Measuring [Beta]-Cell Function Relative to Insulin Sensitivity in Youth: Does the hyperglycemic clamp suffice?

• Autores: Lindsey A. Sjaarda, Sojung Lee, Hala Tfayli, Fida Bacha, Marnie Bertolet
• Localización: Diabetes care, ISSN-e 0149-5992, Vol. 36, Nº. 6, 2013, págs. 1607-1612
• Idioma: inglés
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• Resumen

  • OBJECTIVE-To compare ß-cell function relative to insulin sensitivity, disposition index (DI), calculated from two clamps (2cDI, insulin sensitivity from the hyperinsulinemic-euglycemic clamp and first-phase insulin from the hyperglycemic clamp) with the DI calculated from the hyperglycemic clamp alone (hcDI).

    RESEARCH DESIGN AND METHODS-Complete data from hyperglycemic and hyperinsulinemic-euglycemic clamps were available for 330 youth: 73 normal weight, 168 obese with normal glucose tolerance, 57 obese with impaired glucose tolerance, and 32 obese with type 2 diabetes. The correlation between hcDI and 2cDI and Bland-Altman analysis of agreement between the two were examined.

    RESULTS-Insulin sensitivity and first-phase insulin from hcDI showed a hyperbolic relationship. The hcDI correlated significantly with 2cDI in the groups combined (r = 0.85, P < 0.001) and within each group separately (r & 62, P < 0.001). Similar to 2cDI, hcDI showed a declining pattern of ß-cell function across the glucose-tolerance groups. Overall, hcDI values were 27% greater than 2cDI, due to the hyperglycemic versus euglycemic conditions, reflected in a positive bias with Bland-Altman analysis.

    CONCLUSIONS-ß-Cell function relative to insulin sensitivity could be accurately evaluated from a single hyperglycemic clamp, obviating the need for two separate clamp experiments, when lessening participant burden and reducing research costs are important considerations.