Brief Review |
From Laboratoire de Biochimie des Lipoprotéines, INSERM U498, Faculté de Médecine, Dijon, France.
Correspondence to Frédéric Pont, Laboratoire de Biochimie des Lipoprotéines, Hôpital du Bocage, BP 1542, 21034 Dijon, France.
| Abstract |
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Key Words: compartmental models stable isotopes kinetics lipids lipoproteins
| Introduction |
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Because of the specific features of human lipoprotein metabolism, in vivo studies in humans cannot be replaced by animal experiments. For ethical reasons, the use of radioactive tracers should be avoided or is in fact prohibited in humans. On the other hand, recent improvements in mass spectrometry and isotope ratio mass spectrometry3 have increased the sensitivity and the reliability of stable-isotope enrichment measurements. In consequence, stable-isotope tracer kinetic studies are now an important component of in vivo lipid research programs in humans.
The data provided by a tracer experiment contain more information than can be extracted by simple methods of analysis (eg, linear regression or area under a curve). Compartmental modeling is a powerful mathematical modeling approach that is widely used to obtain quantitative or predictive information about the dynamics of a system. Kinetic modeling has become greatly facilitated by recent improvements in computer hardware and modeling software.4 However, kinetic modeling in stable-isotope experiments differs from radioactive isotope kinetics in many respects, and rigorous rules for compartmental model development must be kept in mind, from the experiment design step until a valid model is achieved. This review presents the practical aspects of model development in stable-isotope experiments. The examples shown in this article were obtained with the widely used SAAM4 software, and the terminology used in this article is analogous to that used in this software.
| Background |
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Stable-Isotope Tracers: Advantages of Their Use to Study Human
Lipid Metabolism
Ideally, a tracer should have the same physical and chemical
properties as the tracee and exactly reflect the tracee's movements in
vivo. The rate constants for chemical and physical processes should be
the same. The tracer should be uniformly mixed with the tracee, and the
number of labeled molecules introduced should not affect the state of
the system. In fact, the rates of chemical and physical processes
depend on the masses of the atoms involved. The difference in rate
constants between the unlabeled and the isotopically labeled molecule
is called the isotope effect.7 To
reduce the total amount of tracer to be used without losing
sensitivity, it has been suggested to combine isotope ratio mass
spectrometry and uniformly labeled molecules. However, uniformly
labeled tracers should be used with great care because they are
potential inducers of a strong isotope effect. The combination of
moderately labeled molecules along with high-precision mass
spectrometry may be the best compromise.3
Stable-isotope tracers offer several advantages over radioactive isotopes.8 The use of labeled compounds with stable isotopes is safe in humans.9 In protein metabolic experiments, the use of amino acids labeled with stable isotopes allows simultaneous study of several proteins and avoids protein alterations induced by exogenous protein radiolabeling.10 For example, it is possible to simultaneously study apoB, apoA-I, and apoA-II kinetics by using [13C]leucine.3 Comparisons between radioactive and stable-isotope tracers have shown that both tracers lead, in general, to the same conclusions.11 12 13 Nevertheless, the two tracers differ in some aspects14 : in contrast to radioactive tracers, stable-isotope tracers have nonnegligible mass and are naturally present in the system, and the measured variable is a ratio of the two isotopic species. These features do not allow stable-isotopic tracer data analysis to use unmodified radioactive tracer approaches.
Data Expression in Stable-Isotope Experiments
The presumed analogy between the radioactive specific activity and
stable-isotope enrichment has been shown to be
incorrect14 15 and to result in significant
errors in model systems when the dose of tracer is
10% of the pool
size.16 The proper analog of specific activity is
the tracer-to-tracee ratio z(t)14 :
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However, in some situations, a variable different from
z(t) is required.14 17 In the
estimation of protein fractional synthetic rate17
or in condensation biosynthesis,18 when the total
flux
(tracer plus tracee) from precursor to product is a
constant value and equal to the value before the tracer experiment, the
variable required for calculating the kinetic
parameters is the ratio of tracer mass to the (tracer plus
tracee) masses:
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In apolipoprotein kinetics, it is generally assumed that the tracee steady state is not perturbed by the tracer experiment. Thus, the tracer to tracee ratio is used to express the measurements.2 13 19 20 21
Principles of Compartmental Models
Definitions
A compartment defines a well-mixed and kinetically
homogeneous amount of material. A compartment is a
mathematical concept that does not necessarily correspond to a
physiological space or a well-delimited physical
volume. A compartmental system is a system made up of a finite number
of compartments that interact by exchanging material. A compartmental
model is a mathematical model whose equations describe the flux of
material between a finite number of compartments.
Symbolic and Mathematical Representation of
Compartmental Models
A compartment is generally represented by a circle or
a box, and transfers of material are represented by arrows.
Each arrow is labeled with the corresponding fractional transfer
coefficient. Fractional transfer coefficients denoted k(i,j)
or L(i,j) express the fraction of compartment j
transferred to compartment i at time t. For
example, k(i,j)=0.3 hour-1 means that
30% of compartment j is transferred to compartment
i per hour. The flux of tracee in mass per unit of time from
compartment j to compartment i at time
t is
FLUX(i,j)=k(i,j)xQj,
where Qj is the tracee mass in compartment
j at time t. The flux of tracer in mass per unit
of time from compartment j to compartment i at
time t is
flux(i,j)=k(i,j)xqj,
where qj is the tracer mass in compartment
j at time t.
In compartmental systems used in tracer experiments, the state variables of the system are the amounts of material in each compartment, and the changes in such systems are usually represented by differential equations.7 So compartmental analysis is a geometric way of representing a system of differential equations. With modeling software, it is possible to solve the differential equations and to fit the model to the data by using a weighted least-squares approach.22 A the end of the fitting process, numerical values for the fractional transfer coefficient k(i,j) are obtained. So fluxes of the tracee can be easily calculated, and a dynamic representation of the system under study is obtained.
A compartmental model is nonlinear if at least one fractional transfer coefficient is a function of the size of at least one compartment. A compartmental model is linear if all fractional transfer coefficient are either constants or functions of time only. In a steady-state tracer experiment, the compartmental model describing the experiment is linear with constant coefficients. The ability of a compartmental model to describe a system depends on some properties of the system. To be well approximated by the model, the system should be easily partitionable into amounts of material with exchanges between them, and the transfer rates between compartments should be negligible compared with the rates of mixing within the compartments.7
Compartmental Model Design in Stable-Isotope Experiments
Steady-State Experiments: Example of ApoB Kinetic Model
Building
In this section, we assume that the tracer mass is not negligible
with respect to the tracee mass, but we assume that the tracer is
"ideal" in the sense that it is indistinguishable from the tracee
and does not perturb the tracee constant steady state during the
experiment. This means that the tracee masses Qi and the
rate constants k(i,j) describing the tracer and the tracee
system are constant. A test of the endogenous constant
steady state has been proposed by Cobelli et
al.14 If the tracee steady state has been
perturbed, the tracee concentration C becomes a function of
time C(t):
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In stable-isotope experiments two sets of differential equations are needed to describe the model, because two state variables, q and Q, appear in the measurement equation z(t)=q(t)/Q(t).14 15 One set of differential equations describes the movement of tracer through the model, and the other set describes the movement of tracee through the model.
As an example, in the Figure
, a
three-compartment model based on information from Reference 2323 is
shown. This model has been chosen to illustrate the development of
differential equations in stable-isotope experiments because of its
extreme simplicity. It represents the minimal model using
stable isotopes for studying the metabolism of
apoB-containing lipoproteins in humans. Compartments 2, 3, and 4
represent VLDL, IDL, and LDL, respectively. Compartment 1
represents the precursor pool of VLDL apoB-100. In practice, it
is often necessary to add a delay compartment (see the section entitled
Delays below) between compartments 1 and 2 to take into account the
assembly time of VLDL.
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Once a model is built, it is necessary to describe the experiment; ie,
to indicate in which compartment(s) the tracer is introduced and in
which compartment(s) the amounts of tracer and tracee are estimated. In
the Figure
, we show that in stable-isotope compartmental modeling it is
necessary to describe separately the fate of the tracer and the tracee
through the model to provide a correct set of differential equations.
That is why two separate "submodels" are represented in
the Figure
to describe the experiment: one model concerns the tracer
and the other concerns the tracee. In SAAM a submodel used
to describe the experiment is called an "experiment." It is
possible to build both tracer and tracee experiments. When one creates
a tracer or a tracee experiment in the model, one has to specify the
inputs (tracer introduction) and the samples (enrichment measurements
and compartments masses). From the structure of the model and
information about the input, the software internally constructs the
system of differential equations represented by the model
and the input. In our example, the differential equations describing
the tracer movement through the model are as follows:
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NonSteady State Experiments: Example of LDL Apheresis and
Intravenous Infusion of Triglyceride Emulsion
In the nonsteady state, the tracee masses Qi as well as
the rate constants k(i,j) are time-varying quantities. One
possible way of describing nonsteady state experiments involving
stable-isotope tracers with a compartmental model is to combine two
tracer experiments. One describes movement of the tracer through the
model and the other describes the movement of the tracee through the
model.
Recently, Parhofer et al25 studied the effects of LDL apheresis on the metabolic parameters of apoB in a kinetic study based on a bolus injection of trideuterated leucine. To calculate nonsteady state metabolic parameters, a multicompartmental model was used. In practice, the nonsteady state condition was modeled with the use of SAAM II software as follows. Two tracer experiments were performed on the model: one described the movement of tracer through the model and the other described the movement of apoB through the model. The link between the two experiments originated from the data that were expressed as tracer-to-tracee ratios. The abrupt reduction in apoB mass in the LDL fraction after apheresis was modeled by using a change condition function in SAAM II.
A similar approach was adopted by Björkegren et al26 to describe the effects of an infusion of triglyceride emulsion on VLDL apoB-100 kinetic. In this study, three subjects underwent a simultaneous stable-isotope kinetic study and triglyceride emulsion infusion. [D3]Leucine was infused for 10 hours, and after 6 hours of [D3]leucine infusion, Intralipid was infused for 4 hours. Infusion of the emulsion caused a perturbation of the steady state. The model for VLDL1 and VLDL2 apoB-100 turnover consisted of two linked parallel systems: one explained the behavior of the tracer and the other described the behavior of tracee (apoB mass in VLDL1 and VLDL2). An instantaneous change in the values of the rate constants was obtained by using the time-interrupt system in SAAM software.
The two previous examples are simple situations in which no nonlinear fractional rate constants were required to fit the data. However, it is generally not the case in nonsteady state experiments, and the estimation of nonlinearity is a difficult task. Therefore, whenever possible, experiments should be performed under steady-state conditions.
| Choices to Be Made When Developing the Compartmental Model |
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In simple cases, an estimation of the number of compartments can be obtained by fitting the curve to a sum of exponentials.7 Otherwise, model development may start with the simplest model based on the study design assumptions. The complexity of the model should be progressively increased by including more known physiological details until the optimal complexity is obtained.28 Statistical tests to compare models are indicated below.
A Priori Identifiability of the Model
A priori identifiability tests whether a mathematical model can
provide unique solutions for unknown parameters from data
collected in an experiment under the ideal condition of noise-free
observations and error-free model structure. A model is a priori
structurally identifiable if all of its parameters are
uniquely identifiable and is nonidentifiable if at least one of its
parameters is nonidentifiable. As pointed out by Cobelli
and DiStefano,29 identifiability of all
parameters does not generally imply a unique model. In this
case the model is said to be identifiable but not uniquely so. For
example, in Reference 2929 it is shown that two distinct
three-compartmental models with the same number of
parameters can fit a set of data equally well. When the
model is a priori nonidentifiable, several strategies are
available: (1) the model structure can be reconsidered, (2) constraints
can be added,21 and (3) the experimental design
can be modified to provide more information. Unidentifiability can
arise with very simple two-or three-compartment models, so
identifiability is truly a critical aspect of model development.
Testing methods for identifiability have been reviewed and compared by
Cobelli and DiStefano in Reference 2929 . A practical example can be
obtained from Reference 2121 . Software is being developed to test a
priori identifiability of linear compartmental
models.30 A posteriori identifiability is related
to both the statistical precision of parameter estimation
and the goodness of fit, to be discussed in a later section of the
current report.
Forcing Functions
Very often, the biologist or clinician is interested only in
obtaining a given set of parameters from his or her study.
In this case it is not necessary to build a very complex model that
fully describes the behavior of the tracer. For example, if one studies
apolipoprotein kinetics by using endogenous labeling with
labeled leucine, it is not necessary to develop a complex model to
describe whole-body leucine metabolism. Plasma leucine
enrichment can be fitted by a function called a forcing
function, and this function can be used directly as input in the
model. Consequently, use of the forcing function takes into account the
"recycling" of the tracer and minimizes its effects on the
slow-turnover compartments.
Forcing functions are used to decouple a complex system. This is accomplished by forcing the contents of a specific compartment to equal a known function. The design of the forcing function is of great importance in model building. In complex model development, forcing functions can also be used to subdivide and fit different portions of the model.6 28 Fisher et al31 demonstrated in an apoB kinetic study following a bolus injection of labeled leucine that plasma leucine is not always a suitable forcing function in the model because the labeling of intracellular and extracellular leucine is not always similar.
Delays
Some physiological processes are not
instantaneous and occur only after a time delay. For example, one VLDL
particle is assembled in
30 minutes. If the investigator wants to
determine the FSR of VLDL apoB, this time delay should be taken into
account. It has been shown that neglecting time delays can cause
significant errors in estimating the FSR.19 In
SAAM software, delays are constructed internally by using
two or more compartments. Increasing the number of compartments within
the delay increases the resolution of the delay but also increases the
computation time.
Experiment Design
Experiment Planning
Whenever possible, each experiment should be improved in the light
of previous ones. Thus, on average, a smaller number of experiments
will be required if they are performed sequentially than if they are
performed simultaneously.32 The
experiments should be planed to facilitate estimation of the
parameters. For example, to estimate a slow component of
the model, it is necessary to perform a long-term
experiment.5 33 On the contrary, to study a
molecule with a fast turnover time, short-term experiments with
frequent sampling are required.
It should be pointed out that in long-term experiments with endogenous labeling, tracer recycling can significantly affect the shape of kinetic curves, especially for pools that turn over slowly.5 Tracer recycling may be the major drawback of long-term experiments, although models that include a recycling loop have been reported.31 However, this kind of model must be used with great care. Indeed, it is very difficult to accurately estimate the true contribution of recycling. This problem is especially crucial in low-turnover protein studies, like those for apoA-I or apoA-II. On one hand, a long-term study of these proteins might be compromised because of tracer recycling; on the other, a short-term experiment would not exactly reflect the metabolism of these proteins. To our knowledge, a satisfactory solution does not exist. So in both cases, the results should be examined with great care.
Sampling Protocol
Selection of the sample time can have a significant effect on
parameter estimate precision. An optimal sampling schedule
is the one in which the maximum precision of model
parameter estimates is
achieved.34 35 36 It also allows the investigator
to optimize the cost of the experiment and to save time by reducing the
number of samples. Optimal sampling schedules are not suitable for
testing model adequacy or for discriminating high-order models because
the number of sample times is too low. Therefore, it is important to
keep in mind that optimal sampling schedules are applicable in vivo for
validated models only in terms of both structure and measurement error
description. Software programs to compute optimal designs have been
reported by Cobelli et al.37 When the optimal
sampling schedule cannot be used, an alternative method for choosing
data sampling time is to use simulation. A set of data can be obtained
by adding random noise to the points calculated by the model. After
removing some data points, the set of data can then be fitted to test
the effect of sampling times on parameter accuracy and
precision. In practice, data points are especially useful in regions of
the graph where changes in the slope of the curve are important.
Data Weighting
Models are fitted to the data by using a weighted least-squares
approach, so that both the value and the weight of the data are taken
into account in the calculations. In SAAM modeling
software, the weights are estimated from the data error as follows,
with the data error variance approximated by
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, ß, and
are parameters that can be estimated
from the data. The weight wi of
datum i is given by
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Data can be weighted by using absolute weights or relative
weights. When absolute weights are used,
is assumed to be equal
to 1; when relative weights are used,
is unknown and is
estimated for each data set. When at least two data sets are used,
relative data weighting allows automated optimization of each data set
weight. Data weighting has a great impact on the model-fitting process.
Thus, when the error structure is not known exactly, use of relative
weights is recommended.
Data Scaling
The scaling of the data is very important because computers keep
track of only a certain number of significant digits. Thus, severe
rounding-off errors can be minimized by optimized data scaling that
avoids very large or very small numbers. In stable-isotope kinetics,
data can be expressed as the tracer-to-tracee ratio in percent. In this
case, the correct expression for sample si is
si=100xqi/Qi. For complex models as
well, in which the amount of tracer differs markedly between
compartments, the model can be subdivided and the different portions
fitted separately (see the section on Forcing
Functions).
Initial Estimates of the Parameters
The best fit of the data and the correct parameter
values are obtained when the weighted residual sum of squares
(WRSS) between observed and calculated values reach a global
minimum:
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When an investigator fits a model to experimental data, the software adjusts the parameter values within high and low limits specified by the user until the best fit between the data and the associated calculated values is obtained. A poor selection of initial values can cause the search to drift indefinitely without finding a minimum or to converge on the wrong solution, ie, to become "trapped" in a local minimum.22 These problems can also arise from an improper choice of weights or poor numerical identifiability. In any case, poorly selected initial values lead to an increase of computer time to reach the solution. So before fitting the data, a reasonable fit should be obtained by adjusting the values of the parameters manually. There are no general guidelines, but whenever possible, initial estimates of the parameters should be based on previous experience or previous knowledge in the field.
| Validation of the Completed Model |
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Validation of Simple Models
Assessing the Goodness of Fit
The scatter of observed data points about the theoretical curve
should be randomly distributed. The residuals should not be
systematically related to the x values. This can be tested
by using the runs test.40 22 A run is a series of
consecutive points with a residual of the same sign, positive or
negative. The expected number of runs is calculated as
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=5%, the z value should fall within the interval
[-1.96,1.96]. As pointed out by Bard,32
failure to pass the runs test is no reason for outright rejection of
the model. In particular, when the data are very accurate, neglected
effects outweigh random errors in measurements.
Estimation of the Parameters
Once a good fit of the data is obtained, the values and the
statistical certainties of the model parameters should be
carefully inspected. When a large fractional SD is associated with some
parameters, either more experimental observations should be
added or some compartments should be removed.41
The values of the parameters should be significantly
different from zero. To build a model of ß-carotene
metabolism, Novotny et al42 tested
parameter values against zero by using a single-tailed,
one-sample, Student's t statistic. In this study,
compartments associated with statistically nonsignificant transfer
coefficients were included in other compartments. The statistical
relationship among parameters should also be checked by
examining the correlation matrix. The occurrence of large correlation
coefficients (>0.85) for certain combinations of
parameters (multicolinearity) indicates that
various combinations of parameter values will fit the data
equally well.43 If the parameter
values are well determined and compatible with the accumulated
knowledge in the field and if the residuals are acceptable, then the
model may be consistent.
Comparison of Models
More than one model can provide a good fit of the data and a
correct parameter estimation. If the models have the same
number of adjustable parameters, then the model that
provides the lowest WRSS is superior. Comparing models with different
numbers of adjustable parameters is less straightforward
because increasing the number of parameters reduces the
WRSS, but at the same time, it may unnecessarily complicate the model.
To test whether or not the WRSSs have been sufficiently reduced to
justify the choice of the model with additional parameters,
the F test may be used.38 The F ratio is defined
by
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The Akaike information criterion (AIC)38 44 and the Schwartz criterion (SC)45 are also commonly used to compare two or more models. The model with the smallest criterion is the best. The formula to calculate the criteria depend on data weighting:
Absolute weights
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Relative weights
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Validation of Complex Models
Complex models are those in which not all of the unknown
parameters can be estimated by formal identification
techniques.39 Such models are generally of high
order, with a small number of variables accessible to direct
measurement. The approach to validate complex models can be obtained
from Cobelli et al.39
Validity of the Model
Validity of the model may be assessed by both internal
and external criteria.39
Internal criteria are mathematical criteria. The model must
contain no conceptual errors, and the algorithm for simulation or
fitting should lead to accurate solutions with acceptable round-off
errors. External criteria refer to purpose, theory, and
data.39 Theoretical rules, such as mass
conservation, which correspond to physical and chemical laws, should be
respected in the model. The model should be consistent with the
experimental data available and provide an accurate estimation of the
parameters. Last, it should provide useful information for
the practical situation that interests the biologist or clinician.
| Conclusions |
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| Acknowledgments |
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Received October 30, 1997; accepted November 25, 1997.
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