摘要
高胰岛素正糖钳夹技术可以测定活体的胰岛素敏感性,但它并不适用于大规模流行病学研究。流行病学研究需要简单的胰岛素抵抗测定法。本文补充报告在空腹血糖(FPG)(75～306mg/dl或4.2～17.1mmol/L)及空腹胰岛素(FIns)(9.7～120mU/L)范围很宽的Pima印第安人群中,正糖钳夹技术测定的胰岛素介导的葡萄糖代谢率(M)与涉及FPG、FIns的多种复合的胰岛素敏感指数的相关性:胰岛素作用指数(IAI)=1/(FPG×FIns)在非糖尿病人群及2型糖尿病人群都与M显著正相关(r>0.7,P=0.0001),而且这两者的相关性强于M与其他指数如FIns或FPG/FIns比值的相关性,也不弱于M与糖负荷后3～5个时间点的血糖、胰岛素曲线下面积乘积的相关性。IAI的五分变量分布情况表明有90.4%的IAI落在所预测的M值五分变量区域或与之相邻的一个五分变量区域之内。1/FPG×FIns虽相对简单但确实与机体的胰岛素敏感性密切相关,它可以做为胰岛素敏感指数在流行病学研究中应用。
Hyperinsulinemic euglycemic clamp technique can be used to evaluate insulin sensitivity in vivo. However， it is not fit for assessing the insulin sensitivity in large scale epidemio-logical studies in which some simple index is needed. In this paper we present some additional data to describe characteristics of the insulin action index（IAI）=1/（FPG×FIns）. The Pima Indians recruited in this study, from which we suggested the IAI, had a very wide range of fasting plasma levels of glucose （75-306 mg/dl or 4.2-17.1 mmol/L）and insulin （9.7-120 mU/L）concentrations, The insu-lin-mediated glucose disposal rate （M value） assessed by the clamp technique were closely correlated to a various complex parameters involved to fasting glucose and insulin levels. The correlation coefficient of M value and IAI was significant （r＞0.7, P=0. 0001） and it was greater than that between M and fasting plasma insulin or the ratio of glucose to insulin and not inferior to the correlation between M and the products of areas of glucose and insulin during OGTT. The quintile distribution of the products of plasma glucose and insulin demonstrated that 90.4% IAI value were within the predicted M vatue quintile or its adjacent quintiles. The reverse of the product of fasting plasma glucose and insulin, 1/（FPG × FIns）,closely correlates to human insulin sensitivity, thus it can be taken as an index of insulin sensitivity in epidemiological studies.
