期刊
DIABETOLOGIA
卷 54, 期 1, 页码 78-86出版社
SPRINGER
DOI: 10.1007/s00125-010-1911-9
关键词
Development; Diabetes; Insulin sensitivity; Validation; Youth
资金
- Pediatric General Clinical Research Center
- University of Colorado, Denver, CO, USA
- National Institute of Diabetes and Digestive and Kidney Diseases
- Centers for Disease Control and Prevention [00097, DP-05-069]
- Kaiser Permanente Southern California [U01 DP000246]
- University of Colorado, Denver, CO, USA [U01 DP000247]
- Pacific Health Research Institute [U01 DP000245]
- Children's Hospital Medical Center (Cincinnati) [U01 DP000248]
- University of North Carolina at Chapel Hill [U01 DP000254]
- University of Washington School of Medicine [U01 DP000244]
- Wake Forest University School of Medicine [U01 DP000250]
- [R01 DK059184]
- [RR020038]
- [JDRF5-2008-291]
- NATIONAL CENTER FOR CHRONIC DISEASE PREV AND HEALTH PROMO [U01DP000250] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES [P30DK057516] Funding Source: NIH RePORTER
Aims/hypothesis The ability to measure insulin sensitivity across the phenotypic spectrum of diabetes may contribute to a more accurate characterisation of diabetes type. Our goal was to develop and validate an insulin sensitivity (IS) score using the euglycaemic-hyperinsulinaemic clamp in a subset (n = 85) of 12- to 19-year-old youths with diabetes participating in the SEARCH study in Colorado, USA. Methods Youths with a diagnosis of type 1 (n = 60) or type 2 diabetes (n = 25) underwent a 3 h clamp to measure glucose disposal rate (GDR, mg kg(-1) min(-1)). Demographic (age, sex, race), clinical (BMI, waist, Tanner stage) and metabolic characteristics (HbA(1c), lipids, blood pressure, urine albumin: creatinine) were used to estimate log(e)IS score via stepwise linear regression on a model-development set (n = 53). Estimated IS score was evaluated for reproducibility on two validation sets: youths with diabetes (n = 33) and healthy control youths (n = 22). Results The best model included waist, triacylglycerol (TG) and HbA(1c) levels (R-2 = 0.74). Diabetes type did not enter the model and there were no significant interactions between diabetes type and other predictors. Estimated IS score correlated well (r = 0.65, p < 0.0001; r = 0.62, p = 0.002) with GDR on the two validation sets. Based on this analysis, we propose the following formula to estimate insulin sensitivity in youths with diabetes: logeIS 4: 64725 = 0: 02032 (waist; cm) = 0: 09779 (HbA(1c), %) - 0: 00235 (TG; mg/dl; to convert TG values from mmol/l to mg/dl; divide by 0.0113). Conclusions/interpretation Insulin sensitivity can be estimated in adolescents with diabetes using routinely collected measures. This score can be applied to epidemiological studies of youths with diabetes to characterise relationships between dimensions of diabetes type.
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