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Estimation of prehepatic insulin secretion: comparison between standardized C-peptide and insulin kinetic models.
MedLine Citation:
PMID:  21944265     Owner:  NLM     Status:  Publisher    
Our aim was to compare traditional C-peptide-based method and insulin-based method with standardized kinetic parameters in the estimation of prehepatic insulin secretion rate (ISR). One-hundred thirty-four subjects with varying degrees of glucose tolerance received an insulin-modified intravenous glucose tolerance test and a standard oral glucose tolerance test with measurement of plasma insulin and C-peptide. From the intravenous glucose tolerance test, we determined insulin kinetics parameters and selected standardized kinetic parameters based on mean values in a selected subgroup. We computed ISR from insulin concentration during the oral glucose tolerance test using these parameters and compared ISR with the standard C-peptide deconvolution approach. We then performed the same comparison in an independent data set (231 subjects). In the first data set, total ISRs from insulin and C-peptide were highly correlated (R(2) = 0.75, P < .0001), although on average different (103 ± 6 vs 108 ± 3 nmol, P < .001). Good correlation was also found in the second data set (R(2) = 0.54, P < .0001). The insulin method somewhat overestimated total ISR (85 ± 5 vs 67 ± 3 nmol, P = .002), in part because of differences in insulin assay. Similar results were obtained for fasting ISR. Despite the modest bias, the insulin and C-peptide methods were consistent in predicting differences between groups (eg, obese vs nonobese) and relationships with other physiological variables (eg, body mass index, insulin resistance). The insulin method estimated first-phase ISR peak similarly to the C-peptide method and better than the simple use of insulin concentration. The insulin-based ISR method compares favorably with the C-peptide approach. The method will be particularly useful in data sets lacking C-peptide to assess β-cell function through models requiring prehepatic secretion.
Andrea Tura; Giovanni Pacini; Alexandra Kautzky-Willer; Amalia Gastaldelli; Ralph A Defronzo; Ele Ferrannini; Andrea Mari
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Publication Detail:
Type:  -     Date:  2011-9-22
Journal Detail:
Title:  Metabolism: clinical and experimental     Volume:  -     ISSN:  1532-8600     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375267     Medline TA:  Metabolism     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Metabolic Unit, Institute of Biomedical Engineering, National Research Council, Padova, Italy.
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