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1、Glucoseclamptechnique:amethodforquantifyinginsulinsecretionandresistanceRALPHA.DEFRONZO,JORDAND.TOBIN,ANDREUBINANDRESDepartmentofMedicine,YaleUn,lersitySchoolofMedicine,NewHaven,Connecticut06510;andClinicalPhysiologyBranch,GerontologyResearchCenter,NationalInstituteofAging,Balti
2、moreCityHospitals,Baltimore,Maryland20014DEFPIONZO,RALPHA.,JORDAND.TOBIN,ANDREUBINattimestheabsoluteIandGconcentrationsareused,ANDRES.Glucoseclamptechnique:amethodforquantifyingbuttheincreasesintheseconcentrationsoverbasallevelsinsulinsecretionandresistance.Am.J.Physiol.237(3):E
3、214-havealsobeenused.TheuseofthisindexcarriestheE223,1979orAm.J.Physiol.:Endocrinol.Metab.Gastrointest.assumptionsthat1)atanymomenttheplasmainsulinPhysiol.6(3):E214--E223,1979.-Methodsforthequantifica-concentrationreflectstheresponsetothatmoment’stionofbeta-cellsensitivitytogluc
4、ose(hyperglycemicclampplasmaglucoseconcentrationand2)thisdose-responsetechnique)andoftissuesensitivitytoinsulin(euglycemicin-sulinclamptechnique)aredescribed.Hyperglycemicclamprelationshipisasimplelinearone.technique.TheplasmaglucoseconcentrationisacutelyraisedThesamedata(plasma
5、glucoseandinsulinvalues)to125mg/dlabovebasallevelsbyapriminginfusionofglucose.havebeenusedtocomputeanindexoftissuesensitivityThedesiredhyperglycemicplateauissubsequentlymaintainedtoinsulin,theG/Iratio.Theprobleminusingsuchabyadjustmentofavariableglucoseinfusion,basedontheratiore
6、sultsfromthefeedbacklooprelatingthesetwonegativefeedbackprinciple.Becausetheplasmaglucosecon-variablesandfromthefactthatneithervariableisheldcentrationisheldconstant,theglucoseinfusionrateisanindexconstant.Thus,ariseinplasmaglucoseconcentrationofglucosemetabolism.Underthesecondi
7、tionsofconstantstimulatesthebeta-cellreleaseofinsulin;theresultanthyperglycemia,theplasmainsulinresponseisbiphasicwithanriseinplasmainsulinconcentrationstimulatesthecel-earlyburstofinsulinreleaseduringthefirst6minfollowedbylularuptakeofglucose,andtheplasmaglucoseconcen-agraduall
8、yprogressiveincreaseinplasmainsulinconcentra-tr
