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Biomedical subjects

C Cobelli

Publications and source records attributed to C Cobelli.

17 recordsLinked to original sources

Tracer-to-tracee ratio for analysis of stable isotope tracer data: link with radioactive kinetic formalism.

A kinetic formalism for the analysis of stable isotope transient tracer data is developed by establishing the link with the formalism available for radioactive tracer data. The crucial variable is the tracer-to-tracee ratio. By expressing the measurements in terms of this ratio, the conventional kinetic formalism used for radioactive data can be applied to estimate noncompartmental parameters using stable isotope tracer data. The tracer-to-tracee ratio also plays an important role in compartmental modeling. By considering the tracer masses in the compartments as state variables the system-experiment model can be written in a format analogous to that usually adopted for the radioactive tracer. Finally, it is shown that the tracer-to-tracee ratio also plays a role in a test of the endogenous steady-state assumption.

Animals

V-A and A-V modes in whole body and regional kinetics: domain of validity from a physiological model.

In turnover studies, both at whole body and regional level, sources of tracer and tracee are in general nonidentical thus resulting in nonuniformity of specific activity (SA). Guidelines are available in literature to deal with the heterogeneous SA problem, and either the V-A or A-V modes, based on the arterial and mixed venous blood SA, respectively, have been recommended for different substrates. In particular, the A-V mode is considered the method of choice for studying lactate, amino acids, free fatty acid, etc. Guidelines are based on specific models chosen to describe kinetic and circulatory events of the substance under study but are often conflicting. A unitary physiological framework to understand assumptions of various models is also lacking. In this paper, we first review these models to assess their domain of validity. In particular, we point out major drawbacks that relate to the tissue compartment being treated as a lumped well-mixed pool with a single SA value. We then attempt to handle the nonuniform tissue SA by employing a more physiological model. The tissue system is thought to be made up of elementary units connected in parallel and categorized according to their functional ability to affect incoming SA. Potential changes of SA within individual units are examined. Thus each tissue unit may provide a different contribution to the overall change in SA, as measured in mixed venous blood. A spatial profile of SA is also identified both along the direction of blood flow and transversely toward the inner cellular space. This distributed model allows assessment of the domain of validity of V-A and A-V modes. We show that, in general, the V-A mode underestimates the production rate both at whole body and regional level, whereas the A-V mode can either under- or overestimate it.

Animals

Power spectral analysis of heart-rate variations improves assessment of diabetic cardiac autonomic neuropathy.

Power spectral analysis (PSA) of heart-rate variations has recently proved a useful tool in evaluating cardiovascular autonomic activity. It offers the possibility of examining both the functioning of parasympathetic and sympathetic pathways through breakdown into two frequency bands, and of their effects on heart-rate cyclic variability. We applied an autoregressive model for PSA to study overall autonomic tone in 20 male age-matched control subjects and 53 insulin-dependent (type I) diabetic subjects, subdivided into three groups of 20, 15, and 18, each group presenting different degrees of autonomic involvement. We found that: 1) power spectrum density (PSD) values at high-frequency bands (parasympathetic dependent) were similar in diabetic subjects without cardiac autonomic neuropathy (CAN) and in control subjects, but differed significantly from diabetic subjects with mild CAN and severe CAN, both standing and lying; 2) PSD values at low frequency (mainly sympathetic dependent) were similar, or slightly different, in diabetic subjects without CAN and in control subjects, but differed significantly from diabetic subjects with mild and severe CAN, both standing and lying; 3) as an expression of parasympathetic versus sympathetic coherence, correlations, both standing and lying, existed between PSD values at low- and high-frequency bands in control and diabetic subjects without CAN, but not in diabetic subjects with CAN; and 4) different degrees of correlation characterized the PSD values of high and low frequencies versus traditional cardiovascular test values in the diabetic subjects. The best correlation was between PSD low-frequency values and the lying-to-standing maneuver.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Domain of validity of classical models of leucine metabolism assessed by compartmental modeling.

Whole-body modeling of in vivo leucine (an essential amino acid) metabolism is fundamentally difficult due to the complexity of the system. This has favored the use of two simple kinetic models, the so-called primary and reciprocal pool models, to interpret tracer data, but their domain of validity is uncertain. We define here the error of these two approaches by using comprehensive compartmental models of leucine metabolism as true representations of the leucine system. Of particular interest is the comparison of the two simple models with an 11-compartment model characterized by a rich intracellular compartmentation that has recently been proposed as a sound physiological description of the system. Formulas are derived that define in structural terms the error of the primary and reciprocal pool models.

Humans

A reduced sampling schedule for estimating the parameters of the glucose minimal model from a labeled IVGTT.

The minimal model of tracer glucose disappearance allows the measurement in man of important metabolic parameters from a labeled IVGTT (intravenous glucose tolerance test). Usually 30 blood samples are drawn to measure the insulin and the labelled glucose concentration time courses, which provide the data base for the model identification. In this paper, we address the problem of reducing the number of blood samples withdrawn without, however, deteriorating parameter estimation. By using a stepwise approach, largely based on optimal experiment design theory, we have derived a reliable reduced sampling schedule, which comprises only 14 total samples. The practical application of this reduced schedule has been validated by applying it in a new set of human experiments, completely independent of the ones used in the design phase.

Blood Glucose

Minimal models of glucose disappearance: lessons from the labelled IVGTT.

In this paper the domain of validity of the unlabelled and labelled minimal models of glucose disappearance is studied. Labelled intravenous glucose tolerance tests were performed in six normal subjects using 3-3H-glucose as the tracer. Insulin and unlabelled glucose data were analysed with the minimal model of glucose disappearance. The model provides estimates of glucose effectiveness (SG) and insulin sensitivity (SI) which measure the effects of glucose per se and insulin on both glucose production and disposal. Insulin and labelled glucose data were analysed with the labelled minimal model of tracer disappearance. Estimates of glucose effectiveness (SG*) and insulin sensitivity (SI*) which reflect disposal processes only were calculated. The results of the two minimal models suggest two areas of model error. Firstly, the relationships between labelled and unlabelled parameters contradict the theoretical expectation. Secondly, the time-course of hepatic glucose production is unrealistic. Possible sources of these inconsistencies are an inadequate description of the glucose and/or insulin effect upon hepatic glucose production, and the assumption that glucose kinetics are monocompartmental. The monocompartmental description of glucose kinetics may affect both model parameters and hepatic glucose production and this leads to a critical reexamination of the previously published validation studies in which the minimal model metabolic indices have been compared with the analogous indices measured during glucose clamp studies.

Adult

Quantitative estimation of insulin sensitivity.

We have evaluated the feasibility of using a mathematical model of glucose disappearance to estimate insulin sensitivity. Glucose was injected into conscious dogs at 100, 200, or 300 mg/kg. The measured time course of insulin was regarded as the "input," and the falling glucose concentration as the "output" of the physiological system storing and using glucose. Seven mathematical models of glucose uptake were compared to identify the representation most capable of simulating glucose disappearance. One specific nonlinear model was superior in that it 1) predicted the time course of glucose after glucose injection, 2) had four parameters that could be precisely estimated, and 3) described individual experiments with similar parameter values. Insulin sensitivity index (SI), defined as the dependence of fractional glucose disappearance on plasma insulin, was the ratio of two parameters of the chosen model and could be estimated with good reproducibility from the 300 mg/kg injection experiments (SI = 7.00 X 10(-4) +/- 24% (coefficient of variation) min-1/(microU/ml) (n = 8)). Thus, from a single glucose injection it is possible to obtain a quantitative index of insulin sensitivity that may have clinical applicability.

Animals

A computer program for the analysis of controllability, observability and structural identifiability of biological compartmental systems.

A computer program to check structural identifiability of biological compartmental systems, that is the priori possibility of estamating all unknown system parameters through a multi input-multi output tracer experiment is presented. The procedure, as based only on the adopted compartmental structure and the chosen input-output experiment, is independent of the numerical values of the parameters: therefore the program can be usefully employed before parameter estimation algorithms, to assure that all the unknown parameters evidenced in the model can be estimated from the experimental data. After a short review on compartmental models, controllability observability and structural identifiability are defined and techniques to check them are provided. The digital computer implementation of the whole procedure is discussed in detail. Some typical program runs regarding the application to biological systems are given.

Computers