A Novel Use of the Hyperinsulinemic-Euglycemic Clamp Technique to Estimate Insulin Sensitivity of Systemic Lipolysis

M. Stumvoll; H. G. Wahl; K. Löblein; R. Becker; A. Volk; W. Renn; S. Jacob; H. Häring

doi:10.1055/s-2001-12403

Hormone and Metabolic Research, Inhaltsverzeichnis

Horm Metab Res 2001; 33(2): 89-95
DOI: 10.1055/s-2001-12403

Original Clinical

A Novel Use of the Hyperinsulinemic-Euglycemic Clamp Technique to Estimate Insulin Sensitivity of Systemic Lipolysis

M. Stumvoll¹ , H. G. Wahl¹ , K. Löblein, R. Becker, A. Volk, W. Renn, S. Jacob, H. Häring

Department of Endocrinology and Metabolism, Eberhard-Karls-Universität, Tübingen, Germany
¹ These authors contributed equally to the study

Abstract

The aim of the present study was to assess whether a standard hyperinsulinemic-euglycemic clamp can provide an estimate for the antilipolytic insulin sensitivity. For this purpose, we infused 9 non-obese, healthy volunteers with [²H₅]glycerol and used the glycerol rate of appearance (Ra) in plasma as an index for systemic lipolysis during a standard (1 mU/kg · min, 120 min) and a 3-step (0.1, 0.25, 1.0 mU/kg · min) hyperinsulinemic-euglycemic clamp. The insulin concentration, which half-maximally suppressed lipolysis (EC₅₀) in the three-step clamp, was considered to be the gold standard for the antilipolytic insulin sensitivity. Glycerol Ra decreased from 1.53 ± 0.11 µmol/kg·min to 0.60 ± 0.09 µmol/kg · min (p < 0.001) during the standard clamp. The decrease in Ra at most time points during the standard clamp significantly correlated with the EC₅₀. The highest correlation for the % decrease of glycerol Ra from baseline was found at 60 min (r = 0.96, p < 0.001) making this parameter a useful index for the antilipoytic insulin sensitivity. Neither plasma glycerol nor plasma free fatty acid (FFA) concentrations were significantly correlated with the EC₅₀. In conclusion, the standard hyperinsulinemic-euglycemic clamp in combination with isotopic determination of glycerol Ra provides a reasonable estimate for the antilipolytic insulin sensitivity. In healthy subjects, the parameter best suited to estimate the insulin EC₅₀ (by linear correlation) was the percentage decrease of glycerol Ra at 60 min.

Key words:

Insulin Resistance - Obesity - Type 2 Diabetes - Free Fatty Acids - Glycerol

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References

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Dr. M. Stumvoll

Medizinische Universitätsklinik

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