Menzies-Gow N J, Harris P A, Elliott J
Department of Clinical Sciences and Services, Royal Veterinary College, London, UK.
Equine Studies Group, Waltham Centre for Pet Nutrition, Waltham on the Wolds, UK.
Equine Vet J. 2017 May;49(3):300-306. doi: 10.1111/evj.12606. Epub 2016 Aug 25.
Certain individuals appear to be predisposed to recurrent pasture-associated laminitis. Previous studies have predominantly investigated risk factors only after disease occurrence.
To investigate risk factors for pasture-associated laminitis prior to disease occurrence.
Prospective cohort study.
Non-laminitic ponies aged ≥7 years were recruited. Body condition score (BCS), height, weight, crest height and thickness were measured and an overnight dexamethasone suppression test performed. Plasma or serum adiponectin, leptin, triglyceride, basal insulin, insulin post-dexamethasone, insulin-like growth factor 1 (IGF-1), IGF binding protein 1 (IGFBP-1), IGFBP-3, C-reactive protein, von Willebrand's factor, soluble E-selectin and P-selectin concentrations were assayed. Follow-up data were obtained from owners annually for 3 years to ascertain occurrences of veterinarian-diagnosed pasture-associated laminitis. Data were analysed by multivariate logistic regression. Receiver operating characteristic (ROC) curves analysis was performed for significant risk factors and cut-off values determined.
A total of 446 animals with a median (interquartile range) age of 15 (10-20) years were recruited. Of these, 50.4% were mares and 49.6% were geldings. The most common breeds were Welsh (36.4%), Shetland (17.0%) and cob (9.4%). Overall, 72.2% of animals were overweight/obese (BCS 7-9/9), 27.3% were of ideal weight (BCS 4-6/9) and 0.5% were underweight (BCS 1-3/9). After 1, 2 and 3 years, respectively, 18 (4.0%), 30 (6.7%) and 44 (9.9%) animals were reported to have had laminitis. Plasma adiponectin, and serum basal (insulin) and (insulin) post-dexamethasone levels were significantly (P ≤ 0.05) associated with laminitis occurrence cumulatively after 1, 2 and 3 years. Use of the area under the ROC curves to distinguish animals that did and did not develop laminitis showed good (basal [insulin] after 1 year), fair (all others) or poor ([insulin] post-dexamethasone) levels of accuracy.
Animals were evaluated at a single time point and biomarkers were assayed using single assays.
Risk factors for future laminitis prior to disease occurrence include low plasma adiponectin and high serum basal insulin or insulin post-dexamethasone concentrations.
某些个体似乎易患复发性牧场相关性蹄叶炎。以往研究主要仅在疾病发生后调查危险因素。
调查疾病发生前牧场相关性蹄叶炎的危险因素。
前瞻性队列研究。
招募年龄≥7岁的非蹄叶炎小马。测量体况评分（BCS）、身高、体重、髻甲高度和厚度，并进行过夜地塞米松抑制试验。检测血浆或血清脂联素、瘦素、甘油三酯、基础胰岛素、地塞米松后胰岛素、胰岛素样生长因子1（IGF-1）、IGF结合蛋白1（IGFBP-1）、IGFBP-3、C反应蛋白、血管性血友病因子、可溶性E选择素和P选择素浓度。每年从主人处获取随访数据，为期3年，以确定兽医诊断的牧场相关性蹄叶炎的发生情况。通过多因素逻辑回归分析数据。对显著危险因素进行受试者操作特征（ROC）曲线分析并确定临界值。
共招募了446只动物，中位（四分位间距）年龄为15（10 - 20）岁。其中，50.4%为母马，49.6%为去势雄马。最常见的品种是威尔士马（36.4%）、设得兰矮种马（17.0%）和科布马（9.4%）。总体而言，72.2%的动物超重/肥胖（BCS 7 - 9/9），27.3%体重理想（BCS 4 - 6/9），0.5%体重过轻（BCS 1 - 3/9）。在1年、2年和3年后，分别有18只（4.0%）、30只（6.7%）和44只（9.9%）动物被报告患蹄叶炎。血浆脂联素以及血清基础（胰岛素）和地塞米松后（胰岛素）水平在1年、2年和3年后与蹄叶炎发生累积显著相关（P≤0.05）。使用ROC曲线下面积区分患蹄叶炎和未患蹄叶炎的动物，显示准确性水平良好（1年后基础[胰岛素]）、中等（其他所有指标）或较差（地塞米松后[胰岛素]）。
动物仅在单个时间点进行评估，生物标志物采用单一检测方法进行检测。
疾病发生前未来蹄叶炎的危险因素包括血浆脂联素水平低以及血清基础胰岛素或地塞米松后胰岛素浓度高。
