糖質関連検査項目における生理的変動：HOMA-R，HOMA-β

1 Vol. 35, No 5 (2012).. HOMA-R HOMA- .. The circadian rhythm of glycosylated compounds: HOMA-R and HOMA- . Akemi Matsubara, Shunji Fukutani, Kahoru Hanada, Michiko Shiga, Yoshio Iwamasu, Hiroko Kawahara, Hajime Sakamoto, Toshio Yoneda, Toshimi Oda, Yasushi Ohkuma, Nobiaki Muro, Kayoko Tadera, Takayuki Yoshioka and Fujio Tange Summary Although there is some difference among an individuals, it is well known that circadian changes are present in nearly all life throughout our bodies. It is important to understand interindividual variations in order to distinguish them from morbidity. Data were obtained from 10 healthy volun- teers (5 males: ages years, 5 females: ages years). Blood specimens were collected every 2 hours, and blood glucose and IRI (immunoreactive insulin) were measured. We evaluated the within-subject biological variations of glycosylated compounds. In this study, we attempted to identify the optimal drawing blood time for the calculation of an insulin resistance index (homeostasis model assessment ratio: HOMA-R and homeostatic model assessment beta cell function: HOMA- ).

2 Key words: HOMA-R, HOMA- , Circadian changes, Interindividual variations, Influence of a meal .. Glucose Glu Insulin Immunoreactive insulin: IRI . HOMA-IR homeostasis model assessment as an , Akemi matsubara 734-8551 1-2-3 734-8551 1-2-3.. Association of Clinical Chemistry in Hiroshima 24 8 27 Prefecture - or Momiji-kai Society 24 9 13 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan 409 .. index of insulin resistance . HOMA-R homeostasis model assessment ratio 2.. Glu HbA1c NaF EDTA2K . 1) Glu 140mg/dL VP-FH072 . HbA1c Glu 3,000 rpm . 1) H O M A - IRI . homeostatic model assessment beta cell function VP-P100 . IRI 15 3,000 rpm 10 . 40 60 30 . 2) Glu HbA1c . 3) .. HOMA-R HOMA- 3.. Glu HK-UV . Glu IRI HbA1c HPLC IRI . 24 ECLIA . IRI . 1 2 .. 1.. 1.. 10 26 56 . Mean . A B AB O SD CV CV . CV . 24 13 3) CV .. Glu IRI HOMA-R . HOMA- . HbA1c 2. 3, 4) 4-6) . HOMA-R IRI: U/mL Glu: mg/dL/405 Glu HOMA- (IRI: U/mL 360)/(Glu: mg/dL 63) mg/dL SD mg/dL HbA1c 12 30 690kcal NGSP SD.

3 18 30 1333kcal . 24g 6 Mean mg/dL SD HbA1c . 30 198kcal SD . 12 15 Glu 78. 20 10 120 Mean IRI 109 674 . Mean Glu 78 238 . Mean IRI 481 2950 Mean . CVI Glu 86 156 Mean . CVG 3) IRI 222 880 Mean . 410 . Vol. 35, No 5 (2012). IRI Mean U/mL SD U/. Glu mL U/m L SD 1,333 kcal U/mL HOMA-R Mean . Glu SD . IRI SD HOMA- . 10 Mean SD . 690 kcal 198 kcal SD . HbA1 HbA1c Glu .. Fig. 1 . 4.. 3.. Glu . IRI HOMA- HOMR-R HOMA- . R HOMR- . AST Fig. 2 . ALT TCho . TG .. Table 1 . Mann-Whitney test . p . Mean SD Glu . Mean mg/dL SD . mg/dL mg/dL SD HOMA-R HOMA- . mg/dL IRI . Fig. 1 Within-subject biological variations by time of day and month of year. 411 .. Circadian rhythm . Glu . IRI 10 . Glu mg/dL Fig. 1 . HbA1c 3) Glu CVI Glu IRI . CVG 7, 8 690 kcal . Fig. 2 Within-subject biological variations of the glucide-related items. (Ages/Male or Female). 412 . Vol. 35, No 5 (2012). 198 kcal Glu Glu.

4 11) . Glu IRI HOMA-R HOMA- . AST ALT TCho TG . Glu . IRI 2 .. Glu . Glu Glu IRI . Table 1 . 9) Glu Homeostasis HOMA-R IRI: U/mL Glu: mg/dL/405 Glu HOMA- . (IRI: U/mL 360)/(Glu: mg/dL 63) IRI .. IRI Glu HOMA-R . IRI .. Fig. 2 . HOMA-R Ishimori . Glu ) ) .. 14) 15) . dawn phenomenon ) 17) ). 10). Glu morning rise .. Glu . 1) Matthews19) . Glu 81 mg/dL IRI U/mL . Table 1 Comparison of fasting data before each meal time 413 .. HOMA-R , 29: 52-56, 2004. Glu 200 mg/dL ) : . : . , 28: 320-326, 2005. ) , : .. : .. Glu IRI .. : 1235-1244, 2007. HOMA- ) Akemi Matsubara, Kiyoshi Ichihara, Shunji Fukutani: R HOMA- Determination of reference intervals for 26 commonly morning rise measured biochemical analytes with consideration of Glu IRI long-term within-individual variations. Clinical Chemistry and Laboratory of Medicine, 46: 691-698, 2008.. ) : .. , 10: 1115-1120, 1996.. 10) Campbell PJ, et.

5 Al: Pathogenesis of the dawn phenom- enon in patients with insulin-dependent diabetes mellitus. N Engl J Med, 312: 1473-1479, 1985. 11) Bolli G & Gerich J: The dawn phenomenon, a common occurrence in both non- insulin-dependent and insulin- HOMA-R HOMA- dependent diabetes mellitus. N Engl J Med, 310: 1706- 1711, 1984.. 12) Masatoshi Ishimori, Noriyuki Takeda, Syouji Okumura, HOMA-R HOMA- . et. al: Increased insulin sensitivity in patients with aldosterone producing adenoma. Clinical Glu IRI Endocrinology, 41: 433-438, 1994. 13) , , : . HOMA-R HOMA- . , 42: 115-117, 1999. 14) , , : .. , 43(Supple-1): S-239, 2000.. 15) , , : HOMA-R .. , 42: 1005-1011, ) , , : . 1999. (Homeostasis model 16) , , : . assessment ratio: HOMA-R) .. HOMA-R . , 26: 123-128, 2003.. 33 , ) , : . 26(Supple): 419, 2001.. 17) : .. , 97: 855-858, 2001.. , 26: 453-457, 2003. 18) , , : . ) : . ADVIA Centaur.

6 28 .. , 44: 1069- . , 27: 221- 1079, 2000. 227, 2004. 19) Matthews DR, Hosker JP, Rudenski AS, et. al: ) : : . Homeostasis model assessment ratio insulin resistance .. and beta-cell function from fasting plasma glucose and , 31: 693-700, 2008 . insulin consentration in men. Diabetologia, 28: 412-419, ) , : . 1985.. 414.