{"title":"在门诊临床实践中，通过葡萄糖钳夹检查对胰岛素代谢清除率进行计算估算。","authors":"Noboru Kurinami, Seigo Sugiyama, Akira Yoshida, Kunio Hieshima, Tomoko Suzuki, Fumio Miyamoto, Keizo Kajiwara, Katsunori Jinnouchi, Hideaki Jinnouchi","doi":"10.1007/s13340-024-00752-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>A subpopulation of Japanese patients with type 2 diabetes mellitus (T2DM) who have elevated insulin clearance (IC) exists. We tested our hypothesis that it is possible to estimate IC using common and simple test results collected in routine clinical practice.</p><p><strong>Methods: </strong>We recruited patients with newly diagnosed, treatment-naïve T2DM and measured the metabolic clearance rate of insulin (MCRI) determined by a hyperinsulinemic-euglycemic clamp examination. Multivariable regression analysis was performed with body mass index (BMI), serum uric acid (UA), and fasting plasma insulin (F-IRI) which were independently associated with IC increase in our previous reports as explanatory variables to calculate a prediction equation for MCRI.</p><p><strong>Results: </strong>We enrolled 101 patients in this study. Because MCRI is not normally distributed, we calculated the logarithmically transformed estimated Log<sub>10</sub>MCRI as a prediction formula for IC. Multivariable regression analysis showed that Log<sub>10</sub>BMI (β = - 0.3257, <i>P</i> < 0.001), UA (β = - 0.1834, <i>P</i> = 0.0081), and Log<sub>10</sub>F-IRI (β = - 0.4367, <i>P</i> < 0.001) were significant independent factors for Log<sub>10</sub>MCRI. The regression equation was as follows: estimated Log<sub>10</sub>MCRI = - 0.5421 × Log<sub>10</sub>BMI - 0.0167 × UA - 0.1792 × Log<sub>10</sub>F-IRI + 3.8251 (<i>r</i> = 0.7677, <i>R</i> <sup>2</sup> = 0.5894, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>IC can easily be predicted using BMI, UA, and F-IRI which are common and simple test results collected in routine clinical practice.</p>","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"15 4","pages":"867-869"},"PeriodicalIF":1.3000,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512974/pdf/","citationCount":"0","resultStr":"{\"title\":\"Calculated estimation of the metabolic clearance rate of insulin measured by glucose clamp examination in out-patient clinical practice.\",\"authors\":\"Noboru Kurinami, Seigo Sugiyama, Akira Yoshida, Kunio Hieshima, Tomoko Suzuki, Fumio Miyamoto, Keizo Kajiwara, Katsunori Jinnouchi, Hideaki Jinnouchi\",\"doi\":\"10.1007/s13340-024-00752-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>A subpopulation of Japanese patients with type 2 diabetes mellitus (T2DM) who have elevated insulin clearance (IC) exists. We tested our hypothesis that it is possible to estimate IC using common and simple test results collected in routine clinical practice.</p><p><strong>Methods: </strong>We recruited patients with newly diagnosed, treatment-naïve T2DM and measured the metabolic clearance rate of insulin (MCRI) determined by a hyperinsulinemic-euglycemic clamp examination. Multivariable regression analysis was performed with body mass index (BMI), serum uric acid (UA), and fasting plasma insulin (F-IRI) which were independently associated with IC increase in our previous reports as explanatory variables to calculate a prediction equation for MCRI.</p><p><strong>Results: </strong>We enrolled 101 patients in this study. Because MCRI is not normally distributed, we calculated the logarithmically transformed estimated Log<sub>10</sub>MCRI as a prediction formula for IC. Multivariable regression analysis showed that Log<sub>10</sub>BMI (β = - 0.3257, <i>P</i> < 0.001), UA (β = - 0.1834, <i>P</i> = 0.0081), and Log<sub>10</sub>F-IRI (β = - 0.4367, <i>P</i> < 0.001) were significant independent factors for Log<sub>10</sub>MCRI. The regression equation was as follows: estimated Log<sub>10</sub>MCRI = - 0.5421 × Log<sub>10</sub>BMI - 0.0167 × UA - 0.1792 × Log<sub>10</sub>F-IRI + 3.8251 (<i>r</i> = 0.7677, <i>R</i> <sup>2</sup> = 0.5894, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>IC can easily be predicted using BMI, UA, and F-IRI which are common and simple test results collected in routine clinical practice.</p>\",\"PeriodicalId\":11340,\"journal\":{\"name\":\"Diabetology International\",\"volume\":\"15 4\",\"pages\":\"867-869\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2024-09-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512974/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Diabetology International\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s13340-024-00752-3\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/10/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetology International","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s13340-024-00752-3","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/10/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Calculated estimation of the metabolic clearance rate of insulin measured by glucose clamp examination in out-patient clinical practice.
Purpose: A subpopulation of Japanese patients with type 2 diabetes mellitus (T2DM) who have elevated insulin clearance (IC) exists. We tested our hypothesis that it is possible to estimate IC using common and simple test results collected in routine clinical practice.
Methods: We recruited patients with newly diagnosed, treatment-naïve T2DM and measured the metabolic clearance rate of insulin (MCRI) determined by a hyperinsulinemic-euglycemic clamp examination. Multivariable regression analysis was performed with body mass index (BMI), serum uric acid (UA), and fasting plasma insulin (F-IRI) which were independently associated with IC increase in our previous reports as explanatory variables to calculate a prediction equation for MCRI.
Results: We enrolled 101 patients in this study. Because MCRI is not normally distributed, we calculated the logarithmically transformed estimated Log10MCRI as a prediction formula for IC. Multivariable regression analysis showed that Log10BMI (β = - 0.3257, P < 0.001), UA (β = - 0.1834, P = 0.0081), and Log10F-IRI (β = - 0.4367, P < 0.001) were significant independent factors for Log10MCRI. The regression equation was as follows: estimated Log10MCRI = - 0.5421 × Log10BMI - 0.0167 × UA - 0.1792 × Log10F-IRI + 3.8251 (r = 0.7677, R2 = 0.5894, P < 0.001).
Conclusion: IC can easily be predicted using BMI, UA, and F-IRI which are common and simple test results collected in routine clinical practice.
期刊介绍：
Diabetology International, the official journal of the Japan Diabetes Society, publishes original research articles about experimental research and clinical studies in diabetes and related areas. The journal also presents editorials, reviews, commentaries, reports of expert committees, and case reports on any aspect of diabetes. Diabetology International welcomes submissions from researchers, clinicians, and health professionals throughout the world who are interested in research, treatment, and care of patients with diabetes. All manuscripts are peer-reviewed to assure that high-quality information in the field of diabetes is made available to readers. Manuscripts are reviewed with due respect for the author''s confidentiality. At the same time, reviewers also have rights to confidentiality, which are respected by the editors. The journal follows a single-blind review procedure, where the reviewers are aware of the names and affiliations of the authors, but the reviewer reports provided to authors are anonymous. Single-blind peer review is the traditional model of peer review that many reviewers are comfortable with, and it facilitates a dispassionate critique of a manuscript.
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