Endocrine- EMS Flashcards
(47 cards)
Associations between feeding and glucagon-like peptide-2in healthy ponies
Increase in GLP2 x3-4 after feeding. No apparent effect of light/dark
GLP2 administrations resulted in no signifant effect on metabolic responses to eating (slightly reduced blood glucose). GLP2 unlkely to have direct causal role in increased post prandial insulin in ID ponies. Further work required
The effect of pre-dosing with metformin on the insulin response to oral sugar in insulin- dysregulated horses
Does not support the use of targeted metformin treatment to reduce post prandial hyperinsulinaemia in horses with naturally occuring ID. May still be worthwhile in individual (had significant effect in 1 individual), or in acute phases of HAL (AMK mimetic effects could modulate epithelial differentiation in the digit)
Factors associated with insulin responses to oral sugars in a mixed breed cohort of ponies
Associated with high risk insulin T60 (>54.2uIu/ml) age, welsh, gelding, BCS, supraorbital fat, exercise.
-Associated with loginsulinT60: age, BCS, adiponectin (inverse), TG, basal insulin (in Spring + bulging supraopbital fat pads, welsh and gelding, in Autumn, turnout, ACTH).
-Season, owner reported and physical features explained 10-27% of the differences in InsulinT60 risk
–>don’t screen based just on phenotype/ owner reported factors
modifiable factors= exercise, particularly in autumn.
These were non-laminitic ponies and just focussed on insulint60
Development of a body condition index to estimate adiposity in ponies and horses from morphometric measurements
BCI was well correlated to fat % (slightly worse than BCS), but was less variable than BCS with inexperienced observers. Obesity Se 79.4%, Sp 81.3%. Overconditioned 84%, Sp 87.5%. Not useful in Shetland/ minis as different body shape. Possibly less useful in horses cf ponies. Further work needed.
Horse owner experiences and observations with the use of SGLT2i for the management of equine metabolic syndrome and hyperinsulinaemia-associated laminitis
Excessive Urination: 20.5% of owners reported their horses experienced excessive urination after starting SGLT2i treatment.
Excessive Drinking: 11.1% of owners observed their horses drinking excessively.
Excessive Weight Loss: 9.9% of owners reported excessive weight loss in their horses.
Dullness: 7.6% of owners noted a state of dullness in their horses.
Use of FreeStyle Libre for continuous glucose monitoring in adult horses
-CGMS are promising for ID diagnostics but need further validation for diagnostic use- could use for CGIT.
-NSD test on post feed measurements
- tended to under estimate at higher concentrations (to do with delay with equilibration of glucose blood to interstitium)
- good agreement, except <25 mins from glucose administration
- unclear for diagnosis of IR- only 1 horse dysregulated
- sensors stayed in place for mean 4.2 days
Diagnosis of Equine Endocrinopathies: The Value of Measuring Blood Glucose During an Oral Glucose Test
Post prandial blood glucose in OST in weakly correlated to insulin, but does have some (weak/most) correlations with crest neck score. Is still worth measuring but remember is variable.
Effects of alpha-2-adrenoceptor agonism and antagonism on equine blood insulin and glucose concentrations after oral carbohydrate load
Vatinoxan is a peripherally acting alpha2 antagonists.
Alleviates the hyperglycaemic effects of detomidine (and produces hypoglycaemia when used alone) and delays insulin response.
Alpha2s reduce insulin by inhibiting release from pancreatic beta cellls
Vatinoxan also increases NEFAs but not TGs- ? mechanism
Preliminary Observations on the Use of Ertugliflozin in Managing Hyperinsulinaemia and Laminitis
-significantly improved hyperinsulinaemia, reduced Obel score and body weight
- 88% hyperinsulinaemic at 30d but no c/s and reduced. No GGT change. Induced glucosuria, sign PU/PD
Oral Sugar Test Responses to Ertugliflozin in Ten Horses with Insulin Dysregulation
4 days of treatment lowered baseline and postprandial insulin, but not all returned to normal. Heterogeneity likely due to genetics, BCS etc but not assessed.
PK remains unknown.
Increases in TG also observed. Glucose response to OST did not change
Retrospective case series
Variation in Insulin Response to Oral Sugar Test in a Cohort of Horses throughout the year and evaluation of risk factors for insulin dysregulation.
No seasonable variation in OST or adiponectin. ID status was variable (unpredictably) so repeating OSTs may be justified. Lack of exercise, age and BCS/CNS was a RF
A Starch-Rich Treat Affects Enteroinsular Responses in Ponies
Increased GLP2 response to feeding after feeding a starch rich treat (bread) for 10 days and increase in peak Dxylose absorption (intestinotrophic)
Glucose and insulin did not change but most ponies healthy= needs repeating in ID.
Equine metabolic syndrome in UK native ponies and cobs is highly prevalent with modifiable risk factors
- prevalence 23%
- RF: age, being female, more sedentary main activity, obesity, shorter periods on pasture during the summer, Welsh Sec A
Comparison of a modified 2-step insulin response test performed with porcine zinc insulin and an oral glucose test to detect hyperinsulinemic Icelandic horses
IRT did not differ between ID vs non ID Icelandic horses (OST= dx).
-possible breed association- peripheral insulin resistance? Different insulin to that validated (recombinant human)
Evaluating Insulin Dysregulation in Horses: Two-Step Insulin-Tolerance Test
Correlated well with recombinant humnan insulin (validated) but -Based on the Youden index, when using the ITT-PZI, an adjusted cut-off value for blood glucose reduction of 40 % at 30 min resulted in better test performance -> 100% Se, 55% Sp. Tests were then perfectly concordant
-icelandic horses and n=4 for ID,
Comparison of One Novel and Four Established Diagnostic Tests for ID in Ponies
-oral responses are most sensitive due to contribution from incretins. Better than CGIT in this study
- proposed cereal test based on weetabix was se/sp but poorly palatable
-fasted insulin performed the worst
Identifying Possible Thresholds for Nonstructural Carbohydrates in the Insulin Dysregulated Horse
ID horses had signifiamcntly increased response (insulin) to all diets where NSC >0.1g/kg vs NID- above this they had an incrementally increasing AUC for insulin curve.
But small number and demonstrated individualised responses
-The threshold for insulin response to starch was around 0.03–0.06 g/kg BW, while for water-soluble carbohydrates (WSC), it ranged from 0.08–0.11 g/kg BW.-> may have a lower tolerance for starch
-Unclear- long term effect and meal sizes (one feed only here)
Insulin but Not Adiponectin Is Detectable in Equine Saliva Using an Automated, Commercial Assay
Insulin Is measurable (Tosoh not Immulite) but does not correlate with serum-> further work on significance/ diagnostic thresholds required.
Adpionectin not measurable in saliva
No measureable stress response recorded to sampling.
Relationships between total adiponectin concentrations and obesity in native-breed ponies in England
-Obese ponies (BCS ≥ 7) had higher median TA concentrations compared to ideal-weight (BCS 4–5.5) and overweight ponies, challenging the notion that obesity uniformly reduces adiponectin.
greater prevalence of normal insulin and adiponectin profiles among obese ponies compared to ideal-weight ones
-A greater percentage of obese (54.6%) than ideal-weight ponies (33.1%, p < 0.001) had both normal [TA] and [basal insulin], and a greater percentage of ideal-weight (38.6%) than obese ponies (16.5%, p < 0.001) showed hypoadiponectinaemia.
-Attempts to develop predictive model for hypoadiponectinaemia were unsuccessful (poor models)
—–> adiponectin and insulin should be monitored in all at risk ponies regardless of obesity. Role of intra-abdominal adipose?
Short-term induced hyperinsulinaemia and dexamethasone challenge do not affect circulating total adiponectin concentrations in insulin-sensitive ponies
One dose of dexamethasone challenge did not alter circulating [insulin] or [total adiponectin] at any timepoint, but significantly upregulated AdipoR1 and IGF-1R expression at 150 and 180 mi (early phsyiological adaptation to IR?)
-Ex vivo incubation of whole blood with dexamethasone did not alter expression of the genes examined-> effects are systemic, not local.
-There was no change in [total adiponectin] or expression of the genes examined associated with EHC-induced hyperinsulinemia. T-cadherin was undetetctable
-The relationship between insulin and adiponectin appears complex and may involve chronic rather than acute mechanisms, necessitating further research into long-term interactions.
Intra-articular triamcinolone acetonide injection results in increases in systemic insulin and glucose concentrations in horses without insulin dysregulation
Blood insulin and glucose concentrations modestly increased for 48 h
following IA TA. (18mg) in non ID horses. 8 horses achieved basal insulin >2-. But none >perceived safety limit-> unlikley to directly cause laminitis
Postprandial Insulin Responses to Various Feedstuffs Differ in Insulin Dysregulated Horses compared with non-insulin
dysregulated controls
Ration NSC is the main driver for postprandial insulin.
ID horses have an exagerrated insulin response vs NID-> cannot extrapolate thresholds between
Predictors of Laminitis Development in a Cohort of Nonlaminitic Ponies
t0 and t60 iunsulin best quantify the risk of future laminitis development in nonlaminitic ponies
-ACTH not asscoiated with laminitis as a sole measure. When measured in autumn and combined with basal insulin, was associated with laminitis.
3x more common in summer than winter but not retained in model
Only modifiable RF was exercise. Morphological was divergent hoof rings
Association between insulin dysregulation and adrenocorticotropic hormone in aged horses and ponies with no clinical signs of pituitary pars intermedia dysfunction
Care with ID horses and ACTH measurement in autumn (particularly ponies) as they are significantly positively correlated. ACTH seasonal variation is greater in ID ponies