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IsletCalc computes surrogate indices of pancreatic islet hormone release from fasting and 75 g oral glucose tolerance test (OGTT) measurements, covering both beta-cell and alpha-cell function:
insulin_release(): beta-cell insulin release indices
(HOMA-beta, CIR, Stumvoll, BIGTT-AIR, disposition indices), following
Madsen et al. (2024) doi:10.1038/s42255-024-01140-6.glucagon_release(): alpha-cell glucagon secretion
magnitude (fasting glucagon, glucagon AUC).glucagon_resistance(): glucagon suppression /
resistance indices, reflecting impaired hepatic glucagon signaling as
described in the liver-alpha-cell-axis literature.data(example_data)
res <- insulin_release(example_data, category = c("fasting", "ogtt"))
head(res)
#> G0 G30 G120 I0 I30 I120 sex bmi Glucagon0 Glucagon30 Glucagon120
#> 1 5.71 8.39 5.59 56.4 283.5 171.5 0 19.3 3.33 2.58 3.72
#> 2 5.06 8.45 6.31 39.7 153.9 115.1 0 29.4 13.71 10.10 6.92
#> 3 4.59 7.85 6.16 87.5 512.8 257.1 0 26.6 6.28 4.27 4.58
#> 4 5.29 7.72 7.01 71.7 390.1 67.7 1 21.4 11.36 8.71 8.77
#> 5 5.13 8.27 5.78 31.3 182.5 90.7 0 31.0 11.98 8.02 9.56
#> 6 5.20 9.56 5.12 52.9 374.3 155.3 1 27.7 9.40 7.17 9.05
#> Homa_beta Cir Stumvoll Xinsdg30 Xinsg30 Di Bigtt_air
#> 1 85.08489 0.3862442 850.5693 0.7847755 4.512225 0.04323715 1161.789
#> 2 84.84603 0.2054480 542.2165 0.3119820 2.252916 0.04498467 1650.537
#> 3 267.63761 0.8485002 1462.1662 1.2082057 9.031530 0.04893109 3477.854
#> 4 133.54626 0.6786166 1196.1813 1.2134723 6.875295 0.05766393 2609.218
#> 5 64.02098 0.2591574 587.8071 0.4459490 3.047768 0.07130919 1734.967
#> 6 103.74624 0.3552093 841.1615 0.6826883 5.604328 0.05052567 2111.044
#> Dibig
#> 1 13100.08
#> 2 16881.84
#> 3 24216.89
#> 4 24179.56
#> 5 17734.61
#> 6 16087.13Request a single category if you only have fasting values:
head(insulin_release(example_data, category = "fasting"))
#> G0 G30 G120 I0 I30 I120 sex bmi Glucagon0 Glucagon30 Glucagon120
#> 1 5.71 8.39 5.59 56.4 283.5 171.5 0 19.3 3.33 2.58 3.72
#> 2 5.06 8.45 6.31 39.7 153.9 115.1 0 29.4 13.71 10.10 6.92
#> 3 4.59 7.85 6.16 87.5 512.8 257.1 0 26.6 6.28 4.27 4.58
#> 4 5.29 7.72 7.01 71.7 390.1 67.7 1 21.4 11.36 8.71 8.77
#> 5 5.13 8.27 5.78 31.3 182.5 90.7 0 31.0 11.98 8.02 9.56
#> 6 5.20 9.56 5.12 52.9 374.3 155.3 1 27.7 9.40 7.17 9.05
#> Homa_beta
#> 1 85.08489
#> 2 84.84603
#> 3 267.63761
#> 4 133.54626
#> 5 64.02098
#> 6 103.74624head(glucagon_release(example_data))
#> G0 G30 G120 I0 I30 I120 sex bmi Glucagon0 Glucagon30 Glucagon120
#> 1 5.71 8.39 5.59 56.4 283.5 171.5 0 19.3 3.33 2.58 3.72
#> 2 5.06 8.45 6.31 39.7 153.9 115.1 0 29.4 13.71 10.10 6.92
#> 3 4.59 7.85 6.16 87.5 512.8 257.1 0 26.6 6.28 4.27 4.58
#> 4 5.29 7.72 7.01 71.7 390.1 67.7 1 21.4 11.36 8.71 8.77
#> 5 5.13 8.27 5.78 31.3 182.5 90.7 0 31.0 11.98 8.02 9.56
#> 6 5.20 9.56 5.12 52.9 374.3 155.3 1 27.7 9.40 7.17 9.05
#> Fasting_glucagon Glucagon_auc
#> 1 3.33 372.15
#> 2 13.71 1123.05
#> 3 6.28 556.50
#> 4 11.36 1087.65
#> 5 11.98 1091.10
#> 6 9.40 978.45head(glucagon_resistance(example_data))
#> G0 G30 G120 I0 I30 I120 sex bmi Glucagon0 Glucagon30 Glucagon120
#> 1 5.71 8.39 5.59 56.4 283.5 171.5 0 19.3 3.33 2.58 3.72
#> 2 5.06 8.45 6.31 39.7 153.9 115.1 0 29.4 13.71 10.10 6.92
#> 3 4.59 7.85 6.16 87.5 512.8 257.1 0 26.6 6.28 4.27 4.58
#> 4 5.29 7.72 7.01 71.7 390.1 67.7 1 21.4 11.36 8.71 8.77
#> 5 5.13 8.27 5.78 31.3 182.5 90.7 0 31.0 11.98 8.02 9.56
#> 6 5.20 9.56 5.12 52.9 374.3 155.3 1 27.7 9.40 7.17 9.05
#> Glucagon_suppression_ratio Glucagon_insulin_ratio
#> 1 1.1171171 0.05904255
#> 2 0.5047411 0.34534005
#> 3 0.7292994 0.07177143
#> 4 0.7720070 0.15843794
#> 5 0.7979967 0.38274760
#> 6 0.9627660 0.17769376A Glucagon_suppression_ratio at or above 1 indicates a
failure to suppress glucagon after the glucose load, a hallmark of
hepatic glucagon resistance.
All three functions expect a data frame with a subset of these columns:
| Column | Meaning | Unit |
|---|---|---|
G0, G30, G120 |
Glucose at 0/30/120 min | mmol/L |
I0, I30, I120 |
Insulin at 0/30/120 min | pmol/L |
sex |
Male indicator | 1 = male, otherwise female |
bmi |
Body mass index | kg/m^2 |
Glucagon0, Glucagon30,
Glucagon120 |
Glucagon at 0/30/120 min | pmol/L |
If a column required for a given index is missing, that index is skipped with a warning rather than the whole function failing, so you can still compute whichever indices your data supports.
This vignette is a quick start. The package website hosts fuller articles with the exact formulas, unit conventions, biological interpretation and references:
These binaries (installable software) and packages are in development.
They may not be fully stable and should be used with caution. We make no claims about them.
Health stats visible at Monitor.