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Báo cáo y học: " Advantages of the single delay model for the assessment of insulin sensitivity from the intravenous glucose tolerance test"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Advantages of the single delay model for the assessment of insulin sensitivity from the intravenous glucose tolerance test. | Panunzi et al. Theoretical Biology and Medical Modelling 2010 7 9 http www.tbiomed.eom content 7 1 9 THEORETICAL BIOLOGY AND MEDICAL MODELLING RESEARCH Open Access Advantages of the single delay model for the assessment of insulin sensitivity from the intravenous glucose tolerance test Simona Panunzi1 Andrea De Gaetano1 Geltrude Mingrone2 Correspondence simona. panunzi@biomatematica.it 1CNR-Institute of Systems Analysis and Computer Science IASI BioMathLab Rome Italy 2 BioMed Central Abstract Background The Minimal Model MM used to assess insulin sensitivity IS from Intra-Venous Glucose-Tolerance Test IVGTT data suffers from frequent lack of identifiability parameter estimates with Coefficients of Variation CV less than 52 . The recently proposed Single Delay Model SDM is evaluated as a practical alternative. Methods The SDM was applied to 74 IVGTTs from lean 19 overweight 22 obese 22 and morbidly obese 11 subjects. Estimates from the SDM KxgI were compared with the corresponding MM SI 1 HOMA-IR index and Euglycemic-Hyperinsulinemic Clamp M-EHC over 7 subjects estimates. Results KxgI was identifiable in 73 out of 74 subjects CV 69 in the 74th subject and ranged from 1.25 X 10-5 to 4.36 X 10-4min-1pM-1 SI CV was 52 in 36 subjects up to 2.36 X 109 and presented 18 extreme values 1.5 X 10-12 or 3.99 . KxgIcorrelated well with 1 HOMA-IR r 0.56 P 0.001 whereas the correlations KxgI-SI and 1 HOMA-IR-SI were high r 0.864 and 0.52 respectively and significant P 0.001 in both cases only in the non-extreme SI sub-sample 56 subjects . Correlations KxgIvs. M-EHC and SI vs. M-EHC were positive r 0.92 P 0.004 and r 0.83 P 0.02 respectively . KxgIdecreased for higher BMI s P 0.001 SI significantly so only over the non-extreme-SI sub-sample. The Acute Insulin Response Index was also computed and the expected inverse hyperbolic relationship with the KxgIobserved. Conclusions Precise estimation of insulin sensitivity over a wide range of BMI stability of all other model parameters .