Understanding Oral Glucose Tolerance: Comparison of Glucose or Insulin Measurements During the Oral Glucose Tolerance Test with Specific Measurements of Insulin Resistance and Insulin Secretion

Diabetic Medicine - Tập 11 Số 3 - Trang 286-292 - 1994
David I. W. Phillips1, Penny Clark2, C. N. Hales2, Clive Osmond3
1Metabolic Programming Group, Southampton General Hospital, UK.
2Dept. of Clinical Biochemistry, University of Cambridge, Cambridge, UK,
3MRC Environmental Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton

Tóm tắt

The extent to which the oral glucose tolerance test can be used to estimate insulin secretion and insulin resistance has been evaluated by comparing glucose and insulin concentrations during an oral glucose tolerance test with specific measurements of insulin secretion and insulin resistance in 85 normoglycaemic subjects and 23 subjects with impaired glucose tolerance (IGT). Insulin secretion was measured by the first phase insulin response to intravenous glucose and insulin resistance by the insulin tolerance test which measures the decline of plasma glucose after the injection of a bolus of insulin. The best measure of insulin secretion was the ratio of the 30 min increment in insulin concentration to the 30 min increment in glucose concentration following oral glucose loading. This correlated with the first phase insulin release following intravenous glucose (r=0.61, p < 0.001) but not insulin resistance (r= −0.05, p >0.05). Insulin resistance could be estimated by the fasting insulin, proinsulin, or split proinsulin concentrations. However, fasting split proinsulin appeared to discriminate best between insulin resistance (r = −0.53, p < 0.001) and insulin secretion (r = 0.07, p > 0.05). Relative insulin resistance estimated by homeostasis model assessment (HOMA) also correlated well with insulin resistance (r= −0.57, p < 0.001) but not insulin secretion (r= 0.01, p > 0.05). We conclude that the oral glucose tolerance test can be used to derive estimates of the relative roles of insulin secretion and insulin resistance in population studies of glucose tolerance.

Từ khóa


Tài liệu tham khảo

10.1136/bmj.301.6749.397

10.1056/NEJM198805123181909

10.1210/edrv-5-3-395

10.2337/diab.38.12.1512

10.1007/BF00280882

10.1152/ajpendo.1979.237.3.E214

10.1016/0002-9343(83)90650-2

10.1007/BF00280883

10.2337/diab.26.10.944

10.1056/NEJM198812083192302

10.1016/S0140-6736(89)91306-8

10.1007/BF00400209

10.1210/jcem-68-2-374

10.1111/j.1464-5491.1992.tb01813.x

10.1111/j.1464-5491.1993.tb00176.x

10.1007/BF00399954

Phillips DIW, 1993, Thinness at birth and insulin resistance in adult life, Diabetologia

10.1042/bj2600535

Alpha B., 1992, Sensitive amplified immunoenzymometric assays (IEMA) for human insulin and intact proinsulin, Eur J Clin Chem Biochem, 30, 27

10.1172/JCI105534

10.1007/BF02342446

10.1210/jcem-64-6-1169

10.1056/NEJM198607243150403

10.1056/NEJM198805123181901

10.1136/bmj.303.6805.755

10.2337/diabetes.40.6.673

10.2337/diab.33.8.717

10.1172/JCI106963

Thông tin
Thông tin xuất bản

Diabetic Medicine

Tập 11 Số 3

286-292

Thông tin tác giả