A Mathematical Model-Derived Disposition Index Without Insulin Validated in Youth with Obesity.
| Autor: | Ha J; Department of Mathematics, Howard University, Washington, DC., Kim JY; Department of Exercise Science, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY., Springer M; Department of Mathematics, University of Maryland., Chhabra A; Department of Biology, Indian Institute of Science Education and Research Pune Maharashtra 411008, India., Chung ST; Section on Pediatric Diabetes, Obesity, and Metabolism, NIDDK, NIH, Bethesda, MD., Sumner AE; Intramural Research Program, National Institute on Minority Health and Health Disparities (NIMHD), National Institutes of Health, Bethesda, MD.; Section on Ethnicity and Health, Diabetes Endocrinology and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health, Bethesda, MD.; Hypertension in Africa Research Team, North-West University, Potchefstroom, North-West, South Africa., Sherman A; Laboratory of Biological Modeling, NIDDK, NIH, Bethesda, MD., Arslanian S; Center for Pediatric Research in Obesity and Metabolism.; Division of Pediatric Endocrinology and Metabolism, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA. |
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| Jazyk: | angličtina |
| Zdroj: | The Journal of clinical endocrinology and metabolism [J Clin Endocrinol Metab] 2024 Aug 22. Date of Electronic Publication: 2024 Aug 22. |
| DOI: | 10.1210/clinem/dgae582 |
| Abstrakt: | Aims: The gold standard clamp measurements for insulin sensitivity (cSI), β-cell function (cBCF) and disposition index (cDI = cSI*cBCF), are not practical in large-scale studies. We sought to: 1) validate a mathematical model-derived DI from oral glucose tolerance tests (OGTT) with insulin (mDI) and without (mDI-woI) against cDI and oral disposition index (oDI) evaluate the ability of the novel indices to detect prediabetes and type 2 diabetes. Methods: We carried out a secondary analysis of previously reported cross-sectional observational studies. The Insulin Sensitivity and Secretion mathematical model for glucose-insulin dynamics was applied to five-point and three-point OGTTs synchronized with hyperinsulinemic-euglycemic and hyperglycemic clamps from 130 youth with obesity (68 NGT, 33 IGT, 29 T2D). Results: Model-derived DI correlated well with clamp DI (R = 0.76 (logged)). Between NGT and IGT, mDI and mDI-woI decreased more than oDI and cDI, (60 and 59% vs 29 and 27%), and by receiver operating characteristic (ROC) analysis were superior at detecting IGT than oDI and cDI (AUC 0.88, 0.87 vs 0.68, 0.65), as was mean glucose (AUC 0.87). Conclusions: mDI-woI is better than oDI or the labor-intensive cDI for detecting dysglycemia in obese youth. Bypassing insulin measurements with mDI-woI from the OGTT provides a cost-effective approach for large-scale epidemiological studies of dysglycemia in youth. (Published by Oxford University Press on behalf of the Endocrine Society 2024.) |
| Databáze: | MEDLINE |
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