+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Insulin secretion, insulin sensitivity and glucose-mediated glucose disposal in thyrotoxicosis: a minimal model analysis



Insulin secretion, insulin sensitivity and glucose-mediated glucose disposal in thyrotoxicosis: a minimal model analysis



Clinical Endocrinology 33(4): 481-493



In order to evaluate simultaneously in thyrotoxic subjects the relative contributions of insulin secretion, insulin-sensitivity (SI) and glucose-mediated (SG) glucose disposal to overall glucose tolerance, seven non-obese patients with thyrotoxicosis were studied by the minimal model analysis of the frequently sampled intravenous glucose tolerance test, before and greater than 1 month after being rendered euthyroid, and compared with eight healthy control subjects. Basal glucose, C-peptide and glucagon levels were similar in all groups but, in the toxic and euthyroid states, basal insulin levels were significantly elevated compared to the control group (11.2 +/- 2.0 and 7.9 +/- 1.1 vs 5.1 +/- 0.6 microU/ml, mean +/- SE, P less than 0.02). FFA levels were raised in the thyrotoxic subjects prior to treatment (0.95 +/- 0.11 vs 0.68 +/- 0.08 and 0.54 +/- 0.08 mmol/l, P less than 0.02). Glucose tolerance (Kg) was reduced in the thyrotoxic subjects compared to the euthyroid state (1.16 +/- 0.12 vs 1.44 +/- 0.13 per min, P less than 0.025) and control group (1.44 +/- 1.0 per min, 0.05 less than P less than 0.1). First phase (phi 1) and second phase (phi 2) insulin release were both significantly elevated in the thyrotoxic and euthyroid states compared to the control group (phi 1 7.10 +/- 1.88 and 5.29 +/- 1.03 vs 1.72 +/- 0.17 microU/mg/min X 10(-2), P less than 0.01; phi 2 18.64 +/- 3.14 and 16.74 +/- 4.48 vs 9.23 +/- 0.74 microU/mg/min X 10(-2) respectively, P less than 0.02). SG was similar in all groups but SI was significantly reduced in the thyrotoxic subjects compared to the control group (2.24 +/- 0.62 vs 5.92 +/- 1.50/min/microU/ml X 10(4), P less than 0.02) and rose post-treatment in the euthyroid subjects (4.23 +/- 1.75/min/microU/ml X 10(4)). In the thyrotoxic subjects before and after treatment, log SI correlated negatively with basal FFA levels (r = -0.57, P less than 0.05) and with phi 2 (r = -0.58, P less than 0.05). The fractional clearance rate of insulin was unaltered by the thyrotoxic state. It is concluded that in thyrotoxicosis the impairment of Kg is due to reduced insulin sensitivity in the presence of enhanced insulin secretion, but glucose-mediated glucose disposal is unaltered by the toxic state.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 040459810

Download citation: RISBibTeXText

PMID: 2225490

DOI: 10.1111/j.1365-2265.1990.tb03885.x


Related references

Insulin secretion, insulin sensitivity and glucose-mediated glucose disposal in Cushing's disease: a minimal model analysis. Clinical Endocrinology 35(6): 509-517, 1991

A modified minimal model analysis of insulin sensitivity and glucose-mediated glucose disposal in insulin-dependent diabetes. Metabolism: Clinical and Experimental 40(1): 4-9, 1991

Minimal model analysis of insulin sensitivity and glucose-mediated glucose disposal in type 1 (insulin-dependent) diabetic pancreas allograft recipients. Diabetologia 35(7): 676-680, 1992

The effect of 3 months of recombinant human growth hormone (GH) therapy on insulin and glucose-mediated glucose disposal and insulin secretion in GH-deficient adults: a minimal model analysis. Journal of Clinical Endocrinology and Metabolism 79(4): 975-983, 1994

Insulin sensitivity, insulin secretion, and glucose effectiveness in subjects with impaired glucose tolerance: a minimal model analysis. Metabolism: Clinical and Experimental 43(6): 714-718, 1994

Insulin mediated and non insulin mediated glucose disposal are reduced in cushings disease a minimal model analysis. Acta Endocrinologica Suppl. 124(3): 3, 1991

Insulin sensitivity, insulin secretion, and glucose effectiveness in anorexia nervosa: a minimal model analysis. Metabolism: Clinical and Experimental 43(4): 529-530, 1994

Insulin sensitivity, insulin secretion, and glucose effectiveness in obese subjects: a minimal model analysis. Metabolism: Clinical and Experimental 44(11): 1397-1400, 1995

Insulin sensitivity, insulin secretion, and glucose effectiveness in anorexia nervosa: a minimal model analysis. Metabolism: Clinical and Experimental 42(9): 1164-1168, 1993

Insulin secretion, insulin sensitivity and glucose effectiveness in Cushings syndrome Minimal model analysis. Diabetologia 39(Suppl. 1): A188, 1996

Insulin sensitivity, insulin secretion and glucose effectiveness in subjects with NIDDM in Korea A minimal model analysis. Diabetologia 40(Suppl. 1): A97, 1997

Epinephrine exerts opposite effects on peripheral glucose disposal and glucose-stimulated insulin secretion. A stable label intravenous glucose tolerance test minimal model study. Diabetes 45(10): 1373-1378, 1996

Plasma leptin concentrations do not appear to decrease insulin-mediated glucose disposal or glucose-stimulated insulin secretion in women with normal glucose tolerance. Diabetes 47(2): 244-247, 1998

Use of the minimal model to assess insulin sensitivity and glucose dependent glucose disposal in cirrhosis. Clinical Science 82(3): 13P, 1992

Glucose disposal minimal model insulin sensitivity index from labelled meal glucose tolerance test. Diabetes 50(Suppl. 2): A65, 2001