Transplant Estimated Function：评估移植后胰岛功能的良好指标

yuji8

Transplant Estimated Function (TEF): A simple index to evaluate beta—cell secretion
after islet transplantion
ABSTRACT

Objective: The ?score is a highly regarded approach to the assessment of transplant functionality. Our aim was to develop an index of ?cell function that hinges on the pillars of ?score (daily insulin requirement and HbA1c), has a straightforward physiological interpretation, and does not require the execution of an insulin-stimulation test.

Research Design And Methods: The new index is denoted TEF (Transplant Estimated Function) and is obtained from daily insulin requirement and HbA1c. TEF estimates the amount of insulin secreted daily and can be normalized to the number of transplanted islets, thus permitting evaluation of the cost-effectiveness of the transplant. TEF was compared with the area under the curve (AUC) of C-peptide concentration over 24 hrs, as well as the acute insulin response to intravenous glucose (AIRglu) and arginine (AIRarg). The association between TEF and ?score was also investigated.

Results: TEF correlation with. 24-hrs-AUC(C-pep) was r=0.73 (p<0.005), whereas ?score vs. 24-hrs AUC(C-pep) was r=0.33 (p=NS). TEF correlation with AIRglu was r=0.59 (p<0.001) and close to ?score vs. AIRglu (r=0.65, p<0.001). TEF correlation with AIRarg was r=0.33 (p<0.005) and similar to ?score vs. AIRarg (r=0.34, p<0.005). TEF and ?score were correlated well (r=0.69, p<0.0001) and showed similar time profiles.

Conclusions: TEF estimates daily insulin secretion, it is simpler than ?score, and its performance against reference indices of ?cell secretion is in line with that exhibited by ?score. TEF can be normalized to the number of transplanted islets, and thereby provide a benchmarking tool to evaluate the cost-effectiveness of the transplant.

http://care.diabetesjournals.org/cgi/content/abstract/dc07-0975