Insulin resistance and compensation in Thoroughbred weanlings adapted to high-glycemic meals1

Effects of short-term training on insulin sensitivity and skeletal muscle glucose metabolism in Standardbred horses

REASONS FOR PERFORMING STUDY

Increased insulin sensitivity occurs after a period of exercise training, but the mechanisms underlying this training-associated increase in insulin action have not been investigated.

OBJECTIVE

To examine the effects of short-term endurance training (7 consecutive days) and a subsequent period of inactivity (5 days) on whole body insulin sensitivity and GLUT-4 protein and the activities of glycogen synthase (GS) and hexokinase (HK) in skeletal muscle. It was hypothesised that training would increase insulin sensitivity in association with increased GLUT-4 protein and activities of GS and HK, but that these changes would be transient, returning to baseline after 5 days of inactivity.

METHODS

Seven mature Standardbred horses completed training consisting of 7 consecutive days of 45 min of treadmill exercise at a speed that elicited 55% of pretraining maximal aerobic capacity (VO2peak). Insulin sensitivity was determined by rate of glucose disposal (M) during the last 60 min of a 120 min euglycaemic-hyperinsulinaemic clamp (EHC) performed before (-2 days) and at 1 and 6 days following training. VO2peak was measured before (UT) and after (TR) training and the period of inactivity (IA).

RESULTS

Training resulted in a 9% increase in mean VO2peak (P<0.05) that was maintained following inactivity (IA). Mean M values were more than 2-fold higher (P<0.05) in TR than in UT. Mean M was also higher (P<0.05) in IA when compared to UT. GLUT-4 protien abundancewas more than 10-fold higher in TR and IA (P<0.001) than in UT. Pre-EHC GS activity and GS fractional velocity were increased (P<0.05) in TR when compared to UT and IA. Pre-EHC HK activity was increased (P<0.05) in IA when compared to UT and TR. Muscle glycogen was 66% lower (P<0.05) in TR than in UT and IA.

CONCLUSIONS

Short-term training resulted in increases in whole body insulin sensitivity, and GLUT-4 protein content and glycogen synthase activity in skeletal muscle. The enhancements in insulin sensitivity, GLUT-4 protein and glycogen synthase activity were still evident after 5 days of inactivity.

POTENTIAL RELEVANCE

Insulin resistance in equids has been associated with obesity and predisposition to laminitis. Regular physical activity may mitigate risk of these conditions via enhancement of insulin sensitivity and/or control of bodyweight.

Role of diet and feeding in normal and stereotypic behaviors in horses

This article reviews the effects of diet on equine feeding behavior and feeding patterns, before considering the evidence that diet affects reactivity in horses. A growing body of work suggests that fat- and fiber-based diets may result in calmer patterns of behavior, and possible mechanisms that may underpin these effects are discussed. In contrast, there is little evidence that herbal- or tryptophan-containing supplements influence equine behavior in any measurable way. The role of diet in the development of abnormal oral behaviors, particularly the oral stereotypy crib-biting, is also reviewed, and suggestions for future work are presented.

Insulin sensitivity and glucose dynamics during pre-weaning foal development and in response to maternal diet composition

Nutritional management of animals during pregnancy can affect glucose and insulin dynamics in the resulting offspring through influences on fetal development. Additionally, high starch feeding in mature horses is associated with reduced insulin sensitivity and an increased risk for diseases such as obesity and laminitis. However, no study has yet evaluated the effect of feeding a high starch diet to pregnant mares on glucose and insulin dynamics in their offspring. Twenty late-gestation mares maintained on pasture were provided two-thirds of digestible energy requirements from isocaloric, isonitrogenous low starch (LS, n=10) or high starch (HS, n=10) feed. Their foals were assessed with an insulin-modified frequently sampled intravenous glucose tolerance test at 5, 40, 80, and 160 d of age. Baseline glucose concentrations, insulin sensitivity, and insulin-independent glucose clearance in 5-d foals were all greater than values observed in mature horses and declined towards mature values as foals reached 160 d of age. Baseline glucose concentrations were all within normal range, but higher in foals born from HS mares through 80 d of age. Insulin sensitivity was not different between dietary groups until a trend for lower insulin sensitivity in HS foals emerged at 160 d of age. These data are the first to characterize decreasing insulin sensitivity and glucose tolerance in Thoroughbred foals from 5 to 160 d of age. This study also presents the first data examining glucose and insulin dynamics in developing foals in response to maternal high starch diet.

A genome scan for positive selection in thoroughbred horses

Thoroughbred horses have been selected for exceptional racing performance resulting in system-wide structural and functional adaptations contributing to elite athletic phenotypes. Because selection has been recent and intense in a closed population that stems from a small number of founder animals Thoroughbreds represent a unique population within which to identify genomic contributions to exercise-related traits. Employing a population genetics-based hitchhiking mapping approach we performed a genome scan using 394 autosomal and X chromosome microsatellite loci and identified positively selected loci in the extreme tail-ends of the empirical distributions for (1) deviations from expected heterozygosity (Ewens-Watterson test) in Thoroughbred (n = 112) and (2) global differentiation among four geographically diverse horse populations (F(ST)). We found positively selected genomic regions in Thoroughbred enriched for phosphoinositide-mediated signalling (3.2-fold enrichment; P<0.01), insulin receptor signalling (5.0-fold enrichment; P<0.01) and lipid transport (2.2-fold enrichment; P<0.05) genes. We found a significant overrepresentation of sarcoglycan complex (11.1-fold enrichment; P<0.05) and focal adhesion pathway (1.9-fold enrichment; P<0.01) genes highlighting the role for muscle strength and integrity in the Thoroughbred athletic phenotype. We report for the first time candidate athletic-performance genes within regions targeted by selection in Thoroughbred horses that are principally responsible for fatty acid oxidation, increased insulin sensitivity and muscle strength: ACSS1 (acyl-CoA synthetase short-chain family member 1), ACTA1 (actin, alpha 1, skeletal muscle), ACTN2 (actinin, alpha 2), ADHFE1 (alcohol dehydrogenase, iron containing, 1), MTFR1 (mitochondrial fission regulator 1), PDK4 (pyruvate dehydrogenase kinase, isozyme 4) and TNC (tenascin C). Understanding the genetic basis for exercise adaptation will be crucial for the identification of genes within the complex molecular networks underlying obesity and its consequential pathologies, such as type 2 diabetes. Therefore, we propose Thoroughbred as a novel in vivo large animal model for understanding molecular protection against metabolic disease.

Effects of processing barley on its digestion by horses

Four horses were randomly fed a diet containing rolled, micronised or extruded barley; the barley intake was adjusted to supply 2 g starch/kg bodyweight per day. During a 10-day acclimatisation period the horses were also fed 1 kg grass hay/100 kg bodyweight per day. Samples of blood and breath were collected at the end of each period after the test meal of barley had been fed after a 12-hour overnight fast. The glycaemic and insulinaemic responses of the horses were measured as an indication of the pre-caecal digestibility of starch, and postprandial breath hydrogen and methane were measured to detect microbial fermentation of starch. The highest peak serum glucose and serum insulin concentrations were observed after feeding the extruded barley, lower concentrations were observed after feeding the micronised barley and the lowest concentrations were observed after feeding the rolled barley. Breath hydrogen increased within four hours of feeding all the barley diets, and the mean (sd) peak hydrogen concentrations were 98.3 (55.2) ppm for rolled barley, 59.3 (31.5) ppm for micronised barley and 96.1 (51.9) ppm for extruded barley. There were wide variations within individual horses but these concentrations were not significantly different. Breath methane concentrations were very variable and, although there were no significant differences, there was a trend for higher methane concentrations after the feeding of rolled barley.

Effect of mixing dietary fibre (purified lignocellulose or purified pectin) and a corn meal on glucose and insulin responses in healthy horses

The aim of this study was to investigate the effect of the addition of a purified soluble (pectin) and insoluble (lignocellulose) fibre to a starchy meal on post-prandial glucose and insulin responses in healthy horses. Four horses were fed in a randomized order three different diets: (i) cracked corn, (ii) cracked corn mixed with purified lignocellulose, and (iii) cracked corn mixed with purified pectin. Each diet was adjusted to a starch intake of 2 g/kg bodyweight (BW). Lignocellulose was aligned to an intake of 0.2 g/kg BW, and pectin was fed in a dosage of 0.1 g/kg BW. Each period consisted of a 10-day acclimatization to the diet (fed once per day); during this time, the horses were fed 1.2 kg hay/100 kg BW/day. Blood was collected after each acclimatization period before and after the test meal was fed, without any hay. The increase in plasma glucose and insulin, peak values, and area under the curves were similar for all diets. The present findings suggest that adding purified soluble or insoluble fibre to a corn meal does not affect post-prandial glucose and insulin responses in healthy horses. Feeding strategies for horses with a high energy requirement should include a starch reduction per meal, rather than the addition of purified fibre.

Plasmid growth hormone releasing hormone therapy in healthy and laminitis-afflicted horses-evaluation and pilot study

BACKGROUND

In vivo electroporation dramatically improves the potency of plasmid-mediated therapies, including in large animal models. Laminitis and arthritis are common and debilitating diseases in the horse, as well as humans.

METHODS

The effects of growth hormone releasing hormone (GHRH) on healthy horses and on horses with laminitis that were followed for 6 months after a single intramuscular injection and electroporation of 2.5 mg of an optimized myogenic GHRH-expressing plasmid were examined.

RESULTS

In the first study on six healthy horses, we observed a significant increase in body mass by day 180 compared to baseline (P < 0.003), and an increase in erythrocyte production (hematocrit, red blood cells, hemoglobin, P = 0.03). IGF-I levels were increased by 7% by day 120 (P = 0.02). A pilot study was performed on two horses with chronic laminitis, a vascular condition often associated with arthritis, with two horses with similar clinical disease serving as non-treated controls. Treated horses experienced an increase in weight compared to control horses that received standard care (P = 0.007). By 6 months post-treatment, treated subjects were rated pasture sound. Physical and radiographic evaluation demonstrated significant improvement with reduced inflammation and decreased lameness.

CONCLUSIONS

These results demonstrate that a plasmid therapy delivered by electroporation can potentially be used to treat chronic conditions in horses, and possibly other very large mammals. While further studies are needed, overall this proof-of-concept work presents encouraging data for studying gene therapeutic treatments for Raynaud's syndrome and arthritis in humans.

Dietary energy source affects glucose kinetics in trained Arabian geldings at rest and during endurance exercise

Advances in modeling and tracer techniques provide new perspective into glucose utilization and potential consequences to health or exercise performance. This study used stable isotope and compartmental modeling to evaluate how adaptation to a feed high in sugar and starch (SS) compared with a feed high in fat and fiber (FF) affects glucose kinetics at rest and during exercise in horses. Six trained Arabians adapted to each feed underwent similar tests at rest and while running approximately 4 m/s on a treadmill. For both tests, horses received 100 micromol/kg body weight [6,6-(2)H]glucose through a venous catheter. Circulating tracer glucose was described for 150 min by exponential decay curves and compartmental analysis. All parameters of glucose transfer increased with exercise (P < or = 0.004). Compared with FF horses, SS horses had higher circulating glucose (P = 0.022) and fractional glucose transfer rates (min(-1)) at rest (P = 0.055). Exercise increased glucose irreversible loss (mmol/min) more in SS horses (P = 0.037). Total glucose transfer during exercise tended to be greater in SS horses (0.027 +/- 0.002 mmol/min) compared with FF horses (0.023 +/- 0.002 mmol/min) (P = 0.109). This study characterized the effect of diet on glucose kinetics in resting and exercising horses using new modeling methods. Horses adapted to a fat-supplemented feed utilized less glucose during low-intensity exercise. Fat supplementation in horses may therefore promote greater flexibility in the selection of substrate to meet energy demands for optimal health and performance.

Insulin-like growth factor I in growing thoroughbreds

The objective of this longitudinal study was to characterize growth and plasma insulin-like growth factor I (IGF-I) concentrations in pasture-raised thoroughbreds fed two sources of dietary energy. Mares and foals were randomly assigned to either a sugar and starch (SS) or fat and fibre (FF)-rich feed, and plasma IGF-I and growth were measured once a month from 1 to 16 months of age. These dependent variables were also compared with day length and ambient temperature. There was an association between plasma IGF-I concentration and average daily gain (ADG) (r = 0.32, p < 0.001). There were also clear seasonal patterns in both ADG and plasma IGF-I, with high values in June and May, and a low value in March. Plasma IGF-I and ADG were positively associated with day length and temperature. Plasma IGF-I was never higher (p > 0.10) in the FF group when compared with the SS group, and was higher in the SS group during a rapid growth phase in the spring of year 2 (p < 0.10). The results establish an association between ADG and IGF-I in the horse and indicate that environment and age may influence this relationship. In addition, plasma IGF-I is influenced by dietary energy source at particular times of year. This link has important implications in designing feeding management strategies that are aimed at addressing skeletal development.

A discrete Single Delay Model for the Intra-Venous Glucose Tolerance Test

Background

Due to the increasing importance of identifying insulin resistance, a need exists to have a reliable mathematical model representing the glucose/insulin control system. Such a model should be simple enough to allow precise estimation of insulin sensitivity on a single patient, yet exhibit stable dynamics and reproduce accepted physiological behavior.

Results

A new, discrete Single Delay Model (SDM) of the glucose/insulin system is proposed, applicable to Intra-Venous Glucose Tolerance Tests (IVGTTs) as well as to multiple injection and infusion schemes, which is fitted to both glucose and insulin observations simultaneously. The SDM is stable around baseline equilibrium values and has positive bounded solutions at all times. Applying a similar definition as for the Minimal Model (MM) S_I index, insulin sensitivity is directly represented by the free parameter K_xgI of the SDM.

In order to assess the reliability of Insulin Sensitivity determinations, both SDM and MM have been fitted to 40 IVGTTs from healthy volunteers. Precision of all parameter estimates is better with the SDM: 40 out of 40 subjects showed identifiable (CV < 52%) K_xgI from the SDM, 20 out of 40 having identifiable S_I from the MM. K_xgI correlates well with the inverse of the HOMA-IR index, while S_I correlates only when excluding five subjects with extreme S_I values. With the exception of these five subjects, the SDM and MM derived indices correlate very well (r = 0.93).

Conclusion

The SDM is theoretically sound and practically robust, and can routinely be considered for the determination of insulin sensitivity from the IVGTT. Free software for estimating the SDM parameters is available.

The effects of diet on blood glucose, insulin, gastrin and the serum tryptophan: Large neutral amino acid ratio in foals

High carbohydrate diets can affect the health and behaviour of foals, but the mechanisms are not always fully understood. The objective of this study was to compare the effects of feeding a starch and sugar (SS), or a fat (oil) and fibre (FF) rich diet to two groups of eight foals. Diets were fed from 4 to 42 weeks of age, alongside ad libitum forage. Faecal pH levels did not differ significantly between groups and endoscopic examination showed that the gastric mucosa was healthy in both groups at 25 and 42 weeks of age. At 40 weeks of age, SS foals had significantly higher total blood glucose and lower total blood gastrin than FF foals during the 6h period following ingestion of their respective diets, but insulin levels did not differ significantly. The ratio between serum tryptophan and other large neutral amino acids showed a trend towards an interaction between diet and sampling time. The results provide preliminary information about the effects of diet on the physiology of young horses.

Effects of dexamethasone on glucose dynamics and insulin sensitivity in healthy horses

OBJECTIVE

To determine effects of dexamethasone on glucose dynamics and insulin sensitivity in healthy horses.

ANIMALS

6 adult Standardbreds.

PROCEDURES

In a balanced crossover study, horses received dexamethasone (0.08 mg/ kg, IV, q 48 h) or an equivalent volume of saline (0.9% NaCl) solution (control treatment) during a 21-day period. Horses underwent a 3-hour frequently sampled IV glucose tolerance test (FSIGT) 2 days after treatment. Minimal model analysis of glucose and insulin data from FSIGTs were used to estimate insulin sensitivity (Si), glucose effectiveness (Sg), acute insulin response to glucose (AIRg), and disposition index. Proxies for Si (reciprocal of the inverse square of basal insulin concentration [RISQI]) and beta-cell responsiveness (modified insulin-to-glucose ratio [MIRG]) were calculated from basal plasma glucose and serum insulin concentrations.

RESULTS

Mean serum insulin concentration was significantly higher in dexamethasone-treated horses than control horses on days 7, 14, and 21. Similarly, mean plasma glucose concentration was higher in dexamethasone-treated horses on days 7, 14, and 21; this value differed significantly on day 14 but not on days 7 or 21. Minimal model analysis of FSIGT data revealed a significant decrease in Si and a significant increase in AIRg after dexamethasone treatment, with no change in Sg or disposition index. Mean RISQI was significantly lower, whereas MIRG was higher, in dexamethasone-treated horses than control horses on days 7, 14, and 21.

CONCLUSIONS AND CLINICAL RELEVANCE

The study revealed marked insulin resistance in healthy horses after 21 days of dexamethasone administration. Because insulin resistance has been associated with a predisposition to laminitis, a glucocorticoid-induced decrease in insulin sensitivity may increase risk for development of laminitis in some horses and ponies.

Digestive and metabolic effects of altering feeding frequency in athletic horses

The aim of this study was to investigate the effect of feeding frequency on total tract digestibility and plasma glucose, insulin, urea, gastrin and cortisol concentrations at rest and following exercise in seven Standardbred horses in race training. The horses were fed every 12 h (twice a day, 2TD) and every 4 h (six times a day, 6TD) for 25 days, in a cross-over design. The diet (64% grass hay, 36% concentrates on weight basis) was fed at twice the maintenance energy requirement. Blood samples were taken every hour for 24 h on day 17, total collection of urine and faeces was made on days 19–21 and an intensive exercise test was performed on day 25. Altering feeding frequency caused small variations in diurnal plasma glucose, urea, gastrin and cortisol concentrations and did not affect total tract nutrient digestibility. There was an increase in the mean diurnal plasma urea concentration on the 2TD regime and low levels of plasma insulin were observed 7 h after feeding 2TD. The response to intensive exercise on heart rate, plasma lactate and plasma glucose was similar on both treatments but the plasma insulin concentration was higher following exercise in the 2TD regime, indicating that post-exercise glucose metabolism was altered. In conclusion, this study shows that feeding athletic horses only 2TD caused metabolic signs resembling those observed during feed deprivation (low levels of plasma insulin and an increased diurnal plasma urea concentration) and an altered post-exercise glucose metabolism, but did not affect the digestive response.

Beyond blood sugar: the potential of NMR-based metabonomics for type 2 human diabetes, and the horse as a possible model

Metabonomic analysis is a powerful tool for identifying and characterizing metabolic disorders, for example type 2 diabetes and the metabolic syndrome. Nuclear magnetic resonance (NMR) spectroscopy is an essential tool for such analysis, with special benefits. The review assesses the current status and potential of NMR-based metabonomics of type 2 diabetes. The horse is proposed as a possible model for studying this condition and disease. Some examples are shown of horse blood analyses by NMR.

Voluntary intake and digestibility of reed canarygrass and timothy hay fed to horses1

Thousands of hectares of timothy (Phleum pretense L.) grown in the Mid-Atlantic region are infected by cereal rust mite (Abacarus hysterix) that causes discoloration and curling of leaves, decreased nutritional quality, and substantial decreases in yield. A decline in production of timothy hay can lower income for hay producers and cause horse owners to search for alternative hays. Low alkaloid reed canarygrass (Phalaris arundinacea L.) hay has potential as an alternative to timothy hay because it grows well in the Mid-Atlantic region, is believed to have a similar nutrient quality to timothy, and is not as susceptible to cereal rust mite. Eleven mature, stalled Thoroughbred geldings (549 +/- 12.1 kg) that were exercised daily were used to compare voluntary DMI and apparent nutrient DM digestibility of timothy and low-alkaloid Chiefton variety reed canarygrass hay. Horses were paired by age and BW and randomly assigned to timothy or reed canarygrass hay during a 14-d period to measure voluntary DMI followed by a 4-d period to measure apparent DM digestibility. Both hays met the minimum requirements for DE, CP, Ca, P, K, Fe, and Mn, but they did not meet the minimum requirements for Cu, Zn, and Na for horses at maintenance and averaging 550 kg of BW. Timothy hay seemed to have a lower CP concentration (14.4%) compared with reed canarygrass hay (17.1%) and a more desirable Ca:P ratio at 1.6:1 compared with 0.8:1 for reed canarygrass hay. Horses fed timothy consumed more hay (P <0.001) during the voluntary DMI period compared with horses fed reed canarygrass. Greater voluntary DMI of timothy occurred on d 1, 3, and 5 (P <0.05), but DMI was similar for other days. Apparent DM digestibility was greater in horses fed timothy hay by 9.6% compared with horses fed reed canarygrass hay (P <0.05). Horses fed timothy had greater DM digestibility of ADF (P = 0.001), NDF (P = 0.001), sugar (P = 0.05), and Ca (P = 0.001) but lower apparent DM digestibility of CP (P = 0.012) and crude fat (P = 0.004). Timothy hay was superior in voluntary DMI and apparent DM digestibility compared with low-alkaloid reed canarygrass hay fed to horses.

Countermeasures for pasture-associated laminitis in ponies and horses

Laminitis occurs throughout the world in horses and ponies and has major welfare implications. It is obviously important to be able to recognize and treat the condition in its early stages so that pain and suffering are kept to a minimum. However, ideally it would be preferred to be able to recommend certain interventions/countermeasures that avoid or prevent the condition from occurring in the first place. Because pasture-associated laminitis occurs with grass consumption, one obvious way to avoid the condition is to prevent access to pasture and to feed forage alternatives that are known to be low in rapidly fermentable material. For the majority of horses, total restriction is not always a viable or desired option for financial, welfare, and health reasons. It also may not be necessary for those animals that are not predisposed to laminitis. This review discusses the possible countermeasures that could be considered now and in the future in the following 7 key areas: 1) Identifying animals predisposed to the condition; 2) Limiting development of insulin resistance; 3) Avoiding high intakes of rapidly fermentable material; 4) Preventing/reducing the formation and absorption of the various "triggering factors"; 5) Reducing/preventing oxidative damage; 6) Preventing/reducing matrix metalloproteinase activity; and 7) Preventing changes in blood flow. It is unfortunate that little or no hard data exist at present on effective countermeasures, only mechanistic evidence for avoiding risk factors. However, there is much to gain, and research in this area is urgently required.

Insulin resistance in equids: possible role in laminitis

Insulin is a major regulatory hormone in glucose and fat metabolism, vascular function, inflammation, tissue remodeling, and the somatotropic axis of growth. Insulin resistance alters insulin signaling by decreasing insulin action in certain resistant pathways while increasing insulin signaling in other unaffected pathways via compensatory hyperinsulinemia. In humans, altered insulin signaling is implicated in reduced glucose availability to insulin-sensitive cells, vasoconstriction and endothelial damage, and inflammatory response. Although no direct evidence exists for insulin's role in these mechanisms in the laminitic horse, changes in the glucose availability, vasculature, and inflammation were all demonstrated in hoof separation. Insulin resistance was first implicated in the pathogenesis of laminitis in the 1980s using tolerance tests. Our present findings provide the first specific evidence of insulin resistance as a major predisposing condition for laminitis. Specific quantitative characterization of insulin resistance is essential toward identifying the following: 1) ponies in need of special management to avoid laminitis, and 2) potential management strategies to avoid laminitis by increasing insulin sensitivity, including reducing obesity, increasing exercise, and moderating dietary carbohydrates, particularly starch.

10.1093/jn/136.7.2090S

Treatment of clinical laminitis usually fails to prevent some degree of persistent disability; thus, intervention should aim at avoiding risk factors and preventing the disease. Efficiency of intervention would be improved by identifying predisposed horses and ponies. A herd of 160 healthy ponies included 54 previously laminitic (PL) and 106 never laminitic (NL). Pedigree analysis was consistent with dominant inheritance partially suppressed in males. Blood analysis revealed higher plasma concentrations of insulin and triglycerides but not cortisol, glucose, or free fatty acids in the PL group. Proxies for insulin sensitivity and beta-cell responsiveness, which were calculated from plasma insulin and glucose, indicated compensated insulin resistance in the PL group. A prelaminitic metabolic syndrome (PLMS) was derived statistically to have cut-off points for the 2 proxies, hypertriglyceridemia, and body condition score. It had a total predictive power of 78%. It identified 62 ponies with PLMS, and 98 as PLMS-free. Two months later, pasture starch concentration doubled, and 13 clinical cases of laminitis developed, 11 in the PLMS group and 2 in the PLMS-free group, giving an odds ratio of 10.4 (P = 0.0006). The PLMS can be used to identify predisposed ponies in need of special care; the efficiency of intervention would increase nearly 3-fold in the present case. It enables the design of new interventions suitable for testing. The PLMS also might influence market values.

Evaluation of genetic and metabolic predispositions and nutritional risk factors for pasture-associated laminitis in ponies

OBJECTIVE

To evaluate genetic and metabolic predispositions and nutritional risk factors for development of pasture-associated laminitis in ponies.

DESIGN

Observational cohort study.

ANIMALS

160 ponies.

PROCEDURES

A previous diagnosis of laminitis was used to differentiate 54 ponies (PL group) from 106 nonlaminitic ponies (NL group). Pedigree analysis was used to determine a mode of inheritance for ponies with a previous diagnosis of laminitis. In early March, ponies were weighed and scored for body condition and basal venous blood samples were obtained. Plasma was analyzed for glucose, insulin, triglycerides, nonesterified fatty acids, and cortisol concentrations. Basal proxies for insulin sensitivity (reciprocal of the square root of insulin [RISQI]) and insulin secretory response (modified insulin-to-glucose ratio [MIRG]) were calculated. Observations were repeated in May, when some ponies had signs of clinical laminitis.

RESULTS

A previous diagnosis of laminitis was consistent with the expected inheritance of a dominant major gene or genes with reduced penetrance. A prelaminitic metabolic profile was defined on the basis of body condition, plasma triglyceride concentration, RISQI, and MIRG. Meeting > or = 3 of these criteria differentiated PL- from NL-group ponies with a total predictive power of 78%. Determination of prelaminitic metabolic syndrome in March predicted 11 of 13 cases of clinical laminitis observed in May when pasture starch concentration was high.

CONCLUSIONS AND CLINICAL RELEVANCE

Prelaminitic metabolic syndrome in apparently healthy ponies is comparable to metabolic syndromes in humans and is the first such set of risk factors to be supported by data in equids. Prelaminitic metabolic syndrome identifies ponies requiring special management, such as avoiding high starch intake that exacerbates insulin resistance.

Use of proxies and reference quintiles obtained from minimal model analysis for determination of insulin sensitivity and pancreatic beta-cell responsiveness in horses

OBJECTIVE

To develop proxies calculated from basal plasma glucose and insulin concentrations that predict insulin sensitivity (SI; L.min(-1) x mU(-1)) and beta-cell responsiveness (ie, acute insulin response to glucose [AIRg]; mU/L x min(-1)) and to determine reference quintiles for these and minimal model variables.

ANIMALS

1 laminitic pony and 46 healthy horses.

PROCEDURE

Basal plasma glucose (mg/dL) and insulin (mU/L) concentrations were determined from blood samples obtained between 8:00 AM and 9:00 AM. Minimal model results for 46 horses were compared by equivalence testing with proxies for screening SI and pancreatic beta-cell responsiveness in humans and with 2 new proxies for screening in horses (ie, reciprocal of the square root of insulin [RISQI] and modified insulin-to-glucose ratio [MIRG]).

RESULTS

Best predictors of SI and AIRg were RISQI (r = 0.77) and MIRG (r = 0.75) as follows: SI = 7.93(RISQI) - 1.03 and AIRg = 70.1(MIRG) - 13.8, where RISQI equals plasma insulin concentration(-0.5) and MIRG equals [800 - 0.30(plasma insulin concentration 50)(2)]/(plasma glucose concentration - 30). Total predictive powers were 78% and 80% for RISQI and MIRG, respectively. Reference ranges and quintiles for a population of healthy horses were calculated nonparametrically.

CONCLUSIONS AND CLINICAL RELEVANCE

Proxies for screening SI and pancreatic beta-cell responsiveness in horses from this study compared favorably with proxies used effectively for humans. Combined use of RISQI and MIRG will enable differentiation between compensated and uncompensated insulin resistance. The sample size of our study allowed for determination of sound reference range values and quintiles for healthy horses.