Assessment of hepatic insulin degradation, in normoglycemic hypertensive patients, by minimal modelling of standard intravenous glucose tolerance test data

Francesco Di Nardo, Massimo Boemi, Roberto Burattini

Research output: Contribution to journalArticle

Abstract

Role of hepatic insulin degradation in modulating insulin delivery to peripheral circulation, in insulin-resistant hypertensive patients, is not yet fully understood. This issue was investigated here by a novel application to hypertension of a previously proposed minimal modelling of insulin and C-peptide data, using population values for insulin and C-peptide kinetics parameters. Data, from frequently sampled intravenous glucose tolerance test (FSIGTT), were analysed in ten normoglycemic, hypertensive patients (H-group), compared with eight normoglycemic, normotensive subjects (N-group), matched for age, gender and body mass index. Minimal modelling of C-peptide and insulin data provided β-cell responsiveness to glucose perturbation (first, Φ1, second, Φ2, and basal, Φb, phase), insulin secretion rate, ISR(t) and total pre-hepatic insulin secretion, TIS, as well as insulin delivery rate, IDR(t), and total insulin delivery, TID, into plasma, over 5-h test. Instantaneous normalized hepatic insulin degradation rate was computed as HIDR(t) = 1 - [IDR(t)/ISR(t)]. In our H-group, insulin sensitivity, SI, assessed by minimal model of glucose kinetics, showed a 56% reduction, which confirmed deterioration of insulin action in hypertension. This was associated with significant increase in Φ1 (105%), TIS (55%) and TID (62%). No significant alterations were observed in other characteristic parameters of secretion and hepatic degradation of insulin, such that no significant difference was observed in HIDR(t) between our H and N groups. In conclusion, an increase of first phase and total insulin secretion occurring, in our H-group, in the presence of no alteration of hepatic insulin degradation, resulted in up-regulation of total insulin delivered to plasma (TID) for insulin-resistance compensation.

Original languageEnglish
Pages (from-to)189-198
Number of pages10
JournalComputer Methods and Programs in Biomedicine
Volume97
Issue number2
DOIs
Publication statusPublished - Feb 2010

Keywords

  • C-peptide and insulin minimal model
  • Glucose metabolism
  • Indexes of β-cell responsiveness
  • Insulin resistance

ASJC Scopus subject areas

  • Computer Science Applications
  • Software
  • Health Informatics

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