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Home / Equine Research Bank / J Vet Intern Med / Evaluation of Four Diagnostic Tests for Insulin Dysregulatio...
Journal of veterinary internal medicine2016; 30(3); 885-891; doi: 10.1111/jvim.13934

Evaluation of Four Diagnostic Tests for Insulin Dysregulation in Adult Light-Breed Horses.

Abstract: Several tests have been evaluated in horses for quantifying insulin dysregulation to support a diagnosis of equine metabolic syndrome. Comparing the performance of these tests in the same horses will provide clarification of their accuracy in the diagnosis of equine insulin dysregulation. Objective: The aim of this study was to evaluate the agreement between basal serum insulin concentrations (BIC), the oral sugar test (OST), the combined glucose-insulin test (CGIT), and the frequently sampled insulin-modified intravenous glucose tolerance test (FSIGTT). Methods: Twelve healthy, light-breed horses. Methods: Randomized, prospective study. Each of the above tests was performed on 12 horses. Results: Minimal model analysis of the FSIGTT was considered the reference standard and classified 7 horses as insulin resistant (IR) and 5 as insulin sensitive (IS). In contrast, BIC and OST assessment using conventional cut-off values classified all horses as IS. Kappa coefficients, measuring agreement among BIC, OST, CGIT, and FSIGTT were poor to fair. Sensitivity of the CGIT (positive phase duration of the glucose curve >45 minutes) was 85.7% and specificity was 40%, whereas CGIT ([insulin]45 >100 μIU/mL) sensitivity and specificity were 28.5% and 100%, respectively. Area under the glucose curve (AUCg0-120 ) was significantly correlated among the OST, CGIT, and FSIGTT, but Bland-Altman method and Lin's concordance coefficient showed a lack of agreement. Conclusions: Current criteria for diagnosis of insulin resistance using BIC and the OST are highly specific but lack sensitivity. The CGIT displayed better sensitivity and specificity, but modifications may be necessary to improve agreement with minimal model analysis.
Copyright © 2016 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.
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Publication Date: 2016-03-25 PubMed ID: 27013065PubMed Central: PMC4913564DOI: 10.1111/jvim.13934Google Scholar: Lookup
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  • Evaluation Study
  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research study is aimed at evaluating and comparing the effectiveness of four different diagnostic tests in identifying insulin dysregulation, which could be indicative of equine metabolic syndrome, in adult light-breed horses.

Objective of the Study

  • The primary objective of the study was to compare the effectiveness and agreement of four diagnostic tests: basal serum insulin concentrations (BIC), oral sugar test (OST), combined glucose-insulin test (CGIT), and frequently sampled insulin-modified intravenous glucose tolerance test (FSIGTT) in identifying insulin dysregulation in adult light-breed horses.

Methods Used

  • In this randomized, prospective study, the four tests were applied to twelve healthy, light-breed horses.
  • FSIGTT was considered the reference standard with its results used for comparison with the outcomes of the other three tests.

Results of the Research

  • FSIGTT classified seven horses as insulin resistant (IR) and five as insulin sensitive (IS).
  • The BIC and OST, when used with conventional cut-off values, classified all the horses as insulin sensitive – revealing a lack of agreement with the reference standard results.
  • The CGIT displayed sensitivity of 85.7% and specificity of 40% when the positive phase duration of the glucose curve was more than 45 minutes – which means that CGIT successfully identified 85.7% of genuine insulin resistance cases, and correctly ruled out 40% of non-cases.
  • This sensitivity and specificity changed to 28.5% and 100% respectively, when using another criterion ([insulin]45 >100 μIU/mL).

Conclusion of the Study

  • The study concludes that BIC and OST criteria for diagnosis of insulin resistance are highly specific, but they lack sensitivity, i.e., they can accurately identify non-cases but fail to correctly diagnose actual cases of insulin resistance.
  • On the other hand, CGIT showed better sensitivity and specificity, but the researchers suggest that modifications may be necessary for it to fall in agreement with minimal model analysis.

Cite This Article

APA
Dunbar LK, Mielnicki KA, Dembek KA, Toribio RE, Burns TA. (2016). Evaluation of Four Diagnostic Tests for Insulin Dysregulation in Adult Light-Breed Horses. J Vet Intern Med, 30(3), 885-891. https://doi.org/10.1111/jvim.13934

Publication

Journal of veterinary internal medicine
ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English
Volume: 30
Issue: 3
Pages: 885-891

Researcher Affiliations

Dunbar, L K
  • Ohio State University College of Veterinary Medicine, Columbus, OH.
Mielnicki, K A
  • Ohio State University College of Veterinary Medicine, Columbus, OH.
Dembek, K A
  • Ohio State University College of Veterinary Medicine, Columbus, OH.
Toribio, R E
  • Ohio State University College of Veterinary Medicine, Columbus, OH.
Burns, T A
  • Ohio State University College of Veterinary Medicine, Columbus, OH.

MeSH Terms

  • Animals
  • Blood Glucose / analysis
  • Female
  • Glucose Tolerance Test / veterinary
  • Horse Diseases / diagnosis
  • Horse Diseases / metabolism
  • Horses
  • Insulin / blood
  • Insulin Resistance
  • Male
  • Prospective Studies
  • Sensitivity and Specificity

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Citations

This article has been cited 12 times.
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