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J Korean Med Sci. 2014;29(3):378-85.

Simulation of oral glucose tolerance tests and the corresponding isoglycemic intravenous glucose infusion studies for calculation of the incretin effect.

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제1저자 김명선, 오태정 · 교신저자 김성완

소속 (4)
  1. Interdisciplinary Program for Bioengineering, Graduate School, Seoul National University, Seoul, Korea.
  2. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
  3. Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Seoul, Korea. ; Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, Korea. ; Department of Biomedical Engineering, Seoul National University Hospital, Seoul, Korea.
  4. Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.

Abstract

The incretin effect, which is a unique stimulus of insulin secretion in response to oral ingestion of nutrients, is calculated by the difference in insulin secretory responses from an oral glucose tolerance test (OGTT) and a corresponding isoglycemic intravenous glucose infusion (IIGI) study. The OGTT model of this study, which is individualized by fitting the glucose profiles during an OGTT, was developed to predict the glucose profile during an IIGI study in the same subject. Also, the model predicts the insulin and incretin profiles during both studies. The incretin effect, estimated by simulation, was compared with that measured by physiologic studies from eight human subjects with normal glucose tolerance, and the result exhibited a good correlation (r > 0.8); the incretin effect from the simulation was 56.5% ± 10.6% while the one from the measured data was 52.5% ± 19.6%. In conclusion, the parameters of the OGTT model have been successfully estimated to predict the profiles of both OGTTs and IIGI studies. Therefore, with glucose data from the OGTT alone, this model could control and predict the physiologic responses, including insulin secretion during OGTTs and IIGI studies, which could eventually eliminate the need for complex and cumbersome IIGI studies in incretin research.

Keywords

IncretinsIndividualized ModelIsoglycemic Intravenous Glucose Infusions (IIGI)Oral Glucose Tolerance Test (OGTT)

Figures

Fig. 1
Fig. 1 A schematic overview of the process of parameter estimation for the model and validation between measured data and simulation results. OGTT, oral glucose tolerance test; IIGI, isoglycemic intravenous glucose infusions; G, glucose; I, insulin; GIP, glucose-dependent insulinotropic polypeptide; iAUC, incremental area under the curves.
Fig. 2
Fig. 2 Plasma glucose concentration profiles in subject #7. The solid lines are from the simulation (blue, 75 g OGTT; red, IIGI study; green, 4 glucose infusion rates). The dotted lines are from the measured data (sky blue [•], OGTT; purple [○], IIGI study).
Fig. 3
Fig. 3 Plasma insulin concentration profiles in subject #7. The solid lines are from the simulation (blue, 75 g OGTT; red, IIGI study). The dotted lines are from the measured data (sky blue [•], OGTT; purple [○], IIGI study).
Fig. 4
Fig. 4 Plasma incretin (GIP) concentration profiles in subject #7. The solid lines are from the simulation (blue, 75 g OGTT; red, IIGI study). The dotted lines are from the measured data (sky blue [•], OGTT; purple [○], IIGI study).
Fig. 5
Fig. 5 The IIGI simulation for all OGTT models with the same intravenous glucose infusion rates for subject #7. The solid lines with different colors show the OGTT model of eight subjects (s1-8). The black dashed line shows the measured data for subject #7.

그림 출처: PubMed Central 공개 논문 (PMC3945133)

Conflict of interest statement

The authors have no conflicts of interest to disclose.

그 밖의 정보
출판 형태
Journal Article, Research Support, Non-U.S. Gov't
저널
Journal of Korean medical science · eISSN 1598-6357
전자 출판
2014-02-27
MeSH
Administration, Oral · Adult · Area Under Curve · Blood Glucose / analysis · Computer Simulation* · Female · Glucose / metabolism / pharmacology · Glucose Tolerance Test · Humans · Incretins / blood · Insulin / blood · Liver / drug effects · Middle Aged · Models, Theoretical* · ROC Curve
Substances
Blood Glucose · Incretins · Insulin · Glucose
참고문헌
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