Frers F, Delarocque J, Huber K, Feige K, Warnken T
Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559 Hanover, Germany.
Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559 Hanover, Germany.
Vet J. 2023 Aug-Sep;298-299:106012. doi: 10.1016/j.tvjl.2023.106012. Epub 2023 Jun 21.
Both, oral and intravenous (IV) testing protocols, are recommended and still used to detect insulin dysregulation (ID) in equids. However, IV tests mainly focus on peripheral insulin resistance (IR), while oral tests assess hyperinsulinemia (HI), which are different aspects of ID. The objective of this study was to describe if horses with HI also demonstrate IR and consequently can be detected by a modified 2-step insulin response test (2-step IRT) performed with a veterinary approved porcine zinc insulin (PZI). Twelve Icelandic horses were subjected to an OGT and 2-step IRT in a crossover study. Serum insulin concentrations during the OGT revealed that six horses were hyperinsulinemic (HI) while six were not (NON-HI). To describe the glucose response to IV injected PZI, the decline of plasma glucose concentration within the first 30 min was analyzed. Glucose reduction was similar in horses with and without HI during the 2-step IRT over time. Additionally, none of the horses reached a glucose reduction of ≥ 50% at 30 min. The results of the present study indicated that a comparable insulin mediated glucose uptake may be observed in horses with and without HI during a modified 2-step IRT. While six out of twelve horses were identified as HI by the OGT, all twelve horses were identified as IR by the modified 2-step IRT performed with PZI underlining the importance, but difficulty in choosing the right diagnostic tool in clinical settings to assess ID.
口服和静脉注射（IV）检测方案均被推荐且仍用于检测马属动物的胰岛素调节异常（ID）。然而，静脉注射检测主要关注外周胰岛素抵抗（IR），而口服检测评估高胰岛素血症（HI），它们是ID的不同方面。本研究的目的是描述患有HI的马是否也表现出IR，因此是否可以通过使用兽用批准的猪锌胰岛素（PZI）进行的改良两步胰岛素反应试验（2步IRT）检测出来。在一项交叉研究中，对12匹冰岛马进行了口服葡萄糖耐量试验（OGT）和2步IRT。OGT期间的血清胰岛素浓度显示，6匹马为高胰岛素血症（HI），而6匹马不是（非HI）。为了描述静脉注射PZI后的葡萄糖反应，分析了前30分钟内血浆葡萄糖浓度的下降情况。在2步IRT过程中，随着时间的推移，有HI和无HI的马的葡萄糖降低情况相似。此外，在30分钟时，没有一匹马的葡萄糖降低≥50%。本研究结果表明，在改良的2步IRT中，有HI和无HI的马可能观察到类似的胰岛素介导的葡萄糖摄取。虽然通过OGT在12匹马中有6匹被鉴定为HI，但在使用PZI进行的改良2步IRT中，所有12匹马都被鉴定为IR，这突出了在临床环境中选择正确的诊断工具来评估ID的重要性和难度。
