Equine Metabolic Syndrome: A Complex Disease Influenced by Genetics and the Environment

McCue, Molly E.; Geor, Raymond J.; Schultz, Nichol

doi:10.1016/j.jevs.2015.03.004

Cited by 48 publications

(44 citation statements)

References 74 publications

(55 reference statements)

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“…It can be concluded that the OST yields repeatable results in horses of different breeds, but breed groups were too small to make comparisons with adequate statistical power. Breed differences in glucose and insulin dynamics are becoming more important as evidence mounts that genetic predispositions exist for EMS …”

Section: Discussionmentioning

confidence: 99%

“…Breed differences in glucose and insulin dynamics are becoming more important as evidence mounts that genetic predispositions exist for EMS. 22 Season is an important consideration when performing endocrine testing in horses and future studies should examine the repeatability of the OST at different times of the year. Plasma adrenocorticotropic hormone concentrations are significantly impacted by season in horses, with higher concentrations detected in the late summer and fall.…”

Section: This Decision Was Madementioning

confidence: 99%

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Repeatability of Oral Sugar Test Results, Glucagon‐Like Peptide‐1 Measurements, and Serum High‐Molecular‐Weight Adiponectin Concentrations in Horses

Frank

Walsh²

2017

Veterinary Internal Medicne

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BackgroundRepeatability of the oral sugar test (OST) has not been evaluated.ObjectivesWe hypothesized that OST glucose, insulin, active (aGLP‐1) and total (tGLP‐1) glucagon‐like peptide 1, and high‐molecular‐weight (HMW) adiponectin results would be repeatable.AnimalsFifty‐three horses from a Tennessee research facility (n = 23) and private practice in Missouri (n = 30), including animals with medical histories of equine metabolic syndrome.MethodsTwo OSTs were performed 7–14 days apart and plasma glucose and insulin concentrations were measured at 0, 60, and 75 minutes; a positive result was defined as detection of an insulin concentration >45 μU/mL at 60 or 75 minutes. Plasma aGLP‐1 and serum tGLP‐1 concentrations at 75 minutes and serum HMW adiponectin concentrations at 0 minute were measured in the Missouri group. Bland‐Altman analyses were performed.ResultsNo adverse events were reported. Bland‐Altman analysis indicated mean ± SD bias of 1.5 ± 14.8 μU/mL (95% confidence interval [CI], −27.6 to 30.5 μU/mL) and 1.2 ± 16.1 μU/mL (95% CI, −30.4 to 32.8 μU/mL) for insulin concentrations at 60 and 75 minutes, respectively. There was 91 and 83% agreement in test interpretation between test days for OST insulin results for all horses in the Tennessee and Missouri groups, respectively.Conclusions and Clinical ImportanceRepeatability of the OST was acceptable when values obtained from Bland‐Altman analyses were evaluated, and there was good agreement in binary (negative/positive) test interpretation for insulin concentrations. However, wide 95% CIs were detected for insulin concentrations.

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Section: Discussionmentioning

confidence: 99%

Section: This Decision Was Madementioning

confidence: 99%

Repeatability of Oral Sugar Test Results, Glucagon‐Like Peptide‐1 Measurements, and Serum High‐Molecular‐Weight Adiponectin Concentrations in Horses

Frank

Walsh²

2017

Veterinary Internal Medicne

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“…Regular insulin d (0.1 U/kg, IV) diluted in 3 mL 0.9% sodium chloride solution was administered 20 minutes after the 50% dextrose c infusion. Blood glucose concentration was measured at all time points, and serum insulin concentration was measured at 1 minute before, 1,2,3,4,5,6,7,8,9,10,12,14,16,19,22,25,27,30,35,40, 50, 60, 70, 80, 90, 100, 120, 150, and 180 minutes after 50% dextrose c administration.…”

Section: Insulin Sensitivity Testingmentioning

confidence: 99%

Evaluation of Four Diagnostic Tests for Insulin Dysregulation in Adult Light‐Breed Horses

Dunbar

Mielnicki

Dembek

et al. 2016

Veterinary Internal Medicne

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BackgroundSeveral tests have been evaluated in horses for quantifying insulin dysregulation to support a diagnosis of equine metabolic syndrome. Comparing the performance of these tests in the same horses will provide clarification of their accuracy in the diagnosis of equine insulin dysregulation.ObjectivesThe aim of this study was to evaluate the agreement between basal serum insulin concentrations (BIC), the oral sugar test (OST), the combined glucose‐insulin test (CGIT), and the frequently sampled insulin‐modified intravenous glucose tolerance test (FSIGTT).AnimalsTwelve healthy, light‐breed horses.MethodsRandomized, prospective study. Each of the above tests was performed on 12 horses.ResultsMinimal model analysis of the FSIGTT was considered the reference standard and classified 7 horses as insulin resistant (IR) and 5 as insulin sensitive (IS). In contrast, BIC and OST assessment using conventional cut‐off values classified all horses as IS. Kappa coefficients, measuring agreement among BIC, OST, CGIT, and FSIGTT were poor to fair. Sensitivity of the CGIT (positive phase duration of the glucose curve >45 minutes) was 85.7% and specificity was 40%, whereas CGIT ([insulin]45 >100 μIU/mL) sensitivity and specificity were 28.5% and 100%, respectively. Area under the glucose curve (AUC g0‐120) was significantly correlated among the OST, CGIT, and FSIGTT, but Bland–Altman method and Lin's concordance coefficient showed a lack of agreement.ConclusionsCurrent criteria for diagnosis of insulin resistance using BIC and the OST are highly specific but lack sensitivity. The CGIT displayed better sensitivity and specificity, but modifications may be necessary to improve agreement with minimal model analysis.

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“…Breeds included 12 stock-type horses (five adult and seven aged), four Thoroughbreds (two adult and two aged) and one Standardbred (adult). Aged mares weighed less than adult horses (455 AE 12 vs. 500 AE 13 kg, P = 0.02) throughout the study but body condition score (BCS scale 1-9 [22]) was not different between age groups (median [range] 5 [4][5][6][7] for adults and 5 [3][4][5][6] for aged, P = 0.20). Prior to the study start, all horses were deemed healthy on basis of physical examination.…”

Section: Introductionmentioning

confidence: 96%

“…Factors affecting insulin sensitivity (SI) in equids include breed, body condition, pregnancy and lactation, physical activity, disease conditions, age and diet [1][2][3][4][5]. With respect to the latter two, ageing is associated with development of glucose intolerance and insulin resistance (IR) in people, manifested by exaggerated glucose and insulin responses to carbohydrate (CHO) challenge [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Effects of age and diet on glucose and insulin dynamics in the horse

Rapson

Schott

Nielsen

et al. 2018

Equine Veterinary Journal

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Equine Metabolic Syndrome: A Complex Disease Influenced by Genetics and the Environment

Cited by 48 publications

References 74 publications

Repeatability of Oral Sugar Test Results, Glucagon‐Like Peptide‐1 Measurements, and Serum High‐Molecular‐Weight Adiponectin Concentrations in Horses

Repeatability of Oral Sugar Test Results, Glucagon‐Like Peptide‐1 Measurements, and Serum High‐Molecular‐Weight Adiponectin Concentrations in Horses

Evaluation of Four Diagnostic Tests for Insulin Dysregulation in Adult Light‐Breed Horses

Effects of age and diet on glucose and insulin dynamics in the horse

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