANTITATIVE ESTIMATION OF INSULIN SENSITIVITY [J].
BERGMAN, RN ;
IDER, YZ ;
BOWDEN, CR ;
COBELLI, C .
AMERICAN JOURNAL OF PHYSIOLOGY, 1979, 236 (06) :E667-E677
[5]   PHYSIOLOGIC EVALUATION OF FACTORS CONTROLLING GLUCOSE-TOLERANCE IN MAN - MEASUREMENT OF INSULIN SENSITIVITY AND BETA-CELL GLUCOSE SENSITIVITY FROM THE RESPONSE TO INTRAVENOUS GLUCOSE [J].
BERGMAN, RN ;
PHILLIPS, LS ;
COBELLI, C .
JOURNAL OF CLINICAL INVESTIGATION, 1981, 68 (06) :1456-1467
[6]   Effects of nonglucose nutrients on insulin secretion and action in people with pre-diabetes [J].
Bock, Gerlies ;
Man, Chiara Dalla ;
Campioni, Marco ;
Chittilapilly, Elizabeth ;
Basu, Rita ;
Toffolo, Gianna ;
Cobelli, Claudio ;
Rizza, Robert .
DIABETES, 2007, 56 (04) :1113-1119
[7]   Pathogenesis of pre-diabetes - Mechanisms of fasting and postprandial hyperglycemia in people with impaired fasting glucose and/or impaired glucose tolerance [J].
Bock, Gerlies ;
Dalla Man, Chiara ;
Campioni, Marco ;
Chittilapilly, Elizabeth ;
Basu, Rita ;
Toffolo, Gianna ;
Cobelli, Claudio ;
Rizza, Robert .
DIABETES, 2006, 55 (12) :3536-3549
[8]   Insulin release in impaired glucose tolerance - Oral minimal model predicts normal sensitivity to glucose but defective response tinges [J].
Breda, E ;
Toffolo, G ;
Polonsky, KS ;
Cobelli, C .
DIABETES, 2002, 51 :S227-S233
[9]   Oral glucose tolerance test minimal model indexes of β-cell function and insulin sensitivity [J].
Breda, E ;
Cavaghan, MK ;
Toffolo, G ;
Polonsky, KS ;
Cobelli, C .
DIABETES, 2001, 50 (01) :150-158