关节内注射曲安奈德会导致无胰岛素调节异常的马匹全身胰岛素和葡萄糖浓度升高。

Intra-articular triamcinolone acetonide injection results in increases in systemic insulin and glucose concentrations in horses without insulin dysregulation.

作者信息

Boger Brooke L, Manfredi Jane M, Loucks Abigail R, Salamey Maya Z, Kapeller Lydia E, Fricano Allie G, Winkler Ani, Yob Chelsey, Colbath Aimee C

机构信息

Department of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA.

Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA.

出版信息

Equine Vet J. 2024 Mar;56(2):326-331. doi: 10.1111/evj.14003. Epub 2023 Sep 13.

DOI:10.1111/evj.14003

PMID:37705233

Abstract

BACKGROUND

Corticosteroids are a commonly used, inexpensive intra-articular treatment for osteoarthritis which may increase the risk for laminitis in horses due, in part, to hyperinsulinaemia. Humans with metabolic syndrome experience increases in insulin and glucose concentrations post-injection, but responses in horses are unknown.

OBJECTIVES

To determine the effect of a single intra-articular (IA) dose of triamcinolone acetate (TA) on blood insulin and glucose concentrations.

STUDY DESIGN

Before-after study.

METHODS

Ten horses with normal insulin regulation as assessed by an oral sugar test received 18 mg of TA into one middle carpal joint. Insulin and glucose concentrations were evaluated at baseline and 4, 6, 8, 24, 48, and 72 h following IA corticosteroid injection. Differences from baseline were evaluated using a repeated measures ANOVA with Dunnett's multiple comparison testing or a Friedman test with Dunn's correction (significant at p < 0.05).

RESULTS

Mean ± SD blood insulin concentration post IA TA injection was increased at 6 h (15.8 ± 3.1 μIU/mL, p = 0.01), 24 h (23 ± 5.8 μIU/mL, p ≤ 0.001), and 48 h (29 ± 13 μIU/mL, p ≤ 0.01) compared to baseline (10 ± 12.3 μIU/mL), with the peak at 48 h. Median ± 95% CI blood glucose concentration post IA TA injection was increased at 6 h (112.7 ± 20.3 mg/dL, p = 0.006), 8 h (112.9 ± 21.4 mg/dL, p = 0.004), 24 h (122.6 ± 14.6, p ≤ 0.0001), and 48 h (123.5 ± 15.4 mg/dL, p ≤ 0.0001) compared to baseline (89.2 ± 6.6 mg/dL), with the peak at 48 h.

MAIN LIMITATIONS

Only horses with normal insulin regulation were evaluated.

CONCLUSIONS

Blood insulin and glucose concentrations modestly increased for 48 h following IA TA.

摘要

背景

皮质类固醇是一种常用的、用于治疗骨关节炎的关节内注射廉价药物，部分原因是高胰岛素血症，它可能会增加马患蹄叶炎的风险。患有代谢综合征的人类在注射后胰岛素和葡萄糖浓度会升高，但马的反应尚不清楚。

目的

确定关节内单次注射醋酸曲安奈德（TA）对血液胰岛素和葡萄糖浓度的影响。

研究设计

前后对照研究。

方法

通过口服糖耐量试验评估胰岛素调节正常的10匹马，向其中一个腕中关节注射18毫克TA。在关节内注射皮质类固醇后，于基线、4、6、8、24、48和72小时评估胰岛素和葡萄糖浓度。使用重复测量方差分析和Dunnett多重比较检验或Friedman检验及Dunn校正评估与基线的差异（p < 0.05为显著）。

结果

与基线（10±12.3 μIU/mL）相比，关节内注射TA后，胰岛素浓度在6小时（15.8±3.1 μIU/mL，p = 0.01）、24小时（23±5.8 μIU/mL，p≤0.001）和48小时（29±13 μIU/mL，p≤0.01）升高，在48小时达到峰值。与基线（89.2±6.6 mg/dL）相比，关节内注射TA后，血糖浓度中位数±95%可信区间在6小时（112.7±20.3 mg/dL，p = 0.006）、8小时（112.9±21.4 mg/dL，p = 0.004）、24小时（122.6±14.6，p≤0.0001）和48小时（123.5±15.4 mg/dL，p≤0.0001）升高，在48小时达到峰值。