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德国猫糖尿病的信号、临床病理特征、管理措施及合并症:144例病例的横断面研究

Signalment, clinicopathological findings, management practices and comorbidities in cats with diabetes mellitus in Germany: cross-sectional study of 144 cases.

作者信息

Guse Bente, Langenstein Judith, Bauer Natali, Hazuchova Katarina

机构信息

Clinic for Small Animals (Internal Medicine, Clinical Pathology and Clinical Pathophysiology), Justus-Liebig-University Giessen, Germany.

Antech Lab Germany, Augsburg, Germany.

出版信息

J Feline Med Surg. 2025 Jan;27(1):1098612X241303303. doi: 10.1177/1098612X241303303.

Abstract

OBJECTIVES

The aim of this study was to describe signalment, clinicopathological findings, management practices and the occurrence of comorbidities in feline diabetes mellitus (DM) in Germany.

METHODS

This was a cross-sectional study using questionnaires and laboratory submissions to a commercial laboratory, Antech Lab Germany, between May 2021 and July 2022. Inclusion criteria were diagnosis of DM by the attending veterinarian and submission of a completed questionnaire besides blood samples. Laboratory testing included haematology, serum biochemistry, concentration of total thyroxine (TT4), insulin-like growth factor 1 (IGF-1), cobalamin (COB), fructosamine, b-hydroxybutyrate and DGGR (1,2--dilauryl--glycero-3-glutaric acid-[6'-methylresorufin] ester) lipase activity. Data are presented as the median (range) and analysed by non-parametric tests.  <0.05 was considered statistically significant.

RESULTS

The median (range) age of the 144 diabetic cats at diagnosis was 11 years (0.9-18.7), 66.4% were male, 84.6% were domestic shorthair, 50.4% were currently overweight and 61.5% were previously overweight (body condition score >5/9). Most cats were treated with insulin (84%), most commonly protamine zinc insulin (57.5%). Blood glucose curves or continuous glucose monitoring alone or in combination with other methods were performed to adjust insulin therapy in 70.6% of cats. Based on questionnaires, 78.6% were poorly controlled and 21.4% were well controlled. Increased TT4 occurred in 3/139 and hyperthyroidism was known in 5/139 cats (frequency of known/suspected hyperthyroidism: 5.8% [n = 8/139]); 17.5% (n = 17/97) had increased IGF-1 (IGF-1 >746 ng/ml, cut-off for hypersomatotropism with the chemiluminescence assay used in this study); 24.5% (n = 34/139) had COB <295.2 pmol/l and 54.2% (n = 78/144) had increased DGGR. Cats with IGF-1 >746 ng/ml were receiving a higher insulin dose than cats with IGF-1 ≤746 ng/ml (median 1.63 vs 0.86 U/kg/day,  = 0.018).

CONCLUSION AND RELEVANCE

Increased DGGR and increased IGF-1 indicating hypersomatotropism are common in diabetic cats and should be tested for. Almost one-quarter of diabetic cats might require COB supplementation.

摘要

目的

本研究旨在描述德国猫糖尿病(DM)的发病情况、临床病理特征、管理措施及合并症的发生情况。

方法

这是一项横断面研究,于2021年5月至2022年7月期间使用问卷并向商业实验室德国安泰克实验室提交实验室样本。纳入标准为经主治兽医诊断为DM且除血样外还提交完整问卷。实验室检测包括血液学、血清生化、总甲状腺素(TT4)浓度、胰岛素样生长因子1(IGF-1)、钴胺素(COB)、果糖胺、β-羟基丁酸和DGGR(1,2-二月桂酰甘油-3-戊二酸-[6'-甲基试卤灵]酯)脂肪酶活性。数据以中位数(范围)表示,并通过非参数检验进行分析。P<0.05被认为具有统计学意义。

结果

144只糖尿病猫诊断时的年龄中位数(范围)为11岁(0.9 - 18.7岁),66.4%为雄性,84.6%为家养短毛猫,50.4%目前超重,61.5%既往超重(体况评分>5/9)。大多数猫接受胰岛素治疗(84%),最常用的是精蛋白锌胰岛素(57.5%)。70.6%的猫采用血糖曲线或连续血糖监测单独或与其他方法结合来调整胰岛素治疗。根据问卷,78.6%控制不佳,21.4%控制良好。139只猫中有3只TT4升高,139只猫中有5只已知患有甲状腺功能亢进(已知/疑似甲状腺功能亢进的频率:5.8% [n = 8/139]);17.5%(n = 17/97)的IGF-1升高(IGF-1>746 ng/ml,为本研究中使用的化学发光法诊断生长激素过多症的临界值);24.5%(n = 34/139)的COB<295.2 pmol/l,54.2%(n = 78/144)的DGGR升高。IGF-1>746 ng/ml的猫比IGF-1≤746 ng/ml的猫接受更高剂量的胰岛素(中位数分别为1.63 U/kg/天和0.86 U/kg/天,P = 0.018)。

结论及意义

糖尿病猫中DGGR升高和提示生长激素过多症的IGF-1升高很常见,应进行检测。近四分之一的糖尿病猫可能需要补充COB。

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