GD Animal Health BV, Deventer, The Netherlands.
PAVO, Heijen, The Netherlands.
J Equine Vet Sci. 2020 May;88:102954. doi: 10.1016/j.jevs.2020.102954. Epub 2020 Feb 7.
Straightforward testing procedures to enable the diagnosis of insulin dysregulation (ID) in horses that are suitable for use in daily veterinary practice are needed because of the risk that ID could result in laminitis. In our study (that included 90 horses), we compared the proportion of horses classified as ID-positive, ID-suspect, and ID-not diagnosed according to the basal insulin concentration (BIC) with the proportion of horses classified as ID-positive or ID-negative according to a practical and feasible version of an oral sugar test (OST). Furthermore, BIC, basal glucose concentration, and insulin and glucose concentration after OST were analyzed and compared. In the total study population, the OST detected significantly more ID-positive cases than the BIC, with cutoffs at equivalent specificities. Receiver operating characteristics analysis showed that at a lower cutoff, the sensitivity of the BIC could be increased, but at the cost of a significantly lower specificity. Taking this into account, we found diagnostic performance of the OST to be considerably better than the BIC and therefore considered it more recommendable for use as a screening test for ID in ambulatory practice. Furthermore, we investigated the relationship between body condition score and breed type with glucose and insulin concentration as determined after our version of the OST. For that purpose, the study group was subdivided into lean, moderate, and obese horses and "easy keeper breeds" versus "non-easy keeper breeds". Results supported the general assumption that obese horses and "easy keeper breeds" are more prone to the development of ID.
由于胰岛素调节障碍（ID）可能导致蹄叶炎，因此需要简单易行的检测程序来诊断马匹的 ID，这些程序应适合在日常兽医实践中使用。在我们的研究（涉及 90 匹马）中，我们比较了根据基础胰岛素浓度（BIC）将马匹分为 ID 阳性、ID 疑似和未诊断的比例，与根据实用可行的口服糖耐量试验（OST）版本将马匹分为 ID 阳性或 ID 阴性的比例。此外，还分析和比较了 BIC、基础葡萄糖浓度以及 OST 后的胰岛素和葡萄糖浓度。在总研究人群中，OST 检测到的 ID 阳性病例明显多于 BIC，在特异性相当的情况下，截断值也更高。受试者工作特征分析显示，在较低的截断值下，BIC 的敏感性可以提高，但特异性会显著降低。考虑到这一点，我们发现 OST 的诊断性能明显优于 BIC，因此认为它更适合作为门诊实践中 ID 的筛查试验。此外，我们还研究了体况评分和品种类型与我们版本的 OST 后确定的葡萄糖和胰岛素浓度之间的关系。为此，将研究组分为瘦马、中马和胖马，以及“易饲养品种”和“不易饲养品种”。结果支持了这样一个普遍假设，即肥胖的马和“易饲养品种”更容易发生 ID。
