Minimal model S(G) overestimation and S(I) underestimation: Improved accuracy by a Bayesian two-compartment model

Claudio Cobelli, Andrea Caumo, Matteo Omenetto

Research output: Contribution to journalArticle

86 Citations (Scopus)

Abstract

The intravenous glucose tolerance test (IVGTT) single-compartment minimal model (1CMM) method has recently been shown to overestimate glucose effectiveness and underestimate insulin sensitivity. Undermodeling, i.e., use of single- instead of two-compartment description of glucose kinetics, has been advocated to explain these limitations. We describe a new two- compartment minimal model (2CMM) into which we incorporate certain available knowledge on glucose kinetics. 2CMM is numerically identified using a Bayesian approach. Twenty-two standard IVGTT (0.30 g/kg) in normal humans were analyzed. In six subjects, the clamp-based index of insulin sensitivity (S(I)/(c)) was also measured. 2CMM glucose effectiveness (S(G)/2) and insulin sensitivity (S(I)/2) were, respectively, 60% lower (P <0.0001) and 35% higher (P <0.0001) than the corresponding 1CMM S(G)/1 and S(I)/1 indexes: 2.81 ± 0.29 (SE) vs. S(G)/1 = 4.27 ± 0.33 ml·min-1·kg-1 and S(I)/2 = 11.67 ± 1.71 vs. S(I)/1 = 8.68 ± 1.62 102 ml·min-1·kg-1 per μU/ml. S(I)/2 was not different from S(I)/(c) = 12.61 ± 2.13 102 ml·min-1·kg-1 per μU/ml (nonsignificant), whereas S(I)/1 was 60% lower (P <0.02). In conclusion, a new 2CMM has been presented that improves the accuracy of glucose effectiveness and insulin sensitivity estimates of the classic 1CMM from a standard IVGTT in normal humans.

Original languageEnglish
JournalAmerican Journal of Physiology - Endocrinology and Metabolism
Volume277
Issue number3 40-3
Publication statusPublished - Sep 1999

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Insulin Resistance
Glucose
Glucose Tolerance Test
Insulin
Bayes Theorem
Kinetics
Clamping devices

Keywords

  • Glucose clamp technique
  • Glucose effectiveness
  • Glucose kinetics
  • Insulin sensitivity

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology
  • Physiology
  • Physiology (medical)

Cite this

Minimal model S(G) overestimation and S(I) underestimation : Improved accuracy by a Bayesian two-compartment model. / Cobelli, Claudio; Caumo, Andrea; Omenetto, Matteo.

In: American Journal of Physiology - Endocrinology and Metabolism, Vol. 277, No. 3 40-3, 09.1999.

Research output: Contribution to journalArticle

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abstract = "The intravenous glucose tolerance test (IVGTT) single-compartment minimal model (1CMM) method has recently been shown to overestimate glucose effectiveness and underestimate insulin sensitivity. Undermodeling, i.e., use of single- instead of two-compartment description of glucose kinetics, has been advocated to explain these limitations. We describe a new two- compartment minimal model (2CMM) into which we incorporate certain available knowledge on glucose kinetics. 2CMM is numerically identified using a Bayesian approach. Twenty-two standard IVGTT (0.30 g/kg) in normal humans were analyzed. In six subjects, the clamp-based index of insulin sensitivity (S(I)/(c)) was also measured. 2CMM glucose effectiveness (S(G)/2) and insulin sensitivity (S(I)/2) were, respectively, 60{\%} lower (P <0.0001) and 35{\%} higher (P <0.0001) than the corresponding 1CMM S(G)/1 and S(I)/1 indexes: 2.81 ± 0.29 (SE) vs. S(G)/1 = 4.27 ± 0.33 ml·min-1·kg-1 and S(I)/2 = 11.67 ± 1.71 vs. S(I)/1 = 8.68 ± 1.62 102 ml·min-1·kg-1 per μU/ml. S(I)/2 was not different from S(I)/(c) = 12.61 ± 2.13 102 ml·min-1·kg-1 per μU/ml (nonsignificant), whereas S(I)/1 was 60{\%} lower (P <0.02). In conclusion, a new 2CMM has been presented that improves the accuracy of glucose effectiveness and insulin sensitivity estimates of the classic 1CMM from a standard IVGTT in normal humans.",
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