The effect of insulin infusion on heart rate and systemic blood pressure in horses with equine metabolic syndrome

Nostell, Katarina; Lindåse, Sanna; Edberg, H.; Bröjer, Johan

doi:10.1111/evj.13110

Cited by 9 publications

(11 citation statements)

References 41 publications

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“…Over time however mean SBP, DBP, and MAP became significantly higher in HE compared to control mares, indicating a diet‐induced difference in BP between the groups. Our findings are similar to those of a previous study that suggested an inability of ID horses to undergo insulin‐induced vasodilatation 11 . Inability to dilate blood vessels in response to insulin is assumed to be the result of a decrease in the vasodilatory (phosphatidylinositol 3‐kinase) pathway during ID states, whereas the vasoconstrictor (mitogen‐activated protein kinase) pathway is intact or enhanced, leading to decreased endothelium‐dependent vasodilatation 5,8‐10 .…”

Section: Discussionsupporting

confidence: 90%

“…Moreover, insulin stimulates the renin‐angiotensin‐aldosterone system, inducing increased renal sodium reabsorption and blood volume expansion 6,7 . There are indications that the vasodilator pathway is suppressed during insulin resistant (IR) states, whereas the vasoconstrictor pathway is intact or heightened, 5,8‐10 leading to diminished variability in the BP response because of limited vasodilatory capacity, as illustrated by the effect of insulin infusion on BP during an euglycemic hyperinsulinemic clamp (EHC) in IR horses 11,12 . Systolic, diastolic (DBP), and mean arterial blood pressure of control horses decreased gradually during the EHC, whereas obese EMS‐horses experienced no decrease 11 and normal weight IR horses experienced less decrease than did controls, 12 indicating a decreased vasodilatory response in IR horses.…”

Section: Introductionmentioning

confidence: 99%

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Effect of a long‐term high‐energy diet on cardiovascular parameters in Shetland pony mares

Fonseca

Beukers

Wijnberg

et al. 2021

Veterinary Internal Medicne

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Background Changes in cardiovascular parameters, including blood pressure (BP) and cardiac anatomical dimensions, are an inconsistent feature of the equine metabolic syndrome. The order in which these changes arise is unknown. Objectives Determine the order in which EMS‐associated changes in cardiovascular parameters arise. Animals Twenty Shetland pony mares. Methods High‐energy (HE) diet mares were fed 200% of net energy requirements for 1 (n = 3) or 2 (n = 7) consecutive diet‐years, with 17 weeks of hay‐only between years. Noninvasive BP measurements and echocardiograms were performed during both years. Resting 24‐hour ECGs and measurements of autonomic tone (splenic volume and packed cell volume [PCV]) were performed at the end of diet‐year 1. Results were compared to control mares receiving a maintenance diet for 1 (n = 7) or 2 (n = 3) consecutive years. Results In year 1, HE mares had significantly higher values than control mares for mean relative left ventricular wall thickness (P = .001). After 2 diet‐years, mean systolic (P = .003), diastolic (P < .001) and mean arterial BP (P = .001), heart rate (HR; P < .001), and mean left ventricular wall thickness (P = .001) also were significantly increased in HE compared to control mares. No pathological arrhythmias or differences in splenic volume or PCV were detected. Conclusions and Clinical Importance Ingesting a HE diet first induced minor changes in BP, and progressed to left‐sided cardiac hypertrophy in Shetland pony mares. These findings are of interest given the increasing incidence of obesity in horses.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Effect of a long‐term high‐energy diet on cardiovascular parameters in Shetland pony mares

Fonseca

Beukers

Wijnberg

et al. 2021

Veterinary Internal Medicne

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“…[47] However, evidence from human and experimental studies supports the major role of hyperinsulinemia in exacerbating hypertension, but not in initiating hypertension. [48][49][50] MC bioactive components, such as charantin, polypeptide-p and phenolic compounds, might be capable of stimulating insulin secretion, improving insulin sensitivity and facilitating the recovery of damaged pancreatic islet beta cells. [51,52] Various mechanisms were reported in this regard, which are mainly based on animal studies, including modulation of insulin signaling pathway, phosphorylation of the insulin receptor substrate-1, and stimulation of peroxisome proliferatoractivated receptors gamma (PPARγ).…”

Section: Discussionmentioning

confidence: 99%

Effects of Momordica charantia L on blood pressure: a systematic review and meta- analysis of randomized clinical trials

Jandari

Ghavami

Ziaei

et al. 2020

International Journal of Food Properties

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Several reports have indicated a positive effect of Momordica charantia (MC) on blood pressure (BP); nevertheless, these findings have been controversial. Therefore, a systematic review and meta-analysis of randomized controlled trials (RCTs) were aimed to investigate the effects of MC supplementation on BP. PubMed, Scopus, ISI Web of Science, and Cochrane library databases were searched (up to June 2020) to identify RCTs investigating the effects of Momordica charantia supplementation on systolic blood pressure (SBP) and diastolic blood pressure (DBP). Weighted mean differences (WMD) were pooled using a random-effects model. Publication bias was assessed by Egger's and Begg's test and heterogeneity was evaluated using Q tests and the I 2 statistic. Eventually, only five articles (six treatment arms) 305 participants (154 as intervention group/151 as control), which reported data of interest entered for data analysis. The meta-analysis showed a non-significant reduction in SBP (WMD: −2.28 mmHg; 95% CI: −6.62, 2.05, P = .302), with significant heterogeneity between selected studies (I 2 = 77.3%) and (WMD: −0.8 mmHg, 95% CI: −2.65 to 1.04, P = .394) with significant between-study heterogeneity (I 2 = 38.1%). When studies were categorized based on participants' mean age and duration of intervention, SBP and DBP had a large non-significant decrease in subjects with equivalent and less than 50 years' subset and short duration (≤8 weeks'). Consumption of MC preparations was not associated with a significant reduction in either SBP or DBP. However, we found a significant hypotensive effect of MC in younger adults and in short-term interventions. Future adequately powered clinical trials, with larger sample size, which consider proper standardization of MC preparations and exclusively include hypertensive patients, are needed to investigate the clinical potential of MC on blood pressure control among these patients.

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“…Horses were classified as IR if their M index was < 2.4 mg/kg/min. This cut-off level was based on the normal distribution of the M index (mean and 95 % confidence interval; 3.8 (2.4-5.2) in a group of metabolically healthy control horses (Icelandic horses and Gotland ponies) from a previous study [30]. The lower confidence interval for the M index in this group of horses was used as the cut-off for IR in the present study.…”

Section: Ehceuglycemic Hyperinsulinemic Clampmentioning

confidence: 99%

Evaluation of fasting plasma insulin and proxy measurements to assess insulin sensitivity in horses

et al. 2021

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Background Proxies are mathematical calculations based on fasting glucose and/or insulin concentrations developed to allow prediction of insulin sensitivity (IS) and β-cell response. These proxies have not been evaluated in horses with insulin dysregulation. The first objective of this study was to evaluate how fasting insulin (FI) and proxies for IS (1/Insulin, reciprocal of the square root of insulin (RISQI) and the quantitative insulin sensitivity check index (QUICKI)) and β-cell response (the modified insulin-to-glucose ratio (MIRG) and the homeostatic model assessment of β-cell function (HOMA-β)) were correlated to measures of IS (M index) using the euglycemic hyperinsulinemic clamp (EHC) in horses with insulin resistance (IR) and normal IS. A second objective was to evaluate the repeatability of FI and proxies in horses based on sampling on consecutive days. The last objective was to investigate the most appropriate cut-off value for the proxies and FI. Results Thirty-four horses were categorized as IR and 26 as IS based on the M index. The proxies and FI had coefficients of variation (CVs) ≤ 25.3 % and very good reliability (intraclass correlation coefficients ≥ 0.89). All proxies and FI were good predictors of the M index (r = 0.76–0.85; P < 0.001). The proxies for IS had a positive linear relationship with the M index whereas proxies for β-cell response and FI had an inverse relationship with the M index. Cut-off values to distinguish horses with IR from horses with normal IS based on the M index were established for all proxies and FI using receiver operating characteristic curves, with sensitivity between 79 % and 91 % and specificity between 85 % and 96 %. The cut-off values to predict IR were < 0.32 (RISQI), < 0.33 (QUICKI) and > 9.5 µIU/mL for FI. Conclusions All proxies and FI provided repeatable estimates of horses’ IS. However, there is no advantage of using proxies instead of FI to estimate IR in the horse. Due to the heteroscedasticity of the data, proxies and FI in general are more suitable for epidemiological studies and larger clinical studies than as a diagnostic tool for measurement of IR in individual horses.

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The effect of insulin infusion on heart rate and systemic blood pressure in horses with equine metabolic syndrome

Cited by 9 publications

References 41 publications

Effect of a long‐term high‐energy diet on cardiovascular parameters in Shetland pony mares

Effect of a long‐term high‐energy diet on cardiovascular parameters in Shetland pony mares

Effects of Momordica charantia L on blood pressure: a systematic review and meta- analysis of randomized clinical trials

Evaluation of fasting plasma insulin and proxy measurements to assess insulin sensitivity in horses

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