Routine OGTT: a robust model including incretin effect for precise identification of insulin sensitivity and secretion in a single individual.

In order to provide a method for precise identification of insulin sensitivity from clinical Oral Glucose Tolerance Test (OGTT) observations, a relatively simple mathematical model (Simple Interdependent glucose/insulin MOdel SIMO) for the OGTT, which coherently incorporates commonly accepted physio...

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Main Authors: Andrea De Gaetano, Simona Panunzi, Alice Matone, Adeline Samson, Jana Vrbikova, Bela Bendlova, Giovanni Pacini
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2013-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC3756988?pdf=render
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author Andrea De Gaetano
Simona Panunzi
Alice Matone
Adeline Samson
Jana Vrbikova
Bela Bendlova
Giovanni Pacini
author_facet Andrea De Gaetano
Simona Panunzi
Alice Matone
Adeline Samson
Jana Vrbikova
Bela Bendlova
Giovanni Pacini
author_sort Andrea De Gaetano
collection DOAJ
description In order to provide a method for precise identification of insulin sensitivity from clinical Oral Glucose Tolerance Test (OGTT) observations, a relatively simple mathematical model (Simple Interdependent glucose/insulin MOdel SIMO) for the OGTT, which coherently incorporates commonly accepted physiological assumptions (incretin effect and saturating glucose-driven insulin secretion) has been developed. OGTT data from 78 patients in five different glucose tolerance groups were analyzed: normal glucose tolerance (NGT), impaired glucose tolerance (IGT), impaired fasting glucose (IFG), IFG+IGT, and Type 2 Diabetes Mellitus (T2DM). A comparison with the 2011 Salinari (COntinuos GI tract MOdel, COMO) and the 2002 Dalla Man (Dalla Man MOdel, DMMO) models was made with particular attention to insulin sensitivity indices ISCOMO, ISDMMO and kxgi (the insulin sensitivity index for SIMO). ANOVA on kxgi values across groups resulted significant overall (P<0.001), and post-hoc comparisons highlighted the presence of three different groups: NGT (8.62×10(-5)±9.36×10(-5) min(-1)pM(-1)), IFG (5.30×10(-5)±5.18×10(-5)) and combined IGT, IFG+IGT and T2DM (2.09×10(-5)±1.95×10(-5), 2.38×10(-5)±2.28×10(-5) and 2.38×10(-5)±2.09×10(-5) respectively). No significance was obtained when comparing ISCOMO or ISDMMO across groups. Moreover, kxgi presented the lowest sample average coefficient of variation over the five groups (25.43%), with average CVs for ISCOMO and ISDMMO of 70.32% and 57.75% respectively; kxgi also presented the strongest correlations with all considered empirical measures of insulin sensitivity. While COMO and DMMO appear over-parameterized for fitting single-subject clinical OGTT data, SIMO provides a robust, precise, physiologically plausible estimate of insulin sensitivity, with which habitual empirical insulin sensitivity indices correlate well. The kxgi index, reflecting insulin secretion dependency on glycemia, also significantly differentiates clinically diverse subject groups. The SIMO model may therefore be of value for the quantification of glucose homeostasis from clinical OGTT data.
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spelling doaj.art-439368ef6a71494fa580f15c6a46bbcb2022-12-22T00:47:18ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0188e7087510.1371/journal.pone.0070875Routine OGTT: a robust model including incretin effect for precise identification of insulin sensitivity and secretion in a single individual.Andrea De GaetanoSimona PanunziAlice MatoneAdeline SamsonJana VrbikovaBela BendlovaGiovanni PaciniIn order to provide a method for precise identification of insulin sensitivity from clinical Oral Glucose Tolerance Test (OGTT) observations, a relatively simple mathematical model (Simple Interdependent glucose/insulin MOdel SIMO) for the OGTT, which coherently incorporates commonly accepted physiological assumptions (incretin effect and saturating glucose-driven insulin secretion) has been developed. OGTT data from 78 patients in five different glucose tolerance groups were analyzed: normal glucose tolerance (NGT), impaired glucose tolerance (IGT), impaired fasting glucose (IFG), IFG+IGT, and Type 2 Diabetes Mellitus (T2DM). A comparison with the 2011 Salinari (COntinuos GI tract MOdel, COMO) and the 2002 Dalla Man (Dalla Man MOdel, DMMO) models was made with particular attention to insulin sensitivity indices ISCOMO, ISDMMO and kxgi (the insulin sensitivity index for SIMO). ANOVA on kxgi values across groups resulted significant overall (P<0.001), and post-hoc comparisons highlighted the presence of three different groups: NGT (8.62×10(-5)±9.36×10(-5) min(-1)pM(-1)), IFG (5.30×10(-5)±5.18×10(-5)) and combined IGT, IFG+IGT and T2DM (2.09×10(-5)±1.95×10(-5), 2.38×10(-5)±2.28×10(-5) and 2.38×10(-5)±2.09×10(-5) respectively). No significance was obtained when comparing ISCOMO or ISDMMO across groups. Moreover, kxgi presented the lowest sample average coefficient of variation over the five groups (25.43%), with average CVs for ISCOMO and ISDMMO of 70.32% and 57.75% respectively; kxgi also presented the strongest correlations with all considered empirical measures of insulin sensitivity. While COMO and DMMO appear over-parameterized for fitting single-subject clinical OGTT data, SIMO provides a robust, precise, physiologically plausible estimate of insulin sensitivity, with which habitual empirical insulin sensitivity indices correlate well. The kxgi index, reflecting insulin secretion dependency on glycemia, also significantly differentiates clinically diverse subject groups. The SIMO model may therefore be of value for the quantification of glucose homeostasis from clinical OGTT data.http://europepmc.org/articles/PMC3756988?pdf=render
spellingShingle Andrea De Gaetano
Simona Panunzi
Alice Matone
Adeline Samson
Jana Vrbikova
Bela Bendlova
Giovanni Pacini
Routine OGTT: a robust model including incretin effect for precise identification of insulin sensitivity and secretion in a single individual.
PLoS ONE
title Routine OGTT: a robust model including incretin effect for precise identification of insulin sensitivity and secretion in a single individual.
title_full Routine OGTT: a robust model including incretin effect for precise identification of insulin sensitivity and secretion in a single individual.
title_fullStr Routine OGTT: a robust model including incretin effect for precise identification of insulin sensitivity and secretion in a single individual.
title_full_unstemmed Routine OGTT: a robust model including incretin effect for precise identification of insulin sensitivity and secretion in a single individual.
title_short Routine OGTT: a robust model including incretin effect for precise identification of insulin sensitivity and secretion in a single individual.
title_sort routine ogtt a robust model including incretin effect for precise identification of insulin sensitivity and secretion in a single individual
url http://europepmc.org/articles/PMC3756988?pdf=render
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