Keen J A, McLaren M, Chandler K J, McGorum B C
Easter Bush Veterinary Centre, University of Edinburgh, Roslin, Midlothian EH25 9RG, UK.
Equine Vet J. 2004 Apr;36(3):226-9. doi: 10.2746/0425164044877215.
The mechanisms underlying the increased risk of laminitis in horses with equine Cushing's disease (ECD) are poorly understood.
That abnormalities in glucose homeostasis, similar to those which cause microvascular dysfunction in human diabetics, contribute to development of laminitis in horses with ECD.
Thirty-one aged horses were divided into 3 groups based on clinical signs and dexamethasone suppression testing (DST). Group 1 (n = 12) had clinical ECD as evidenced by hirsutism. Group 2 (n = 10) had a positive DST but no hirsutism. Group 3 (n = 9) were controls without ECD, with a negative DST and no clinical evidence of ECD. Biochemical indices of glucose metabolism, vascular function and oxidative stress were determined in single morning blood samples.
Group 1 had abnormalities in glucose homeostasis, including increased levels of glucose and insulin, compared to Groups 2 and 3. Groups 1 and 2 had significantly lower plasma thiol (PSH) levels and nonsignificantly lower albumin-corrected PSH levels than Group 3, consistent with oxidative stress.
The observed abnormalities in glucose metabolism and oxidative stress could potentially contribute to development of laminitis in horses with ECD, by similar mechanisms to those that cause microvascular dysfunction in human diabetics. The absence of inter-group differences in the biochemical indices of vascular function precludes their use as preclinical diagnostic indicators of vascular dysfunction. The study also highlighted limitations in the premortem diagnosis of ECD.
马垂体嗜碱性细胞增多症(ECD)马匹发生蹄叶炎风险增加的潜在机制尚不清楚。
与导致人类糖尿病患者微血管功能障碍的异常情况类似,葡萄糖稳态异常会促使ECD马匹发生蹄叶炎。
根据临床症状和地塞米松抑制试验(DST)将31匹老龄马分为3组。第1组(n = 12)有多毛症等临床ECD证据。第2组(n = 10)DST呈阳性但无毛多症。第3组(n = 9)为无ECD的对照组,DST呈阴性且无ECD的临床证据。在单次晨间血样中测定葡萄糖代谢、血管功能和氧化应激的生化指标。
与第2组和第3组相比,第1组存在葡萄糖稳态异常,包括血糖和胰岛素水平升高。第1组和第2组的血浆硫醇(PSH)水平显著低于第3组,白蛋白校正后的PSH水平虽无显著差异但也低于第3组,这与氧化应激一致。
观察到的葡萄糖代谢和氧化应激异常可能通过与导致人类糖尿病患者微血管功能障碍类似的机制,促使ECD马匹发生蹄叶炎。血管功能生化指标在组间无差异,因此不能用作血管功能障碍的临床前诊断指标。该研究还突出了ECD生前诊断的局限性。