Beta cell function: difference between revisions
Diff·revision 4 → 5·16:09, 28 Sep 2024
Difference between revision 4 and revision 5 of Beta cell function. 3 lines changed; the page grew by 455 bytes.
| Revision 4 — 14:37, 20 Sep 2024 ReceptorRhoda (talk) expand §Change under treatment and weight loss 2,291 bytes ±0 | Revision 5 — 16:09, 28 Sep 2024 ArchiveBot (talk) bot: expand PMID to full citation 2,746 bytes +455 | ||
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| 10 | The central methodological difficulty is that secretion and sensitivity are not independent. A healthy beta cell compensates for insulin resistance by secreting more, so an absolute secretion figure that looks normal may represent substantial dysfunction in a very insulin-resistant person. Measures that do not adjust for sensitivity — including fasting insulin and HOMA-B — are therefore weak, and the disposition index, the product of a secretion measure and a sensitivity measure, was devised to address exactly this.{{r|bergman2002}} | 10 | The central methodological difficulty is that secretion and sensitivity are not independent. A healthy beta cell compensates for insulin resistance by secreting more, so an absolute secretion figure that looks normal may represent substantial dysfunction in a very insulin-resistant person. Measures that do not adjust for sensitivity — including fasting insulin and HOMA-B — are therefore weak, and the disposition index, the product of a secretion measure and a sensitivity measure, was devised to address exactly this.{{r|bergman2002}} |
| 11 | 11 | ||
| + | 12 | Beta cell function is relevant to this wiki chiefly because it changes under incretin therapy and after substantial weight loss, and because indices derived from it appear in trial reports as secondary endpoints where their limitations are rarely restated.{{r|drucker2018}} | |
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| 12 | == What is being measured == | 14 | == What is being measured == |
| 13 | Insulin secretion cannot be sampled at source. Peripheral venous insulin has already passed the liver, which extracts a variable 40–80% at first pass, so peripheral concentration understates secretion by an amount that itself varies between people and with pulsatility.{{r|rorsman2013}} | 15 | Insulin secretion cannot be sampled at source. Peripheral venous insulin has already passed the liver, which extracts a variable 40–80% at first pass, so peripheral concentration understates secretion by an amount that itself varies between people and with pulsatility.{{r|rorsman2013}} |
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| 19 | <ref name="rorsman2013">Rorsman P, Braun M. "Regulation of insulin secretion in human pancreatic islets." ''Annual Review of Physiology'' 75:155–179 (2013). PMID 22974438.</ref> | 21 | <ref name="rorsman2013">Rorsman P, Braun M. "Regulation of insulin secretion in human pancreatic islets." ''Annual Review of Physiology'' 75:155–179 (2013). PMID 22974438.</ref> |
| 20 | <ref name="bergman2002">Bergman RN, Ader M, Huecking K, Van Citters G. "Accurate assessment of beta-cell function: the hyperbolic correction." ''Diabetes'' 51 Suppl 1:S212–S220 (2002). PMID 11815482.</ref> | 22 | <ref name="bergman2002">Bergman RN, Ader M, Huecking K, Van Citters G. "Accurate assessment of beta-cell function: the hyperbolic correction." ''Diabetes'' 51 Suppl 1:S212–S220 (2002). PMID 11815482.</ref> |
| + | 23 | <ref name="drucker2018">Drucker DJ. "Mechanisms of action and therapeutic application of glucagon-like peptide-1." ''Cell Metabolism'' 27(4):740–756 (2018). PMID 29617641.</ref> | |
| 21 | 24 | ||
| 22 | {{DEFAULTSORT:Beta cell function}} | 25 | {{DEFAULTSORT:Beta cell function}} |