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Fresa K, Catandi GD, Whitcomb L, Gonzalez-Castro RA, Chicco AJ, Carnevale EM. Adiposity in mares induces insulin dysregulation and mitochondrial dysfunction which can be mitigated by nutritional intervention. Sci Rep 2024; 14:13992. [PMID: 38886475 PMCID: PMC11183153 DOI: 10.1038/s41598-024-64628-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 06/11/2024] [Indexed: 06/20/2024] Open
Abstract
Obesity is a complex disease associated with augmented risk of metabolic disorder development and cellular dysfunction in various species. The goal of the present study was to investigate the impacts of obesity on the metabolic health of old mares as well as test the ability of diet supplementation with either a complex blend of nutrients designed to improve equine metabolism and gastrointestinal health or L-carnitine alone to mitigate negative effects of obesity. Mares (n = 19, 17.9 ± 3.7 years) were placed into one of three group: normal-weight (NW, n = 6), obese (OB, n = 7) or obese fed a complex diet supplement for 12 weeks (OBD, n = 6). After 12 weeks and completion of sample collections, OB mares received L-carnitine alone for an additional 6 weeks. Obesity in mares was significantly associated with insulin dysregulation, reduced muscle mitochondrial function, and decreased skeletal muscle oxidative capacity with greater ROS production when compared to NW. Obese mares fed the complex diet supplement had better insulin sensivity, greater cell lipid metabolism, and higher muscle oxidative capacity with reduced ROS production than OB. L-carnitine supplementation alone did not significantly alter insulin signaling, but improved lipid metabolism and muscle oxidative capacity with reduced ROS. In conclusion, obesity is associated with insulin dysregulation and altered skeletal muscle metabolism in older mares. However, dietary interventions are an effective strategy to improve metabolic status and skeletal muscle mitochondrial function in older mares.
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Affiliation(s)
- Kyle Fresa
- Department of Biomedical Sciences, Colorado State University, Fort Collins, CO, 80523, USA
| | - Giovana D Catandi
- Department of Biomedical Sciences, Colorado State University, Fort Collins, CO, 80523, USA
| | - Luke Whitcomb
- Department of Biomedical Sciences, Colorado State University, Fort Collins, CO, 80523, USA
| | - Raul A Gonzalez-Castro
- Department of Biomedical Sciences, Colorado State University, Fort Collins, CO, 80523, USA
| | - Adam J Chicco
- Department of Biomedical Sciences, Colorado State University, Fort Collins, CO, 80523, USA
| | - Elaine M Carnevale
- Department of Biomedical Sciences, Colorado State University, Fort Collins, CO, 80523, USA.
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Carslake HB, Pinchbeck GL, Argo CM, Dugdale AHA, McGowan CM. Investigation of glucagon-like peptide-1 response to six oral carbohydrates in ponies. Vet J 2024; 305:106110. [PMID: 38604332 DOI: 10.1016/j.tvjl.2024.106110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 04/03/2024] [Accepted: 04/08/2024] [Indexed: 04/13/2024]
Abstract
Glucagon-like peptide-1 (GLP-1), the principal incretin in horses, may play a role in the pathophysiology of insulin dysregulation (ID). This study aimed to describe its concentration in response to three preserved forages and four dynamic tests for ID in ponies. Twelve adult ponies of mixed ID status were given a meal of hay, soaked hay or haylage, an in-feed oral glucose test (OGT), oral sugar test (OST), an oral test using a proprietary breakfast cereal (WEET) or a combined glucose-insulin tolerance test (CGIT) weekly in a randomised cross-over study. Glucose, insulin and GLP-1 concentrations were measured before and following each intervention. Ponies were designated ID or non-ID and insulin resistant (IR) or non-IR according to OGT and CGIT results, respectively. All interventions apart from the CGIT provoked a GLP-1 response within 30 min. The OGT and WEET interventions, (containing the greatest dose of non-structural carbohydrate, 1.06 and 1 g/kg BW, respectively), resulted in a greater area under the curve (AUC) for GLP-1 compared to all other interventions (P < 0.001). No difference in GLP-1 response was detected according to ID or IR status, despite there being strong positive correlations (rs [95 % CI]) between GLP-1 and insulin concentrations measured at individual time points (0.67 [0.62 - 0.71]; P < 0.001) and as AUC (0.66 [0.49-0.79], P < 0.001). These data do not support of the use of GLP-1 as an adjunctive diagnostic test for ID or IR, as defined by conventional intravenous or oral dynamic tests.
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Affiliation(s)
- H B Carslake
- Institute of Infection, Veterinary and Ecological sciences, Faculty of Health and Life Sciences, University of Liverpool, Leahurst CH64 7TE, UK.
| | - G L Pinchbeck
- Institute of Infection, Veterinary and Ecological sciences, Faculty of Health and Life Sciences, University of Liverpool, Leahurst CH64 7TE, UK
| | - C M Argo
- Scotland's Rural College, Aberdeen, Scotland AB21 9YA, UK
| | | | - C M McGowan
- Institute of Infection, Veterinary and Ecological sciences, Faculty of Health and Life Sciences, University of Liverpool, Leahurst CH64 7TE, UK
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3
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Colmer SF, Adams AA, Adam E, Miller R, Stefanovski D, Kulp JC, van Eps A. The effect of pre-dosing with metformin on the insulin response to oral sugar in insulin-dysregulated horses. Equine Vet J 2024; 56:318-325. [PMID: 37545128 DOI: 10.1111/evj.13979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 07/13/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND A single dose of metformin administered 1 h prior to oral glucose challenge was previously shown to reduce insulinaemic responses in horses with experimentally-induced insulin dysregulation (ID). Targeted administration could be useful for controlling post-prandial hyperinsulinaemia in horses with naturally-occurring ID. OBJECTIVES The objective was to compare the insulinaemic and glycaemic responses to oral sugar testing (OST) performed at different intervals after a single dose of metformin in horses with naturally-occurring ID. We hypothesised that pre-treatment with one dose of metformin would significantly decrease the insulinaemic response to OST. STUDY DESIGN Randomised cross-over in vivo experiment. METHODS Eight university-owned adult horses with naturally-occurring ID underwent OST 1, 2 and 6 h following a single oral dose of metformin (30 mg/kg) or 1 h after placebo (240 mL water) with a 7-day washout between treatments over a period of 3 weeks. Plasma insulin, C-peptide and glucose concentrations were measured at 0, 60 and 90 min after 0.45 mL/kg light corn syrup and the effect of treatment (and the interval since dosing) examined using a mixed effects linear regression model. RESULTS Metformin treatment had no significant effect on plasma glucose, insulin or C-peptide concentrations at any time point compared with placebo (p > 0.05). For OST 1 h post metformin, median (IQR) plasma insulin was 91.3 (62.4-114.9) μIU/mL at 60 min versus 76.2 (59.1-134.5) for placebo (p = 0.8) and 62.7 (31.4-109.7) at 90 min versus 51.8 (29.2-126.3) for placebo (p = 0.9). MAIN LIMITATIONS Small sample size may limit identification of more subtle decreases in insulin concentration with metformin pre-dosing. The results of this study are relevant only for one pre-treatment dose (30 mg/kg) which limits extrapolation to predictions about the effects of longer-term metformin administration on insulin and glucose dynamics in the horse. CONCLUSIONS AND CLINICAL IMPORTANCE The results do not support the use of targeted metformin treatment to reduce post-prandial hyperinsulinaemia in horses with naturally-occurring ID.
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Affiliation(s)
- Sarah F Colmer
- Department of Clinical Studies-New Bolton Center, The University of Pennsylvania School of Veterinary Medicine, Kennett Square, Pennsylvania, USA
| | - Amanda A Adams
- Department of Veterinary Science, Gluck Equine Research Center, The University of Kentucky College of Agriculture, Food and Environment, Lexington, Kentucky, USA
| | - Emma Adam
- Department of Veterinary Science, Gluck Equine Research Center, The University of Kentucky College of Agriculture, Food and Environment, Lexington, Kentucky, USA
| | - Rachel Miller
- Department of Clinical Sciences, Lincoln Memorial University College of Veterinary Medicine, Harrogate, Tennessee, USA
| | - Darko Stefanovski
- Department of Clinical Studies-New Bolton Center, The University of Pennsylvania School of Veterinary Medicine, Kennett Square, Pennsylvania, USA
| | - Jeaneen C Kulp
- Department of Clinical Studies-New Bolton Center, The University of Pennsylvania School of Veterinary Medicine, Kennett Square, Pennsylvania, USA
| | - Andrew van Eps
- Department of Clinical Studies-New Bolton Center, The University of Pennsylvania School of Veterinary Medicine, Kennett Square, Pennsylvania, USA
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Clark BL, Norton EM, Bamford NJ, Randhawa IAS, Kemp KL, McCue ME, Bertin FR, Stewart AJ. Epidemiological investigation of insulin dysregulation in Shetland and Welsh ponies in Australia. Equine Vet J 2024; 56:281-290. [PMID: 38173146 DOI: 10.1111/evj.14044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 12/12/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Insulin dysregulation (ID) is central to equine metabolic syndrome. There are limited epidemiological studies investigating dynamic testing of ID in ponies. OBJECTIVES To evaluate prevalence and risk factors for ID through dynamic testing of hyperinsulinaemia (DHI) and insulin resistance (IR). STUDY DESIGN Cross-sectional. METHODS Sex, age, breed, height, cresty neck score (CNS), body condition score (BCS), laminitis, HMGA2:c.83G>A genotype and pituitary pars intermedia dysfunction (PPID) status were documented. Dynamic hyperinsulinaemia was diagnosed with an oral sugar test (OST) and IR with an insulin tolerance test (ITT). Owners completed surveys reporting activity, laminitis history and perception of body condition using a (1-9) visual analogue scale (VASo). Ordinal scores were converted to binary outcomes for CNS (≤2/5 or ≥3/5), BCS and VASo (≤6/9 or ≥7/9). Variables associated with insulin concentrations, glucose reduction after the ITT and laminitis were evaluated with mixed effects regression models accounting for random effects of farms. RESULTS Among 167 ponies tested, median (range) age was 9 (4-21) years and BCS was 6 (4-8). Prevalence (95% confidence interval [CI]) of ID was 61 (53-68)%. Factors associated with insulin concentrations (estimate [95% CI]; μIU/mL) 60 min post-OST were: age (1.07 [1.02-1.11]), CNS (≥3/5, 1.52 [1.04-2.23]) and VASo (≥7/9, 1.75 [1.09-2.79]); and 90 min post-OST were: age (1.08 [1.03-1.12]), CNS (≥3/5, 1.80 [1.22-2.64]), VASo (≥7/9, 2.49 [1.52-4.08]) and sex (male, 0.64 [0.45-0.91]). Factors associated with glucose reduction after the ITT (estimate [95% CI]; %) were: age (-1.34 [-2.01 to -0.67]), sex (female, -6.21 [-11.68 to -0.74]) and VASo (≥7/9, -1.74 [-18.89 to -4.78]). Factors associated with laminitis (odds ratio [95% CI]) were DHI (4.60 [1.68-12.58]), IR (3.66 [1.26-10.61]) and PPID (11.75 [1.54-89.40]). MAIN LIMITATIONS Single time-point sampling, laminitis definition and diet analysis. CONCLUSIONS Ageing, being female and owner-perceived obesity were associated with ID.
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Affiliation(s)
- Brianna L Clark
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia
| | - Elaine M Norton
- College of Agricultural and Life Sciences, The University of Arizona, Tucson, Arizona, USA
| | - Nicholas J Bamford
- Melbourne Veterinary School, The University of Melbourne, Parkville, Victoria, Australia
| | - Imtiaz A S Randhawa
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia
| | - Kate L Kemp
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia
| | - Molly E McCue
- College of Veterinary Medicine, The University of Minnesota, St Paul, Minnesota, USA
| | - François-René Bertin
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia
| | - Allison J Stewart
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia
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Al-Ansari AS, Golding E, Walshe N, Mooney CT, Duggan V. Obesity and obesity-associated metabolic disease conditions in Connemara ponies in Ireland. Equine Vet J 2024; 56:273-280. [PMID: 37985219 DOI: 10.1111/evj.14029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/31/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Equine obesity combined with insulin dysregulation (ID) is a major risk factor associated with laminitis. Some pony breeds appear to be at increased risk. However, little is known regarding the prevalence of obesity or hyperinsulinaemia as evidence of ID in Irish ponies. OBJECTIVE To investigate the prevalence of obesity and associated endocrine/metabolic disease conditions in Connemara ponies and to determine if hyperinsulinaemia in these ponies could be predicted by morphometric or metabolic markers. STUDY DESIGN Cross-sectional study. METHODS The study population included registered Connemara ponies recruited through public and veterinary social media posts. Ponies underwent a physical examination and information on their management and clinical history was obtained via owner questionnaire. The body condition score (BCS) was measured using the Henneke system; cresty neck score (CNS) and regionalised adiposity were also assessed. Hyperinsulinaemia was confirmed by measuring serum basal insulin concentration (BIC) or insulin concentration after an oral sugar test (OST). Blood glucose and triglyceride concentrations were measured. Characteristics of hyperinsulinaemic and insulin-sensitive ponies were compared by logistic regression. RESULTS Two hundred ponies were included; 59 ponies (29.5%) had a BCS ≥7, 58 (29.0%) had a CNS ≥2.5 and 135 (67.5%) had regionalised adiposity; 137 (68.5%) ponies had at least one of these abnormalities. Owner-reported history or clinical evidence of chronic laminitis was found in 92 ponies (46.0%). Hyperinsulinaemia was confirmed in 32 ponies (16.0%), including 23 of 91 (25.3%) detected by OST and 9 of 109 (8.3%) by BIC. Hypertriglyceridaemia was observed in 12 of 198 ponies (6.1%) ponies and hyperglycaemia in 11 of 197 ponies (5.6%) ponies. The odds of hyperinsulinaemia increased by a factor of 6.53 (95% confidence interval: 2.95, 15.21) when BCS was ≥7. MAIN LIMITATIONS The OST was not performed in all ponies. CONCLUSIONS Increased adiposity, laminitis and metabolic derangements are prevalent in this native Irish pony breed.
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Affiliation(s)
| | - Emma Golding
- School of Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - Nicola Walshe
- School of Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - Carmel T Mooney
- School of Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - Vivienne Duggan
- School of Veterinary Medicine, University College Dublin, Dublin, Ireland
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Carslake HB, Pinchbeck GL, Argo CM, Dugdale AHA, McGowan CM. Comparison of one novel and four established diagnostic tests for insulin dysregulation in ponies. Vet J 2024; 303:106059. [PMID: 38103885 DOI: 10.1016/j.tvjl.2023.106059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 12/19/2023]
Abstract
Several tests have been advocated for diagnosis of insulin dysregulation (ID). Tests using simple sugars may not reflect the response to naturally ingested carbohydrates. This study aimed to evaluate agreement between the oral glucose test (OGT), the oral sugar test (OST), a novel oral test using a proprietary cereal (WEET), the IV combined glucose-insulin tolerance test (CGIT) and fasted basal insulin (FI) for diagnosis of ID. Each of the five tests above was performed on a group of six normal and six insulin dysregulated mixed-breed ponies in a randomised crossover study. Area under the curve (AUC) and maximum concentration of insulin from OGT, OST and WEET showed strong to very strong bivariate correlations (r = 0.85-0.94, and r = 0.87-0.92, respectively; P ≤ 0.001) and were significantly different between tests (associated with dose of carbohydrate) and between CGIT-positive and -negative ponies. Dichotomous results showed substantial agreement between OST and both WEET (κ = 0.65; P = 0.02) and OGT (κ = 0.67; P = 0.01) and between CGIT and both OST (κ = 0.63; P = 0.03) and OGT (κ = 0.67; P = 0.01), and no agreement between FI, which had low sensitivity, and all other tests (κ = 0.15 - 0.31; P > 0. 05). Palatability of WEET was variable, resulting in one pony being excluded for analysis of WEET data. Further work on development of an oral test using a more palatable feedstuff and appropriate cut-offs or diagnostic thresholds for tests of ID is warranted.
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Affiliation(s)
- H B Carslake
- Institute of Infection, Veterinary and Ecological sciences, Faculty of Health and Life Sciences, University of Liverpool, Leahurst, UK CH64 7TE, UK.
| | - G L Pinchbeck
- Institute of Infection, Veterinary and Ecological sciences, Faculty of Health and Life Sciences, University of Liverpool, Leahurst, UK CH64 7TE, UK
| | - C M Argo
- Scotland's Rural College, Aberdeen, Scotland AB21 9YA, UK
| | - A H A Dugdale
- Paragon Veterinary referrals, Wakefield UK WF1 2DF, UK
| | - C M McGowan
- Institute of Infection, Veterinary and Ecological sciences, Faculty of Health and Life Sciences, University of Liverpool, Leahurst, UK CH64 7TE, UK
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de Laat MA, Sillence MN. Diagnosis of equine endocrinopathies: The value of measuring blood glucose during an oral glucose test. Vet J 2023; 300-302:106034. [PMID: 37778651 DOI: 10.1016/j.tvjl.2023.106034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 09/18/2023] [Accepted: 09/27/2023] [Indexed: 10/03/2023]
Abstract
Blood glucose concentration is often measured during an oral glucose test (OGT), but is not thought to aid in diagnosing insulin dysregulation (ID) or pituitary pars intermedia dysfunction (PPID). The aim of this retrospective study was to investigate whether the change in blood glucose concentration during an OGT aligned with indicators of equine metabolic syndrome or PPID, including serum insulin and plasma ACTH concentrations, clinical observations, age, sex, breed type and the test dose. The cohort included 149 horses, miniature horses, and ponies that had undergone an in-feed OGT and clinical examination between 2015 and 2021. The animals were diagnosed as either metabolically healthy, insulin-dysregulated, having PPID or both endocrinopathies. The mean ± standard error increase in blood glucose during the OGT was 3.41 ± 0.21 mM, and this change showed a weak positive correlation with the increase in serum insulin concentration (r = 0.36; P 0.001), body condition score (BCS; r = 0.26; P = 0.002) and cresty neck score (CNS; r = 0.38; P 0.001). The median [interquartile range] increase in blood glucose for miniature horses (5.25 [2.98-6.5] mM), was more than twice that seen in full-sized horses (2.4 [1.33-3.45] mM; P = 0.03). In metabolically healthy animals the increase in blood glucose during an OGT (+2.2 [1-3.5] mM) was smaller (P 0.001) than in animals with ID (+3.8 [2.73-5.33] mM), or both endocrine diseases (+6.1 [3.6-6.85] mM). There was an effect of the dose of dextrose on the blood glucose response, with higher doses yielding larger responses (P 0.001). The variability in these data support that basal and post-prandial blood glucose responses to an OGT are not appropriate as stand-alone diagnostic markers of ID or PPID. However, the association between blood glucose and CNS supports the use of CNS when evaluating animals for ID.
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Affiliation(s)
- M A de Laat
- School of Biology and Environmental Science, Queensland University of Technology, Brisbane, Queensland 4001, Australia.
| | - M N Sillence
- School of Biology and Environmental Science, Queensland University of Technology, Brisbane, Queensland 4001, Australia
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Delarocque J, Feige K, Carslake HB, Durham AE, Fey K, Warnken T. Development of a Web App to Convert Blood Insulin Concentrations among Various Immunoassays Used in Horses. Animals (Basel) 2023; 13:2704. [PMID: 37684968 PMCID: PMC10487020 DOI: 10.3390/ani13172704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/18/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
The measurement of the blood insulin concentration, and comparison to cut-offs, is essential in diagnosing insulin dysregulation, a common equine endocrinopathy. However, different insulin assays provide disparate results. We aimed to ease comparison between assays by compiling original and published data into a web app to convert insulin measurements from one assay to another. Data were available for ADVIA Centaur insulin chemiluminescent immunoassay (CLIA), Beckman Coulter insulin radioimmunoassay (RIA), Immulite 1000 CLIA, Immulite 2000 CLIA, Immulite 2000 XPi CLIA, Mercodia equine insulin enzyme-linked immunosorbent assay (ELISA), and Millipore porcine insulin RIA. Linear models were fitted for 13 assay pairs using non-decreasing splines, and integrated into this app. Assay comparisons including data from several studies showed a lower performance. This indicates technical variation between laboratories, which has not been described before, but is relevant when diagnostic measurements and cut-offs are provided by different laboratories. Nevertheless, the models' overall high performance (median r2 = 0.94; range 0.57-1.00) supports their use to interpret results from diagnostic insulin measurements when the reference assay is unavailable, and to compare values obtained from different assays.
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Affiliation(s)
- Julien Delarocque
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559 Hannover, Germany
| | - Karsten Feige
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559 Hannover, Germany
| | - Harry B. Carslake
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst, Neston CH64 7TE, Cheshire, UK
| | - Andy E. Durham
- The Liphook Equine Hospital, Forest Mere, Liphook GU30 7JG, Hampshire, UK
| | - Kerstin Fey
- Equine Clinic, Internal Medicine, Faculty of Veterinary Medicine, Justus-Liebig-University of Giessen, Frankfurter Str. 126, 35392 Giessen, Germany
| | - Tobias Warnken
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559 Hannover, Germany
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Clark BL, Stewart AJ, Kemp KL, Bamford NJ, Bertin FR. Evaluation of field-testing protocols to diagnose insulin dysregulation in ponies using a Bayesian approach. Vet J 2023; 298-299:106019. [PMID: 37536451 DOI: 10.1016/j.tvjl.2023.106019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 07/23/2023] [Accepted: 07/31/2023] [Indexed: 08/05/2023]
Abstract
Field tests and their association with laminitis have not been evaluated in large cohorts. The objectives of this study were to evaluate the performance of basal insulin (BI), the oral sugar test (OST) and the insulin tolerance test (ITT) to diagnose ID and investigate their association with laminitis. Insulin dysregulation status was determined in 146 ponies using BI (insulin concentration >20 µIU/mL), an OST (insulin concentration >65 µIU/mL at 60 or 90 min after oral administration of 0.45 mL/kg corn syrup) and an ITT (< 50% reduction in glucose concentration 30 min after intravenous administration of 0.1 IU/kg insulin). Laminitis was identified using modified-Obel scores. A Bayesian approach was used to define the characteristics of the tests and receiver operating characteristic curves were used to assess their association with laminitis. All tests were well tolerated and laminitis was diagnosed in 9% of ponies. Insulin dysregulation was diagnosed in 15% of ponies using BI, 38% using the OST and 54% using the ITT with 11% of ponies positive for all three tests. The sensitivities and specificities of BI, the OST and the ITT to diagnose ID were 0.52 (95% confidence interval [CI], 0.35-0.79) and 0.97 (95% CI, 0.91 - 1.00), 0.84 (95% CI, 0.70 - 0.94) and 0.60 (95% CI, 0.49 - 0.71), and 0.85 (95% CI, 0.68-0.96) and 0.88 (95% CI, 0.75 - 0.97), respectively. Only BI and the OST were associated with laminitis (P = 0.003 and 0.015, respectively).
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Affiliation(s)
- B L Clark
- The University of Queensland, 5391 Warrego Hwy, Gatton, QLD 4343, Australia.
| | - A J Stewart
- The University of Queensland, 5391 Warrego Hwy, Gatton, QLD 4343, Australia
| | - K L Kemp
- The University of Queensland, 5391 Warrego Hwy, Gatton, QLD 4343, Australia
| | - N J Bamford
- The University of Melbourne, Park Drive, Parkville, VIC 3010, Australia
| | - F-R Bertin
- The University of Queensland, 5391 Warrego Hwy, Gatton, QLD 4343, Australia
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Warnken T, Schaub C, Delarocque J, Frers F, Feige K, Sonntag J, Reiche DB. Palatability, glycemic, and insulinemic responses to various carbohydrate formulations: Alternatives for the diagnosis of insulin dysregulation in horses? Vet Med (Auckl) 2023; 37:282-291. [PMID: 36625459 PMCID: PMC9889704 DOI: 10.1111/jvim.16614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 12/08/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Oral glycemic challenge (GC) tests are recommended for diagnosis of insulin dysregulation (ID). Various protocols are used, but all have limitations in terms of palatability, ease of use, variable composition, geographic availability, or some combination of these. HYPOTHESIS/OBJECTIVE To evaluate newly developed formulations with defined carbohydrate composition for use as oral GCs. ANIMALS Thirty-four horses and ponies in various metabolic states. METHODS Our objectives were carried out in 2 separate cross-over experiments. First, the palatability and acceptance of various GCs (2 syrups, 1 granulate) offered for free intake were compared to glucose mixed in a chaff-based diet. Subsequently, syrups were administered by syringe and compared to an oral glucose test using naso-gastric tubing (tube OGT) to investigate the glycemic and insulinemic responses. Second, these variables were compared in the best performing GC-formulations (granulate further optimized to pelleted formulation and 1 syrup) and a tube OGT. All GCs were administered with equivalent amounts of 0.5 g glycemic carbohydrates per kg body weight. RESULTS Only the GC pellets were consumed completely by all horses (consumption time 5 ± 2 min). When administered by syringe, the GC syrup also was well accepted. The insulin concentrations at 120 min correlated significantly between tube OGT and GC pellets (r = .717; P < .001) or GC syrup (r = .913; P < .001). The new GC syrup and GC pellets discriminate between healthy and ID horses. CONCLUSIONS AND CLINICAL SIGNIFICANCE The GC pellets (DysChEq)™ and GC syrup can be used as palatable and well-accepted oral GC tests for assessment of ID in horses.
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Affiliation(s)
- Tobias Warnken
- Clinic for HorsesUniversity of Veterinary Medicine Hannover, Foundation, Bünteweg 930559 HannoverGermany
| | - Claudia Schaub
- Clinic for HorsesUniversity of Veterinary Medicine Hannover, Foundation, Bünteweg 930559 HannoverGermany
| | - Julien Delarocque
- Clinic for HorsesUniversity of Veterinary Medicine Hannover, Foundation, Bünteweg 930559 HannoverGermany
| | - Florian Frers
- Clinic for HorsesUniversity of Veterinary Medicine Hannover, Foundation, Bünteweg 930559 HannoverGermany
| | - Karsten Feige
- Clinic for HorsesUniversity of Veterinary Medicine Hannover, Foundation, Bünteweg 930559 HannoverGermany
| | - Johanna Sonntag
- Boehringer Ingelheim Vetmedica GmbH, Binger Straße 17355216 Ingelheim am RheinGermany
| | - Dania Birte Reiche
- Boehringer Ingelheim Vetmedica GmbH, Binger Straße 17355216 Ingelheim am RheinGermany
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Manfredi JM, Jacob S, Norton E. A one-health lens offers new perspectives on the importance of endocrine disorders in the equine athlete. J Am Vet Med Assoc 2023; 261:153-164. [PMID: 36595370 DOI: 10.2460/javma.22.11.0485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Endocrine disorders are associated with joint pain and tendon injury in humans, but the effects in the horse are only starting to be understood. Similar patterns of clinical signs and injury appear to affect horses and humans for both orthopedic and endocrine disorders, supporting the use of a one-health approach to tackle these issues. In this Currents in One Health, we will discuss common equine endocrinopathies, current testing recommendations, dietary management, genetic predispositions, and endocrine disorders' effects on performance. Our aim is to use a one-health lens to describe current comparative research so that veterinarians can employ cutting-edge preventative, diagnostic, and therapeutic recommendations. Identified key gaps in knowledge include whether equine metabolic osteoarthritis exists, if steroid joint injections are safe in horses with endocrine disorders, and if the return to performance percentage improves with concurrent treatment of endocrine and musculoskeletal disorders. Key takeaways include that the relationship between endocrine disorders and musculoskeletal disease in the horse goes beyond laminitis to include lameness, muscle atrophy, suspensory ligament degeneration, osteochondritis dissecans, and potentially metabolic osteoarthritis. Approaches learned from human and equine comparative studies can offer insight into injury recognition and management, thus mitigating the impact of endocrine disorders on performance in both species. Readers interested in an in-depth description of current and future research involving pathophysiology, novel interventions, and multiomic approaches to identify individuals with athletic limitations induced by endocrine disorders are invited to read the companion Currents in One Health by Manfredi et al, AJVR, February 2023.
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Affiliation(s)
- Jane M Manfredi
- 1Department of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, MI
| | - Sarah Jacob
- 1Department of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, MI
| | - Elaine Norton
- 2Department of Animal and Comparative Biomedical Sciences, College of Agriculture and Life Sciences, University of Arizona, Tucson, AZ
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Knowles EJ, Elliott J, Harris PA, Chang YM, Menzies-Gow NJ. Predictors of laminitis development in a cohort of nonlaminitic ponies. Equine Vet J 2023; 55:12-23. [PMID: 35263471 PMCID: PMC10084125 DOI: 10.1111/evj.13572] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 01/20/2022] [Accepted: 02/17/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND Quantifying risk factors for laminitis development requires improvement. OBJECTIVES To identify the most useful physical examination, metabolic and management factors to predict laminitis development in client-owned, nonlaminitic ponies. STUDY DESIGN Prospective cohort study. METHODS Physical examination, metabolic and management data were collected from a pony cohort 6 monthly for up to 4 years. Ponies were monitored for the development of laminitis. Metabolic data included basal plasma concentrations of ACTH ([ACTH]), adiponectin ([adiponectin]), triglycerides and glucose. Serum insulin concentrations ([insulin]) were measured in the unfasted basal state ([insulin]T0) and 60 minutes ([insulin]T60) after administration of corn syrup (0.3ml/kg). Separate multivariable Cox proportional-hazards models were developed for physical, management/signalment and metabolic data and later combined into two final models. Low-, medium- and high-laminitis risk categories were defined based on basal or T60 [insulin]. RESULTS Overall, 374 ponies (age 5-32 years) and 891 pony-years were included in the main analysis. Laminitis incidence (95% confidence interval (CI)) was 4.8 (3.5-6.5) cases/100 pony-years. Laminitis development was associated with numerous univariable factors. Significant (P < .05) factors retained in the final multivariable models included [insulin]T0, [insulin]T60, [adiponectin] and divergent hoof growth. [ACTH] was not independently associated with laminitis. Based on [Insulin]T0, low- (<21.6 µIU/ml), medium- (21.6-45.2 µIU/ml) and high-risk (>45.2 µIU/ml) categories encompassed 70, 20 and 10% of the population and had estimated 4-year laminitis incidences (95%CI) of 6 (2-9)%, 22 (10-33)% and 69 (48-82)% respectively. Based on [Insulin]T60 the low- (<53.4 µIU/ml), medium- (53.4-153 µIU/ml) and high-risk (≥153 µIU/ml) categories comprised 60, 30 and 10% of the population and had estimated 4-year laminitis incidences (95%CI) of 3 (0-6)%, 20 (10-29)% and 73 (52-84)% respectively. MAIN LIMITATIONS Results may not apply to different insulin assays, geographical regions, breeds or management types. CONCLUSIONS [Insulin]T0 or [insulin]T60 best quantify the risk of future laminitis development in nonlaminitic ponies.
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Affiliation(s)
- Edward J Knowles
- The Royal Veterinary College, Hatfield, UK.,Bell Equine Veterinary Clinic, Mereworth, UK
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13
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de Laat MA, Warnken T, Delarocque J, Reiche DB, Grob AJ, Feige K, Carslake HB, Durham AE, Sillence MN, Thane KE, Frank N, Brojer J, Lindase S, Sonntag J. Carbohydrate pellets to assess insulin dysregulation in horses. Vet Med (Auckl) 2022; 37:302-314. [PMID: 36583553 PMCID: PMC9889680 DOI: 10.1111/jvim.16621] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 12/14/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND A glycemic challenge test is used for the diagnosis of insulin dysregulation (ID) in horses and ponies. Different forms of the test exist where the administrative route and dose of glucose vary, which makes interpretation of results challenging. HYPOTHESIS/OBJECTIVES To evaluate the palatability of, and blood glucose and insulin responses to, carbohydrate pellets fed as an oral glucose test (OGT), and to establish the diagnostic threshold for ID when using the pellets. ANIMALS University and privately-owned horses and ponies (n = 157) comprised of 31 breeds and both sexes. METHODS Multicenter cohort study. A custom-produced glycemic pellet was offered for free intake at 0.5 g/kg BW soluble carbohydrate and serum insulin and blood glucose concentrations measured before and after (60, 120, and 180 minutes) the pellets were offered. Pellet acceptance and intake time (those that finished within 10 minutes) were determined to assess palatability. RESULTS The pellets were palatable to 132/157 animals, and ponies found the pellets more (P = .004) palatable than horses. The median intake time (4 [3-6] minutes) was positively correlated with acceptance grade (r = .51; P < .0001). Consumption of the pellets elicited peak blood glucose (6.6 [5.8-7.8] mmol/L) and serum insulin (40.5 [19-99.8] μIU/mL) responses at 120 minutes. At 120 minutes the optimal cut-off was 83 μIU/mL (95% CI: 70-99 μIU/mL) for the IMMULITE 2000XPi assay. CONCLUSIONS AND CLINICAL IMPORTANCE The pellets were palatable and a suitable, novel carbohydrate source for the OGT.
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Affiliation(s)
- Melody A. de Laat
- Faculty of ScienceQueensland University of TechnologyBrisbaneQueenslandAustralia
| | - Tobias Warnken
- Boehringer Ingelheim Vetmedica GmbHIngelheimGermany,Clinic for HorsesUniversity of Veterinary MedicineHannoverGermany
| | | | | | - Anne J. Grob
- Clinic for HorsesUniversity of Veterinary MedicineHannoverGermany
| | - Karsten Feige
- Clinic for HorsesUniversity of Veterinary MedicineHannoverGermany
| | - Harry B. Carslake
- Institute of Infection, Veterinary and Ecological SciencesUniversity of LiverpoolLiverpoolUK
| | | | - Martin N. Sillence
- Faculty of ScienceQueensland University of TechnologyBrisbaneQueenslandAustralia
| | - Kristen E. Thane
- Department of Comparative PathobiologyCummings School of Veterinary Medicine, Tufts UniversityNorth GraftonMassachusettsUSA
| | - Nicholas Frank
- Department of Comparative PathobiologyCummings School of Veterinary Medicine, Tufts UniversityNorth GraftonMassachusettsUSA
| | - Johan Brojer
- Department of Clinical SciencesSwedish University of Agricultural SciencesUppsalaSweden
| | - Sanna Lindase
- Department of Clinical SciencesSwedish University of Agricultural SciencesUppsalaSweden
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14
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Seasonal Insulin Responses to the Oral Sugar Test in Healthy and Insulin Dysregulated Horses. J Equine Vet Sci 2022; 113:103945. [DOI: 10.1016/j.jevs.2022.103945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 03/30/2022] [Accepted: 04/04/2022] [Indexed: 11/22/2022]
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15
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Fuentes-Romero B, Muñoz-Prieto A, Cerón JJ, Martín-Cuervo M, Iglesias-García M, Aguilera-Tejero E, Díez-Castro E. Measurement of Plasma Resistin Concentrations in Horses with Metabolic and Inflammatory Disorders. Animals (Basel) 2021; 12:ani12010077. [PMID: 35011183 PMCID: PMC8744951 DOI: 10.3390/ani12010077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/27/2021] [Accepted: 12/29/2021] [Indexed: 11/24/2022] Open
Abstract
Simple Summary Obesity and its associated complications, such as metabolic syndrome, are an increasing problem in both humans and horses in the developed world. Adipose tissue is a key endocrine organ that communicates with other organs by multiple endocrine substances called adipokines. There is evidence to suggest that adipokines may contribute to the regulation of biological processes, such as metabolism, immunity, and inflammation. The aim of this study was to investigate the usefulness of one of these adipokines in horses, resistin, and its relationship with insulin dysregulation (ID) and inflammation. Seventy-two horses, included in one of the four following groups, were studied: healthy controls, horses with inflammatory conditions, horses with mild, and horses with severe ID. Plasma resistin concentrations were significantly different between groups, and the highest values were recorded in the inflammatory and severe ID groups. The lack of correlation of resistin with basal insulin concentration and the significant correlation of resistin with the inflammatory marker serum amyloid A suggest that, as is the case in humans, plasma resistin concentrations in horses are predominantly related to inflammatory conditions and not to ID. Abstract Obesity and its associated complications, such as metabolic syndrome, are an increasing problem in both humans and horses in the developed world. The expression patterns of resistin differ considerably between species. In rodents, resistin is expressed by adipocytes and is related to obesity and ID. In humans, resistin is predominantly produced by inflammatory cells, and resistin concentrations do not reflect the degree of obesity, although they may predict cardiovascular outcomes. The aim of this study was to investigate the usefulness of resistin and its relationship with ID and selected indicators of inflammation in horses. Seventy-two horses, included in one of the four following groups, were studied: healthy controls (C, n = 14), horses with inflammatory conditions (I, n = 21), horses with mild ID (ID1, n = 18), and horses with severe ID (ID2, n = 19). Plasma resistin concentrations were significantly different between groups and the higher values were recorded in the I and ID2 groups (C: 2.38 ± 1.69 ng/mL; I: 6.85 ± 8.38 ng/mL; ID1: 2.41 ± 2.70 ng/mL; ID2: 4.49 ± 3.08 ng/mL). Plasma resistin was not correlated with basal insulin concentrations. A significant (r = 0.336, p = 0.002) correlation was found between resistin and serum amyloid A. Our results show that, as is the case in humans, plasma resistin concentrations in horses are predominantly related to inflammatory conditions and not to ID. Horses with severe ID showed an elevation in resistin that may be secondary to the inflammatory status associated with metabolic syndrome.
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Affiliation(s)
- Beatriz Fuentes-Romero
- Department of Equine Internal Medicine, University of Extremadura, 10004 Cáceres, Spain;
- Correspondence:
| | - Alberto Muñoz-Prieto
- Interdisciplinary Laboratory of Clinical Pathology, Interlab-UMU, University of Murcia, 30003 Murcia, Spain; (A.M.-P.); (J.J.C.)
| | - José J. Cerón
- Interdisciplinary Laboratory of Clinical Pathology, Interlab-UMU, University of Murcia, 30003 Murcia, Spain; (A.M.-P.); (J.J.C.)
| | - María Martín-Cuervo
- Department of Equine Internal Medicine, University of Extremadura, 10004 Cáceres, Spain;
| | | | | | - Elisa Díez-Castro
- Department of Equine Internal Medicine, University of Córdoba, 14014 Córdoba, Spain; (E.A.-T.); (E.D.-C.)
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16
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Mendoza FJ, Buzon-Cuevas A, Toribio RE, Perez-Ecija A. Characterisation of the oral glucose and sugar tolerance tests and the enteroinsular axis response in healthy adult donkeys. Equine Vet J 2021; 54:1123-1132. [PMID: 34897779 DOI: 10.1111/evj.13544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 10/18/2021] [Accepted: 12/09/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Insulin dysregulation (ID) is diagnosed in horses and ponies using oral glucose (OGTT) and oral sugar (OSTT) tolerance tests. The enteroinsular axis plays a major role in postprandial glucose disposal and insulin response in horses, ponies and foals. The insulin and incretin response to oral carbohydrate challenges has not been characterised in donkeys. OBJECTIVES (a) To characterise OGTT and OSTT, and (b) to assess the plasma incretin response to OGTT and OSTT in healthy donkeys. STUDY DESIGN In vivo experiments. METHODS Six healthy adult female Andalusian donkeys were challenged with OGTT (1 g/kg glucose, 20% solution by nasogastric tube) and OSTT (0.45 mL/kg corn syrup orally by syringe) with a 1-week washout. Blood samples were collected for glucose (spectrophotometry), insulin (radioimmunoassay), glucose-dependent insulinotropic polypeptide (GIP, ELISA) and active glucagon-like peptide-1 (aGLP-1, ELISA) determination over 6 hours. Curves were analysed and proxies calculated. RESULTS Glucose and insulin concentrations peaked at 180 minutes in OGTT, but at 300 and 150 minutes in OSTT, respectively. Plasma GIP concentrations increased in the OGTT and OSTT (peaked at 180 and 360 minutes, respectively), but aGLP-1 increased only in OGTT (240 minutes). MAIN LIMITATIONS Single breed, narrow age and sample, diet, season and not having donkeys with evidence of ID to provide clinical validation. CONCLUSIONS Donkeys have a functional enteroinsular axis that is activated by enteral carbohydrates. Donkeys have evident endocrine differences with horses, supporting the validation of the OSTT and OGTT to assess insulin sensitivity in this species to avoid extrapolation from horses.
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Affiliation(s)
- Francisco J Mendoza
- Department of Animal Medicine and Surgery, University of Cordoba, Cordoba, Spain
| | - Antonio Buzon-Cuevas
- Department of Animal Medicine and Surgery, University of Cordoba, Cordoba, Spain
| | - Ramiro E Toribio
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio, USA
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Lyn Macon E, Harris P, Partridge E, Day Barker V, Adams A. Effect of Dose and Fasting on Oral Sugar Test Responses in Insulin Dysregulated Horses. J Equine Vet Sci 2021; 107:103770. [PMID: 34802623 DOI: 10.1016/j.jevs.2021.103770] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 09/02/2021] [Accepted: 09/13/2021] [Indexed: 11/15/2022]
Abstract
The oral sugar test (OST) is frequently used to identify insulin dysregulated (ID) equines. The effect of fasting and varying sugar dose for the OST has been investigated in the pony but little work has been done in the horse. This study aimed to investigate (1) an OST response with access to forage continued until the time of the OST or prevented for 3 hours prior to the OST and (2) responses of ID and non-insulin dysregulated (NID) horses to two different OST doses. Twenty-one mixed-breed horses (14.8 ± 3.2 years; 574.3 ± 83.3 kg) were used in two randomized crossover studies. Seven ID and seven NID horses were used in study A, and eight ID and eight NID in study B. Study A horses underwent an OST (0.15 mL/kg BW) either after a fast (FA) or directly off pasture (FE). Study B horses received either a low (LD; 0.15 mL/kg BW) or high dose (HD; 0.45 mL/kg BW) OST on one occasion each. Blood was collected at basal (T0), and post-60 minute (T60) for later determination of insulin (RIA). Data were analyzed via ANOVA with repeated measures. ID horses had significantly (P < 0.05) greater insulin responses than NID for all OSTs. There was no statistical difference between LD versus HD mean insulin concentrations (T0, T60, delta insulin) for either ID or NID horses. ID had higher T0 (P < 0.01) for FE compared to FA; however, FE and FA did not significantly affect T60 or delta insulins (DI) concentrations.
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Affiliation(s)
- Erica Lyn Macon
- 108 M. H. Gluck Equine Research Center, Department of Veterinary Science, University of Kentucky, Lexington, KY.
| | - Patricia Harris
- Equine Studies Group, WALTHAM Petcare Science Institute, Freeby Lane, Waltham-on-the-Wold, Leicestershire, UK
| | - Emma Partridge
- 108 M. H. Gluck Equine Research Center, Department of Veterinary Science, University of Kentucky, Lexington, KY
| | - Virginia Day Barker
- 108 M. H. Gluck Equine Research Center, Department of Veterinary Science, University of Kentucky, Lexington, KY
| | - Amanda Adams
- MARS Equestrian Research Fellow, Department of Veterinary Science, M. H. Gluck Equine Research Center, University of Kentucky, Lexington, KY
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18
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Dunkel B, Knowles EJ, Chang YM, Menzies-Gow NJ. Influence of endocrine disease on l-lactate concentrations in blood of ponies. J Vet Intern Med 2021; 35:1582-1588. [PMID: 34043845 PMCID: PMC8162605 DOI: 10.1111/jvim.16079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 02/05/2021] [Accepted: 02/05/2021] [Indexed: 12/12/2022] Open
Abstract
Background Blood l‐lactate concentrations are higher in people with developing or established diabetes mellitus and insulin resistance. Objectives To investigate whether blood l‐lactate concentrations are positively correlated with measures of insulin dysregulation (ID) or increased autumnal ACTH concentrations in ponies. Animals Systemically healthy client‐owned ponies (n = 101). Methods Prospective case‐control study. Blood samples were obtained from 101 clinically healthy ponies. Breed, weight, height, and subjective and objective measures of body condition were recorded. Blood l‐lactate, glucose, triglyceride, total adiponectin, and ACTH concentrations were measured and an oral sugar test (OST) was carried out. Correlations between blood l‐lactate and variables of endocrine health were determined. Results Using a seasonal cutoff point of ACTH concentrations ≥47 pg/mL, 55 ponies had increased autumnal ACTH concentrations and 45 did not. Using a basal insulin concentration of >50 μiU/mL, 42 ponies were diagnosed with ID and 58 were not. Using a 60 minutes after OST cutoff point of >45 μiU/mL, 57 ponies had ID and 37 did not. Blood l‐lactate concentrations were significantly lower in obese (average body condition score ≥ 7/9) compared to nonobese ponies (0.6 mmol/L; range, 0.0‐1.9 mmol/L vs 0.8 mmol/L; range, 0.3‐2.7 mmol/L; P = .01). No other significant correlations were detected. No differences were detected between ponies with and without increased autumnal ACTH concentrations (0.7 mmol/L; range, 0.0‐2.7 mmol/L vs 0.7 mmol/L; range, 0.3‐1.8 mmol/L; P = .84) and with and without ID (0.7 mmol/L; range, 0.3‐2.7 mmol/L vs 0.8 mmol/L; range, 0.0‐1.6 mmol/L; P = .63). Conclusions and Clinical Importance Results do not support an effect of endocrine status on l‐lactate concentrations in blood of ponies.
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Affiliation(s)
- Bettina Dunkel
- Department of Clinical Science and Services, The Royal Veterinary College, North Mymms, United Kingdom
| | - Edward J Knowles
- Department of Clinical Science and Services, The Royal Veterinary College, North Mymms, United Kingdom
| | - Yu-Mei Chang
- Research Support Office, The Royal Veterinary College, North Mymms, United Kingdom
| | - Nicola J Menzies-Gow
- Department of Clinical Science and Services, The Royal Veterinary College, North Mymms, United Kingdom
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19
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Knowles EJ, Grieve L. Clinical insights: Equine obesity. Equine Vet J 2020; 52:635-638. [PMID: 32748989 DOI: 10.1111/evj.13307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 06/08/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Edward J Knowles
- Royal Veterinary College Clinical Services Division, Hatfield, Hertfordshire, UK.,Bell Equine Veterinary Clinic, Maidstone, Kent, UK
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Box JR, McGowan CM, Raekallio MR, Mykkänen AK, Carslake H, Karikoski NP. Insulin dysregulation in a population of Finnhorses and associated phenotypic markers of obesity. J Vet Intern Med 2020; 34:1599-1605. [PMID: 32557899 PMCID: PMC7379004 DOI: 10.1111/jvim.15782] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 04/02/2020] [Accepted: 04/02/2020] [Indexed: 01/01/2023] Open
Abstract
Background Obesity and insulin dysregulation (ID) predispose horses to laminitis. Determination of management practices or phenotypic markers associated with ID may benefit animal welfare. Objectives Determine ID status of a population of Finnhorses using an oral sugar test (OST) and compare phenotypes and management factors between ID and non‐ID Finnhorses. Animals One hundred twenty‐eight purebred Finnhorses ≥3 years of age. Methods Owners were recruited using an online questionnaire regarding signalment, history, feeding, and exercise of their horses. Selected contributing stables within a predefined area were visited. Phenotypic markers of obesity and the weight of each horse were recorded. After fasting overnight, horses received 0.45 mL/kg corn syrup PO. Serum samples before and at 60 and 90 minutes after syrup administration were analyzed for insulin by chemiluminescent assay. Horses met ID criteria if insulin concentrations were ≥33 μIU/mL at T0, ≥66 μIU/mL at T60 or T90 or some combination thereof. Associations between phenotypic markers, feeding and exercise variables, and ID were examined using mixed effects logistic regression modeling. Results Several phenotypic markers of obesity were significant on univariable analysis but in the final multivariable model, only obesity (body condition score ≥8) was associated with ID (P = .04). Over half of the horses (60% [95% confidence interval (CI), 51%‐68%]) were considered overweight or obese whereas 16% (95% CI, 10%‐23%) were classified as having ID. Conclusions and Clinical Importance Because obesity is associated with ID in cold‐blooded type horses, objective monitoring of phenotypic markers by owners may be beneficial for health outcomes.
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Affiliation(s)
- Justin R Box
- Department of Equine and Small Animal Sciences, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Cathy M McGowan
- Institute of Veterinary Science, University of Liverpool, Neston, United Kingdom
| | - Marja R Raekallio
- Department of Equine and Small Animal Sciences, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Anna K Mykkänen
- Department of Equine and Small Animal Sciences, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Harry Carslake
- Institute of Veterinary Science, University of Liverpool, Neston, United Kingdom
| | - Ninja P Karikoski
- Department of Equine and Small Animal Sciences, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
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Van Den Wollenberg L, Vandendriessche V, van Maanen K, Counotte GHM. Comparison of Two Diagnostic Methods to Detect Insulin Dysregulation in Horses Under Field Conditions. J Equine Vet Sci 2020; 88:102954. [PMID: 32303301 DOI: 10.1016/j.jevs.2020.102954] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 01/29/2020] [Accepted: 02/01/2020] [Indexed: 11/16/2022]
Abstract
Straightforward testing procedures to enable the diagnosis of insulin dysregulation (ID) in horses that are suitable for use in daily veterinary practice are needed because of the risk that ID could result in laminitis. In our study (that included 90 horses), we compared the proportion of horses classified as ID-positive, ID-suspect, and ID-not diagnosed according to the basal insulin concentration (BIC) with the proportion of horses classified as ID-positive or ID-negative according to a practical and feasible version of an oral sugar test (OST). Furthermore, BIC, basal glucose concentration, and insulin and glucose concentration after OST were analyzed and compared. In the total study population, the OST detected significantly more ID-positive cases than the BIC, with cutoffs at equivalent specificities. Receiver operating characteristics analysis showed that at a lower cutoff, the sensitivity of the BIC could be increased, but at the cost of a significantly lower specificity. Taking this into account, we found diagnostic performance of the OST to be considerably better than the BIC and therefore considered it more recommendable for use as a screening test for ID in ambulatory practice. Furthermore, we investigated the relationship between body condition score and breed type with glucose and insulin concentration as determined after our version of the OST. For that purpose, the study group was subdivided into lean, moderate, and obese horses and "easy keeper breeds" versus "non-easy keeper breeds". Results supported the general assumption that obese horses and "easy keeper breeds" are more prone to the development of ID.
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22
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Harris PA, Bamford NJ, Bailey SR. Equine metabolic syndrome: evolution of understanding over two decades: a personal perspective. ANIMAL PRODUCTION SCIENCE 2020. [DOI: 10.1071/an19386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
There has been a marked increase in the incidence of equine obesity globally, especially in countries where there has been a shift away from the horse having an economically essential working role. This change in its core role, plus the increasing numbers of individual horse owners without access to traditional knowledge of animal and land management, have helped fuel this equine obesity ‘epidemic’. Other important potential contributory factors include increased availability of good grazing and/or forage, as well as supplementary feeds. Obesity now presents a major welfare issue for horses and ponies, not only because of the direct weight-associated effects, but also due to the increased risk it poses for certain clinical conditions, in particular laminitis. For many owners and veterinarians, obesity and the equine metabolic syndrome are synonymous, but this is not necessarily the case. Furthermore, as we understand more about this syndrome and the causes of endocrinopathic laminitis, the emphasis has shifted from tissue or peripheral insulin resistance to insulin dysregulation. The present paper outlines how our knowledge of equine metabolic syndrome arose and continues to develop, as well as the authors’ personal involvement in some of these advances.
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23
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Menzies-Gow NJ. Clinical insights: Diagnosis of laminitis. Equine Vet J 2019; 51:143-144. [PMID: 30724397 DOI: 10.1111/evj.13057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 11/22/2018] [Indexed: 11/29/2022]
Affiliation(s)
- N J Menzies-Gow
- Department of Clinical Sciences and Services, Royal Veterinary College, North Mymms, Hertfordshire, UK
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Durham AE, Frank N, McGowan CM, Menzies-Gow NJ, Roelfsema E, Vervuert I, Feige K, Fey K. ECEIM consensus statement on equine metabolic syndrome. J Vet Intern Med 2019; 33:335-349. [PMID: 30724412 PMCID: PMC6430910 DOI: 10.1111/jvim.15423] [Citation(s) in RCA: 140] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 01/11/2019] [Indexed: 12/26/2022] Open
Abstract
Equine metabolic syndrome (EMS) is a widely recognized collection of risk factors for endocrinopathic laminitis. The most important of these risk factors is insulin dysregulation (ID). Clinicians and horse owners must recognize the presence of these risk factors so that they can be targeted and controlled to reduce the risk of laminitis attacks. Diagnosis of EMS is based partly on the horse's history and clinical examination findings, and partly on laboratory testing. Several choices of test exist which examine different facets of ID and other related metabolic disturbances. EMS is controlled mainly by dietary strategies and exercise programs that aim to improve insulin regulation and decrease obesity where present. In some cases, pharmacologic aids might be useful. Management of an EMS case is a long‐term strategy requiring diligence and discipline by the horse's carer and support and guidance from their veterinarians.
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Affiliation(s)
| | - Nicholas Frank
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts
| | - Cathy M McGowan
- Institute of Veterinary Science, University of Liverpool, Neston, United Kingdom
| | - Nicola J Menzies-Gow
- Department of clinical sciences and services, Royal Veterinary College, Herts, United Kingdom
| | - Ellen Roelfsema
- Department of Equine Sciences, Utrecht University, Utrecht, The Netherlands
| | - Ingrid Vervuert
- Faculty of Veterinary Medicine, University of Leipzig, Institute of Animal Nutrition, Nutrition Diseases and Dietetics, Leipzig, Germany
| | - Karsten Feige
- Clinic for Horses, University of Veterinary Medicine Hannover, Germany
| | - Kerstin Fey
- Equine Clinic, Internal Medicine, Faculty of Veterinary Medicine, Justus-Liebig-University of Giessen, Giessen, Germany
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