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Kim H, Jung DY, Lee S, Cho J, Yim HW, Kim H. Retrospective cohort analysis comparing changes in blood glucose level and body composition according to changes in thyroid-stimulating hormone level. J Diabetes 2022; 14:620-629. [PMID: 36114679 PMCID: PMC9512769 DOI: 10.1111/1753-0407.13315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 08/08/2022] [Accepted: 08/27/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND In the euthyroid state, the risk of developing diabetes according to changes in thyroid-stimulating hormone (TSH) levels remains controversial. Additionally, the correlation of various body indices affecting blood glucose levels according to changes in TSH levels over a certain period is not well known. METHODS Patients who underwent health check-ups twice at a 2 year interval at a tertiary university hospital between 2009 and 2018 were included. By dividing baseline TSH levels into quartiles (TSH_Q1, Q2, Q3, and Q4), various variables were compared, and their changes after 2 years (∆TSH_Q1, Q2, Q3, and Q4) were confirmed. RESULTS Among 15 557 patients, the incidence of diabetes mellitus after 2 years was 2.4% (377/15 557 patients). There was no statistically significant difference in the incidence of diabetes according to TSH_Q (p = 0.243) or ∆TSH_Q (p = 0.131). However, as TSH levels increased, skeletal muscle mass decreased (p < 0.001), and body fat mass and percent body fat significantly increased (p < 0.001). As ∆TSH increased, ∆fasting blood glucose and ∆body mass index also significantly increased (all p < 0.001). The incidence of diabetes decreased significantly as skeletal muscle mass increased (odds ratio 0.734, p < 0.001). CONCLUSIONS Owing to the short study period, it was not possible to prove a statistical relationship between the incidence of diabetes mellitus and TSH levels in the euthyroid state. Significant decreases in skeletal muscle mass and increases in body mass index and body fat mass according to baseline TSH levels were demonstrated. Therefore, a focus on improving physical functions, such as increasing muscle mass and decreasing fat, is required in this case.
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Affiliation(s)
- Hyunah Kim
- College of PharmacySookmyung Women's UniversitySeoulRepublic of Korea
| | - Da Young Jung
- Department of Biostatistics, Clinical Research Coordinating Center, Catholic Medical CenterThe Catholic University of KoreaSeoulRepublic of Korea
| | - Seung‐Hwan Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of MedicineThe Catholic University of KoreaSeoulRepublic of Korea
| | - Jae‐Hyoung Cho
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of MedicineThe Catholic University of KoreaSeoulRepublic of Korea
| | - Hyeon Woo Yim
- Department of Preventive Medicine, College of MedicineThe Catholic University of KoreaSeoulRepublic of Korea
| | - Hun‐Sung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of MedicineThe Catholic University of KoreaSeoulRepublic of Korea
- Department of Medical Informatics, College of MedicineThe Catholic University of KoreaSeoulRepublic of Korea
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Obesity-Related Metabolic Dysfunction in Dairy Cows and Horses: Comparison to Human Metabolic Syndrome. Life (Basel) 2021; 11:life11121406. [PMID: 34947937 PMCID: PMC8705694 DOI: 10.3390/life11121406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/06/2021] [Accepted: 12/13/2021] [Indexed: 12/17/2022] Open
Abstract
Obesity has become a serious health problem with frequent occurrence both in human and animal populations. It is estimated that it may affect over 85% of the human population and 70–80% of horses and cows by 2030. Fat cow syndrome (FCS) is a combination of metabolic, digestive, infectious, and reproductive disorders that affects obese periparturient dairy cows, and occurs most frequently in loose-housing systems, where periparturient and dry cows are fed and managed in one group disregarding the lactation stages. Equine metabolic syndrome (EMS) was named after human metabolic syndrome (MetS) and has insulin dysregulation as a central and consistent feature. It is often associated with obesity, although EMS may occur in a lean phenotype as well. Other inconsistent features of EMS are cardiovascular changes and adipose dysregulation. Laminitis is the main clinical consequence of EMS. MetS holds a 30-years old lead in research and represents a clustering of risk factors that comprise abdominal obesity, dyslipidemia, hypertension, and hyperglycemia (impaired fasting glucose or type 2 diabetes mellitus—T2DM), which are associated with doubled atherosclerotic cardiovascular disease risk, and a 5-fold increased risk for T2DM. The main aim of this review is to provide critical information for better understanding of the underlying mechanisms of obesity-related metabolic dysfunction in animals, especially in cows and horses, in comparison with MetS. Human medicine studies can offer suitable candidate mechanisms to fill the existing gap in the literature, which might be indispensable for owners to tackle FCS, EMS, and their consequences.
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Elzinga SE, Betancourt A, Stewart JC, Altman MH, Barker VD, Muholland M, Bailey S, Brennan KM, Adams AA. Effects of Docosahexaenoic Acid-Rich Microalgae Supplementation on Metabolic and Inflammatory Parameters in Horses With Equine Metabolic Syndrome. J Equine Vet Sci 2019; 83:102811. [PMID: 31791524 DOI: 10.1016/j.jevs.2019.102811] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 10/14/2019] [Accepted: 10/14/2019] [Indexed: 12/11/2022]
Abstract
Much of the equine population is obese and therefore predisposed to the development of additional health concerns such as equine metabolic syndrome (EMS). However, pharmacologic treatments for EMS are limited. Omega-3 fatty acid supplementation is a therapeutic strategy in humans with metabolic dysfunction that improves insulin sensitivity and reduces inflammation, but the effects of omega-3 fatty acid supplementation in horses with EMS are unclear. Therefore, in this pilot study, 10 mixed-sex and mixed-breed horses with EMS were fed a docosahexaenoic acid (DHA)-rich microalgae containing 16 g DHA/horse/d or served as controls for 46 days. Inflammatory status was measured using serologic enzyme-linked immunosorbent assay and in peripheral blood mononuclear cells (PBMCs) using flow cytometry and reverse transcription polymerase chain reaction. Circulating fatty acids, triglyceride, leptin, and adiponectin concentrations were also determined. Insulin and glucose dynamics were assessed with oral sugar test (OST) and frequently sampled intravenous glucose tolerance testing. Postsupplementation, treated horses had an increase in many circulating fatty acids, including DHA (P < .001). Treated horses also had lower serum triglycerides postsupplementation (P = .02) and a trend (P = .07) for reduced PBMC tumor necrosis factor α. Interestingly, after 46 days, control horses had an increase in insulin responses to the OST (P = .01), whereas treated horses did not (P = .69). These pilot data indicate that DHA-rich microalgae supplementation alters circulating fatty acids, modulates metabolic parameters, and may reduce inflammation in horses with EMS.
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Affiliation(s)
- Sarah E Elzinga
- Department of Veterinary Science, M.H. Gluck Equine Research Center, University of Kentucky, Lexington, KY.
| | - Alejandra Betancourt
- Department of Veterinary Science, M.H. Gluck Equine Research Center, University of Kentucky, Lexington, KY
| | - John C Stewart
- Department of Veterinary Science, M.H. Gluck Equine Research Center, University of Kentucky, Lexington, KY
| | - Melissa H Altman
- Department of Veterinary Science, M.H. Gluck Equine Research Center, University of Kentucky, Lexington, KY
| | - Virginia D Barker
- Department of Veterinary Science, M.H. Gluck Equine Research Center, University of Kentucky, Lexington, KY
| | - Mason Muholland
- Department of Veterinary Science, M.H. Gluck Equine Research Center, University of Kentucky, Lexington, KY
| | - Simon Bailey
- Faculty of Veterinary and Agricultural Sciences, Melbourne Veterinary School, University of Melbourne, Werribee, Victoria, Australia
| | | | - Amanda A Adams
- Department of Veterinary Science, M.H. Gluck Equine Research Center, University of Kentucky, Lexington, KY
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Luethy D, Johnson AL, Stefanovski D, Boston RC, Orsini JA. Glucose and insulin response after intravenous and subcutaneous somatostatin administration in healthy horses. J Vet Pharmacol Ther 2019; 42:541-547. [PMID: 31325161 DOI: 10.1111/jvp.12793] [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: 02/27/2019] [Revised: 05/15/2019] [Accepted: 06/10/2019] [Indexed: 11/27/2022]
Abstract
Equine metabolic syndrome (EMS) is prevalent in the equine population, and somatostatin analogs might be useful for diagnosis and/or treatment of EMS in horses. The purpose of this study was to evaluate the glucose and insulin responses to subcutaneous and intravenous administration of somatostatin. Six healthy research horses were included in this prospective study. An initial pilot study was performed to assess several different doses (10-22 µg/kg [4.5-10 µg/lb]) in two horses, then a final dosage of 22 µg/kg (10 µg/lb) was administered to six horses IV and SQ in a two-period randomized cross-over study performed over a 3-month study period. Blood samples were collected for measurement of plasma insulin and glucose concentrations during a 24-hr study period. Both IV and SQ somatostatin resulted in decreased insulin and increased glucose concentrations. SQ somatostatin resulted in a longer clinical effect, with return to baseline insulin occurring at 1.5 hr postadministration, versus 45 min for IV. Both IV and SQ administration of somatostatin to normal horses resulted in decreased insulin and increased glucose concentrations, likely due to suppression of insulin secretion by somatostatin. A more prolonged effect was seen following SQ administration as compared to IV administration, and no adverse effects were noted at varying doses. This study provides additional information regarding the effect of somatostatin administration on insulin and glucose concentrations in clinically healthy horses.
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Affiliation(s)
- Daniela Luethy
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pennsylvania
| | - Amy L Johnson
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pennsylvania
| | - Darko Stefanovski
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pennsylvania
| | - Raymond C Boston
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pennsylvania
| | - James Anthony Orsini
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pennsylvania
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Bertin FR, Eichstadt Forsythe L, Kritchevsky JE. Effects of high doses of levothyroxine sodium on serum concentrations of triiodothyronine and thyroxine in horses. Am J Vet Res 2019; 80:565-571. [DOI: 10.2460/ajvr.80.6.565] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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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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Rendle D, McGregor Argo C, Bowen M, Carslake H, German A, Harris P, Knowles E, Menzies-Gow N, Morgan R. Equine obesity: current perspectives. ACTA ACUST UNITED AC 2018. [DOI: 10.12968/ukve.2018.2.s2.3] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- David Rendle
- David is a director at Rainbow Equine Hospital, North Yorkshire, and splits his time between leading the internal medicine and critical care services and running the referral laboratory
| | - Caroline McGregor Argo
- Caroline graduated from the University of Aberdeen with Honours in Zoology and received the Kilgour Scholarship to fund PhD studies at the Rowett Research Institute
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Arana-Valencia N, Cater MW, Walker N. Assessment of Owner and Veterinarian Awareness of Equine Insulin Dysregulation and Available Treatments in Southeastern United States. J Equine Vet Sci 2017. [DOI: 10.1016/j.jevs.2017.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Castillo C, Jaramillo C, Loaiza M, Blanco R. Equine metabolic syndrome in Colombian creole horse: case report. ARQ BRAS MED VET ZOO 2017. [DOI: 10.1590/1678-4162-9119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT The equine metabolic syndrome is a condition that can be recognized because of obesity, insulin resistance and laminitis. Genetic factors could play a role in the occurrence of this syndrome. Certain breeds such as ponies (including the South American creole horses) have a lower sensibility to insulin and a higher prevalence of hyperinsulinemia. The environment and management conditions, such as overfeeding and lack of exercise are factors that bring a propensity for obesity. The adipose tissue works as an endocrine organ producing hormones (adipokines or adipocytokines) that affect the horse´s metabolism. The objective of this report is to describe the first case report of a Colombian creole mare with a metabolic syndrome, diagnosed by means of the combined test of glucose-insulin and clinical signs. Early diagnosis of this entity and an adequate treatment are useful for improving the life and the zootechnical conditions of the patient.
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Affiliation(s)
| | | | - M.J. Loaiza
- Corporación Universitaria Lasallista, Colombia
| | - R. Blanco
- Corporación Universitaria Lasallista, Colombia
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Lewis SL, Holl HM, Streeter C, Posbergh C, Schanbacher BJ, Place NJ, Mallicote MF, Long MT, Brooks SA. Genomewide association study reveals a risk locus for equine metabolic syndrome in the Arabian horse. J Anim Sci 2017; 95:1071-1079. [PMID: 28380523 DOI: 10.2527/jas.2016.1221] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Equine obesity can cause life-threatening secondary chronic conditions, similar to those in humans and other animal species. Equine metabolic syndrome (EMS), primarily characterized by hyperinsulinemia, is often present in obese horses and ponies. Due to clinical similarities to conditions such as pituitary pars intermedia dysfunction (formerly equine Cushing's disease), conclusive diagnosis of EMS often proves challenging. Aside from changes in diet and exercise, few targeted treatments are available for EMS, emphasizing the need for early identification of at-risk individuals to enable implementation of preventative measures. A genomewide association study (GWAS) using Arabian horses with a history of severe laminitis secondary to EMS revealed significant genetic markers near a single candidate gene () that may play a role in cholesterol homeostasis. The best marker, BIEC2-263524 (chr14:69276814 T > C), was correlated with elevated insulin values and increased frequency of laminitis ( = 0.0024 and = 9.663 × 10, respectively). In a second population of Arabian horses, the BIEC2-263524 marker maintained its associations with higher modified insulin-to-glucose ratio (MIRG) values ( = 0.0056) and BCS ( = 0.0063). Screening of the predicted coding regions by sequencing identified a polymorphic guanine homopolymer and 5 haplotypes in the 3' untranslated region (UTR). An 11 guanine (11-G) allele at was correlated with elevated insulin values in the GWAS population ( = 0.0008) and, in the second population, elevated MIRG and increased BCS > 6.5 ( = 0.0055 and = 0.0162, respectively). The BIEC2-263524-C and the 3' UTR -11(G) polymorphisms were correlated at a 98% frequency, indicating strong linkage disequilibrium across this 150-kb haplotype. Assays for these markers could diagnose horses with a genetic predisposition to develop obesity. Additionally, discovery of FAM174A function may improve our understanding of the etiology of this troubling illness in the horse and warrants investigation of this locus for a role in metabolic- and obesity-related disorders of other species.
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Fazio E, Medica P, Cravana C, Bruschetta G, Ferlazzo A. Seasonal thyroid and lipid profiles in Thoroughbred pregnant and nonpregnant mares ( Equus caballus ). Theriogenology 2016; 85:1582-1589. [DOI: 10.1016/j.theriogenology.2016.01.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 01/19/2016] [Accepted: 01/19/2016] [Indexed: 12/20/2022]
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Abstract
Laminitis is one of the most common and frustrating clinical presentations in equine practice. While the principles of treatment for laminitis have not changed for several decades, there have been some important paradigm shifts in our understanding of laminitis. Most importantly, it is essential to consider laminitis as a clinical sign of disease and not as a disease in its own right. Once this shift in thinking has occurred, it is logical to then question what disease caused the laminitis. More than 90 per cent of horses presented with laminitis as their primary clinical sign will have developed it as a consequence of endocrine disease; most commonly equine metabolic syndrome (EMS). Given the fact that many horses will have painful protracted and/or chronic recurrent disease, a good understanding of the predisposing factors and how to diagnose and manage them is crucial. Current evidence suggests that early diagnosis and effective management of EMS should be a key aim for practising veterinary surgeons to prevent the devastating consequences of laminitis. This review will focus on EMS, its diagnosis and management.
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Affiliation(s)
- R Morgan
- BHF Centre for Cardiovascular Science, The Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - J Keen
- European Specialist in Equine Internal Medicine, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Midlothian EH25 9RG, UK
| | - C McGowan
- European Specialist in Equine Internal Medicine, Institute of Aging and Chronic Disease, University of Liverpool, Leahurst Campus, Neston, Cheshire CH64 7TE, UK
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Orsini JA. Science-in-brief: Equine laminitis research: Milestones and goals. Equine Vet J 2014; 46:529-33. [DOI: 10.1111/evj.12301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- J. A. Orsini
- New Bolton Center; School of Veterinary Medicine; University of Pennsylvania; USA
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Expression and regulation of facilitative glucose transporters in equine insulin-sensitive tissue: from physiology to pathology. ISRN VETERINARY SCIENCE 2014; 2014:409547. [PMID: 24977043 PMCID: PMC4060548 DOI: 10.1155/2014/409547] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Accepted: 12/09/2013] [Indexed: 01/12/2023]
Abstract
Glucose uptake is the rate-limiting step in glucose utilization in mammalians and is tightly regulated by a family of specialized proteins, called the facilitated glucose transporters (GLUTs/SLC2). GLUT4, the major isoform in insulin-responsive tissue, translocates from an intracellular pool to the cell surface and as such determines insulin-stimulated glucose uptake. However, despite intensive research over 50 years, the insulin-dependent and -independent pathways that mediate GLUT4 translocation are not fully elucidated in any species. Insulin resistance (IR) is one of the hallmarks of equine metabolic syndrome and is the most common metabolic predisposition for laminitis in horses. IR is characterized by the impaired ability of insulin to stimulate glucose disposal into insulin-sensitive tissues. Similar to other species, the functional capability of the insulin-responsive GLUTs is impaired in muscle and adipose tissue during IR in horses. However, the molecular mechanisms of altered glucose transport remain elusive in all species, and there is still much to learn about the physiological and pathophysiological functions of the GLUT family members, especially in regard to class III. Since GLUTs are key regulators of whole-body glucose homeostasis, they have received considerable attention as potential therapeutic targets to treat metabolic disorders in human and equine patients.
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Seddighi R, Doherty TJ. Anesthesia of the geriatric equine. VETERINARY MEDICINE-RESEARCH AND REPORTS 2012; 3:53-64. [PMID: 30101084 DOI: 10.2147/vmrr.s34162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Advancements in veterinary medicine have resulted in an increased number of geriatric horses being presented for medical or surgical procedures that require general anesthesia. Due to the physiological changes associated with aging and the likelihood of concurrent disease conditions, the geriatric equine is at an increased risk during anesthesia. The main physiological changes associated with aging, and their impact on anesthesia, are discussed in this review.
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Affiliation(s)
- Reza Seddighi
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Veterinary Medical Center, University of Tennessee, Knoxville, TN, USA,
| | - Thomas J Doherty
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Veterinary Medical Center, University of Tennessee, Knoxville, TN, USA,
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Secombe CJ, Lester GD. The role of diet in the prevention and management of several equine diseases. Anim Feed Sci Technol 2012. [DOI: 10.1016/j.anifeedsci.2011.12.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Field treatment and management of endocrinopathic laminitis in horses and ponies. Vet Clin North Am Equine Pract 2010; 26:379-90. [PMID: 20699182 DOI: 10.1016/j.cveq.2010.05.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Endocrinopathic laminitis in horses and ponies has the potential to cause extensive damage to the feet before clinical signs of laminitis are apparent. Early diagnosis and intervention based on the detection and control of hyperinsulinemia are critical if the crippling changes that are seen in the disease are to be avoided. Preventing endocrinopathic laminitis, rather than treating it, is good practice management benefiting not only equine patients but also their owners.
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Johnson PJ, Wiedmeyer CE, LaCarrubba A, Ganjam VKS, Messer NT. Laminitis and the equine metabolic syndrome. Vet Clin North Am Equine Pract 2010; 26:239-55. [PMID: 20699172 DOI: 10.1016/j.cveq.2010.04.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Although much has been written about laminitis in the context of its association with inflammatory processes, recognition is growing that most cases of laminitis examined by veterinarians in private practice are those associated with pasture grazing, obesity, and insulin resistance (IR). The term 'endocrinopathic laminitis' has been adopted to classify the instances of laminitis in which the origin seems to be more strongly associated with an underlying endocrinopathy, such as either IR or the influence of corticosteroids. Results of a recent study suggest that obesity and IR represent the most common metabolic and endocrinopathic predispositions for laminitis in horses. IR also plays an important role in the pathogenesis of laminitis that develops when some horses or ponies are allowed to graze pastures at certain times of the year. The term equine metabolic syndrome (EMS) has been proposed as a label for horses whose clinical examination results (including both physical examination and laboratory testing) suggest heightened risk for developing laminitis as a result of underlying IR.
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Affiliation(s)
- Philip J Johnson
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, 900 East Campus Drive, Columbia, MO 65211, USA.
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Optimisation of the frequently sampled intravenous glucose tolerance test to reduce urinary glucose spilling in horses. Equine Vet J 2010; 41:844-51. [DOI: 10.2746/042516409x439661] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Tóth F, Frank N, Geor RJ, Boston RC. Effects of pretreatment with dexamethasone or levothyroxine sodium on endotoxin-induced alterations in glucose and insulin dynamics in horses. Am J Vet Res 2010; 71:60-8. [DOI: 10.2460/ajvr.71.1.60] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Correlation of Plasma Insulin Concentration with Laminitis Score in a Field Study of Equine Cushing's Disease and Equine Metabolic Syndrome. J Equine Vet Sci 2009. [DOI: 10.1016/j.jevs.2008.12.006] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Frank N, Elliott SB, Boston RC. Effects of long-term oral administration of levothyroxine sodium on glucose dynamics in healthy adult horses. Am J Vet Res 2008; 69:76-81. [PMID: 18167090 DOI: 10.2460/ajvr.69.1.76] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the effects of long-term oral administration of levothyroxine sodium (L-T(4)) on glucose dynamics in adult euthyroid horses. ANIMALS 6 healthy adult mares. PROCEDURES Horses received L-T(4) (48 mg/d) orally for 48 weeks. Frequently sampled IV glucose tolerance test procedures were performed on 3 occasions (24-hour intervals) before and at 16, 32, and 48 weeks during the treatment period. Data were assessed via minimal model analysis. The repeatability of measurements was evaluated. RESULTS During treatment, body weight decreased significantly from the pretreatment value; mean +/- SD weight was 49 +/- 14 kg, 43 +/- 7 kg, and 25 +/- 18 kg less than the pretreatment value at weeks 16, 32, and 48, respectively. Compared with pretreatment findings, 1.8-, 2.4-, and 1.9-fold increases in mean insulin sensitivity (SI) were detected at weeks 16, 32, and 48, respectively; SI was negatively correlated with body weight (r = -0.42; P < 0.001). During treatment, glucose effectiveness increased and the acute insulin response to glucose decreased. Overall mean within-horse coefficients of variation were 5% and 29% for plasma glucose and serum insulin concentrations, respectively, and 33%, 26%, and 23% for SI, glucose effectiveness, and the acute insulin response to glucose, respectively. CONCLUSIONS AND CLINICAL RELEVANCE Long-term administration of L-T(4) was associated with weight loss and increased SI in adult euthyroid horses, although other factors may have confounded results. Levothyroxine sodium may be useful for the treatment of obesity and insulin resistance in horses, but further studies are required.
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Affiliation(s)
- Nicholas Frank
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996, USA
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Abstract
Insulin resistance is thought to be involved in the pathogenesis of many equine conditions such as pars intermedia dysfunction, equine metabolic syndrome, diabetes mellitus, hyperlipaemia, laminitis, endotoxaemia and osteochondrosis dissecans (OCD); whereas polysaccharide storage myopathy in Quarter Horses and equine motor neuron disease (EMD) have been associated with increased insulin sensitivity. However, it is clear that there is not one ideal test, in terms of both practicality and accuracy, for evaluating insulin sensitivity in horses and improved diagnostic techniques are required. This review sets out the background to the subject and identifies current knowledge regarding the measurement of insulin sensitivity by tolerance testing and clamping techniques. Factors affecting insulin sensitivity, such as breed, pregnancy, lactation, obesity and nutritional factors are discussed. In addition, the relationship with training, nutritional supplementation and drug administration are considered.
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Affiliation(s)
- A M Firshman
- Department of Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, Oregon 97331, USA
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Frank N, Buchanan BR, Elliott SB. Effects of long-term oral administration of levothyroxine sodium on serum thyroid hormone concentrations, clinicopathologic variables, and echocardiographic measurements in healthy adult horses. Am J Vet Res 2008; 69:68-75. [DOI: 10.2460/ajvr.69.1.68] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Evidence-based literature pertaining to thyroid dysfunction and Cushing's syndrome in the horse. Vet Clin North Am Equine Pract 2007; 23:329-64. [PMID: 17616317 DOI: 10.1016/j.cveq.2007.04.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The evidence-based literature pertaining to thyroid dysfunction and Cushing's syndrome is discussed in this article. Summaries of and recommendations for the treatment of these conditions are made. There is a need for reliable diagnostic tests for these conditions in horses.
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Endocrine Profile Comparisons of Fat Versus Moderately Conditioned Mares Following Parturition. J Equine Vet Sci 2007. [DOI: 10.1016/j.jevs.2006.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Treiber KH, Kronfeld DS, Geor RJ. Insulin resistance in equids: possible role in laminitis. J Nutr 2006; 136:2094S-2098S. [PMID: 16772509 DOI: 10.1093/jn/136.7.2094s] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
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.
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Affiliation(s)
- Kibby H Treiber
- Department Animal and Poultry Science, Virginia Polytechnic and State University, Blacksburg, VA 24061-0303, USA.
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Frank N, Elliott SB, Brandt LE, Keisler DH. Physical characteristics, blood hormone concentrations, and plasma lipid concentrations in obese horses with insulin resistance. J Am Vet Med Assoc 2006; 228:1383-90. [PMID: 16649943 DOI: 10.2460/javma.228.9.1383] [Citation(s) in RCA: 188] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare obese horses with insulin resistance (IR) with nonobese horses and determine whether blood resting glucose, insulin, leptin, and lipid concentrations differed between groups and were correlated with combined glucose-insulin test (CGIT) results. ANIMALS 7 obese adult horses with IR (OB-IR group) and 5 nonobese mares. PROCEDURES Physical measurements were taken, and blood samples were collected after horses had acclimated to the hospital for 3 days. Response to insulin was assessed by use of the CGIT, and maintenance of plasma glucose concentrations greater than the preinjection value for > or = 45 minutes was used to define IR. Area under the curve values for glucose (AUC(g)) and insulin (AUC(i)) concentrations were calculated. RESULTS Morgan, Paso Fino, Quarter Horse, and Tennessee Walking Horse breeds were represented in the OB-IR group. Mean neck circumference and BCS differed significantly between groups and were positively correlated with AUC values. Resting insulin and leptin concentrations were 6 and 14 times as high, respectively, in the OB-IR group, compared with the nonobese group, and were significantly correlated with AUC(g) and AUC(i). Plasma nonesterified fatty acid, very low-density lipoprotein, and high-density lipoprotein-cholesterol (HDL-C) concentrations were significantly higher (86%, 104%, and 29%, respectively) in OB-IR horses, and HDL-C concentrations were positively correlated with AUC values. CONCLUSIONS AND CLINICAL RELEVANCE Measurements of neck circumference and resting insulin and leptin concentrations can be used to screen obese horses for IR. Dyslipidemia is associated with IR in obese horses.
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Affiliation(s)
- Nicholas Frank
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996, USA
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Vick MM, Sessions DR, Murphy BA, Kennedy EL, Reedy SE, Fitzgerald BP. Obesity is associated with altered metabolic and reproductive activity in the mare: effects of metformin on insulin sensitivity and reproductive cyclicity. Reprod Fertil Dev 2006; 18:609-17. [PMID: 16930507 DOI: 10.1071/rd06016] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2006] [Accepted: 04/09/2006] [Indexed: 11/23/2022] Open
Abstract
In mares, obesity is associated with continuous reproductive activity during the non-breeding season. To investigate the effect of obesity and associated alterations in metabolic parameters on the oestrous cycle, two related studies were conducted. In Experiment 1, obese (body condition score > 7) mares were fed ad libitum or were moderately feed restricted during the late summer and autumn months. Feed restriction did not alter the proportion of mares entering seasonal anoestrus. However, obese mares exhibited a significantly longer duration of the oestrous cycle, significant increases in circulating concentrations of leptin and insulin, and decreased insulin sensitivity and concentrations of thyroxine compared with feed-restricted mares throughout the experiment. Experiment 2 was designed to investigate the effects of administration of the insulin-sensitising drug metformin hydrochloride on insulin sensitivity and the characteristics of the oestrous cycle in obese mares. In a dose–response trial, metformin increased insulin sensitivity after 30 days following administration of 3 g day–1, but not 6 or 9 g day–1, compared with controls receiving vehicle only. However, there were no differences in insulin sensitivity or oestrous cycle characteristics between control and metformin-treated groups when the 3 g day–1 dose was tested for a longer period of 2 months. These results demonstrate that obesity is associated with aberrations in the oestrous cycle and perturbations in several markers of metabolic status. The results also indicate that metformin is not an effective long-term monotherapy for increasing insulin sensitivity in horses at the doses tested. Additional studies are needed to examine possible effects of increasing insulin sensitivity on reproductive activity in obese mares.
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Affiliation(s)
- M M Vick
- Department of Veterinary Science, Maxwell Gluck Equine Research Center, University of Kentucky, Lexington, KY 40546, USA
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