Insulin dysregulation in horses with systemic inflammatory response syndrome.
Abstract: Systemic inflammation is a cause of insulin dysregulation in many species, but the insulin and glucose dynamics in adult horses diagnosed with systemic inflammatory response syndrome (SIRS) are poorly documented. Objective: In SIRS in horses, insulin and glucose dynamics will be altered and associated with survival. Methods: Adult horses diagnosed with SIRS admitted to a referral hospital. Methods: Prospective study enrolling horses diagnosed with SIRS in which serum insulin and glucose concentrations were measured. Horses were grouped by outcome (survival, hyperinsulinemia, and hyperglycemia) and compared with P < .05 considered significant. Results: Fifty-eight horses were included in the study and 36 (62%) survived. At admission, 21 horses (36%) were hyperinsulinemic and 44 horses (88%) were hyperglycemic, with survivors having significantly higher serum insulin and a significantly lower serum glucose concentration. Horses diagnosed with hyperinsulinemia at any time during hospitalization were 4 times more likely to survive whereas horses that were hyperglycemic at any time during hospitalization were 5 times less likely to survive. Serum glucose concentration and presence of hyperglycemia both were associated with severity of disease. Insulin/glucose ratio, reflecting insulin secretion, was significantly higher in survivors whereas glucose/insulin ratio, reflecting peripheral tissue insulin resistance, was significantly lower in nonsurvivors. Only in survivors was there a significant correlation between serum insulin and glucose concentrations. Conclusions: Hyperinsulinemia and hyperglycemia are common features of SIRS in horses, but those presenting with relative hypoinsulinemia and corresponding hyperglycemia suggestive of endocrine pancreatic dysfunction have a worse prognosis.
Copyright © 2018 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.
Publication Date: 2018-05-10 PubMed ID: 29749643PubMed Central: PMC6060318DOI: 10.1111/jvim.15138Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- 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.
The research article investigates the effect of systemic inflammation on insulin and glucose regulation in horses, highlighting significant correlations with survival rates.
Objective and Methods
- With systemic inflammatory response syndrome (SIRS) being a cause of insulin dysregulation in many animals, the paper sought to better understand how it affects adult horses. It hypothesized that alterations in insulin and glucose dynamics are linked with survival chances.
- For this prospective study, adult horses diagnosed with SIRS were admitted to a referral hospital. The horses’ serum insulin and glucose concentrations were measured and they were grouped based on outcome (whether they survived, and whether they experienced hyperinsulinemia or hyperglycemia).
Results
- A total of 58 horses were involved in the study, with a survival rate of around 62% (36 horses). Upon admission, 36% (21 horses) were hyperinsulinemic and 76% (44 horses) were hyperglycemic.
- Interestingly, the survivors had significantly higher serum insulin and significantly lower serum glucose concentrations. This indicated that horses which were diagnosed with hyperinsulinemia at any point during their hospitalization were 4 times more likely to survive, whilst those that were hyperglycemic at any point were 5 times less likely to survive.
- The study found significant links between serum glucose concentration and the presence of hyperglycemia with the severity of the disease. The insulin/glucose ratio, which indicates insulin secretion, was higher in survivors, while the glucose/insulin ratio, a measure of peripheral tissue insulin resistance, was lower in nonsurvivors. This correlation between serum insulin and glucose concentrations was only found in the surviving horses.
Conclusion
- Hyperinsulinemia and hyperglycemia were found to be common in horses with SIRS. However, those with relative hypoinsulinemia and corresponding hyperglycemia, implying endocrine pancreatic dysfunction, had a worse prognosis. The research thus suggests that managing insulin and glucose levels could have implications for the treatment and survival of horses diagnosed with SIRS.
Cite This Article
APA
Bertin FR, Ruffin-Taylor D, Stewart AJ.
(2018).
Insulin dysregulation in horses with systemic inflammatory response syndrome.
J Vet Intern Med, 32(4), 1420-1427.
https://doi.org/10.1111/jvim.15138 Publication
Researcher Affiliations
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia.
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, Alabama.
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia.
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, Alabama.
MeSH Terms
- Animals
- Blood Glucose / analysis
- Female
- Horse Diseases / blood
- Horse Diseases / mortality
- Horse Diseases / physiopathology
- Horses
- Hyperglycemia / etiology
- Hyperglycemia / veterinary
- Hyperinsulinism / etiology
- Hyperinsulinism / veterinary
- Insulin / blood
- Male
- Prospective Studies
- Survival Analysis
- Systemic Inflammatory Response Syndrome / blood
- Systemic Inflammatory Response Syndrome / complications
- Systemic Inflammatory Response Syndrome / physiopathology
- Systemic Inflammatory Response Syndrome / veterinary
References
This article includes 53 references
- Torre DM, deLaforcade AM, Chan DL. Incidence and clinical relevance of hyperglycemia in critically ill dogs.. J Vet Intern Med 2007 Sep-Oct;21(5):971-5.
- Cely CM, Arora P, Quartin AA, Kett DH, Schein RM. Relationship of baseline glucose homeostasis to hyperglycemia during medical critical illness.. Chest 2004 Sep;126(3):879-87.
- Tóth F, Frank N, Elliott SB, Geor RJ, Boston RC. Effects of an intravenous endotoxin challenge on glucose and insulin dynamics in horses.. Am J Vet Res 2008 Jan;69(1):82-8.
- Gross JJ, Wellnitz O, Bruckmaier RM. Cortisol secretion in response to metabolic and inflammatory challenges in dairy cows.. J Anim Sci 2015 Jul;93(7):3395-401.
- LEVINE R, GOLDSTEIN MS, HUDDLESTUN B, KLEIN SP. Action of insulin on the 'permeability' of cells to free hexoses, as studied by its effect on the distribution of galactose.. Am J Physiol 1950 Oct;163(1):70-6.
- Sonksen P, Sonksen J. Insulin: understanding its action in health and disease.. Br J Anaesth 2000 Jul;85(1):69-79.
- Shangraw RE, Jahoor F, Miyoshi H, Neff WA, Stuart CA, Herndon DN, Wolfe RR. Differentiation between septic and postburn insulin resistance.. Metabolism 1989 Oct;38(10):983-9.
- van den Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M, Vlasselaers D, Ferdinande P, Lauwers P, Bouillon R. Intensive insulin therapy in critically ill patients.. N Engl J Med 2001 Nov 8;345(19):1359-67.
- Stafeev IS, Vorotnikov AV, Ratner EI, Menshikov MY, Parfyonova YV. Latent Inflammation and Insulin Resistance in Adipose Tissue.. Int J Endocrinol 2017;2017:5076732.
- Laird AM, Miller PR, Kilgo PD, Meredith JW, Chang MC. Relationship of early hyperglycemia to mortality in trauma patients.. J Trauma 2004 May;56(5):1058-62.
- Agwunobi AO, Reid C, Maycock P, Little RA, Carlson GL. Insulin resistance and substrate utilization in human endotoxemia.. J Clin Endocrinol Metab 2000 Oct;85(10):3770-8.
- Capes SE, Hunt D, Malmberg K, Gerstein HC. Stress hyperglycaemia and increased risk of death after myocardial infarction in patients with and without diabetes: a systematic overview.. Lancet 2000 Mar 4;355(9206):773-8.
- Malmberg K, Rydén L, Efendic S, Herlitz J, Nicol P, Waldenström A, Wedel H, Welin L. Randomized trial of insulin-glucose infusion followed by subcutaneous insulin treatment in diabetic patients with acute myocardial infarction (DIGAMI study): effects on mortality at 1 year.. J Am Coll Cardiol 1995 Jul;26(1):57-65.
- Vanhorebeek I, Langouche L, Van den Berghe G. Tight blood glucose control with insulin in the ICU: facts and controversies.. Chest 2007 Jul;132(1):268-78.
- Griesdale DE, de Souza RJ, van Dam RM, Heyland DK, Cook DJ, Malhotra A, Dhaliwal R, Henderson WR, Chittock DR, Finfer S, Talmor D. Intensive insulin therapy and mortality among critically ill patients: a meta-analysis including NICE-SUGAR study data.. CMAJ 2009 Apr 14;180(8):821-7.
- Preiser JC, Devos P, Ruiz-Santana S, Mélot C, Annane D, Groeneveld J, Iapichino G, Leverve X, Nitenberg G, Singer P, Wernerman J, Joannidis M, Stecher A, Chioléro R. A prospective randomised multi-centre controlled trial on tight glucose control by intensive insulin therapy in adult intensive care units: the Glucontrol study.. Intensive Care Med 2009 Oct;35(10):1738-48.
- Marik PE. Glycemic control in critically ill patients: What to do post NICE-SUGAR?. World J Gastrointest Surg 2009 Nov 30;1(1):3-5.
- Van den Berghe G, Schetz M, Vlasselaers D, Hermans G, Wilmer A, Bouillon R, Mesotten D. Clinical review: Intensive insulin therapy in critically ill patients: NICE-SUGAR or Leuven blood glucose target?. J Clin Endocrinol Metab 2009 Sep;94(9):3163-70.
- Hollis AR, Boston RC, Corley KT. Blood glucose in horses with acute abdominal disease.. J Vet Intern Med 2007 Sep-Oct;21(5):1099-103.
- Tadros EM, Frank N, De Witte FG, Boston RC. Effects of intravenous lipopolysaccharide infusion on glucose and insulin dynamics in horses with equine metabolic syndrome.. Am J Vet Res 2013 Jul;74(7):1020-9.
- Hassel DM, Hill AE, Rorabeck RA. Association between hyperglycemia and survival in 228 horses with acute gastrointestinal disease.. J Vet Intern Med 2009 Nov-Dec;23(6):1261-5.
- Hollis AR, Furr MO, Magdesian KG, Axon JE, Ludlow V, Boston RC, Corley KT. Blood glucose concentrations in critically ill neonatal foals.. J Vet Intern Med 2008 Sep-Oct;22(5):1223-7.
- Barsnick RJ, Hurcombe SD, Smith PA, Slovis NM, Sprayberry KA, Saville WJ, Toribio RE. Insulin, glucagon, and leptin in critically ill foals.. J Vet Intern Med 2011 Jan-Feb;25(1):123-31.
- Vick MM, Murphy BA, Sessions DR, Reedy SE, Kennedy EL, Horohov DW, Cook RF, Fitzgerald BP. Effects of systemic inflammation on insulin sensitivity in horses and inflammatory cytokine expression in adipose tissue.. Am J Vet Res 2008 Jan;69(1):130-9.
- Armengou L, Jose-Cunilleras E, Ríos J, Cesarini C, Viu J, Monreal L. Metabolic and endocrine profiles in sick neonatal foals are related to survival.. J Vet Intern Med 2013 May-Jun;27(3):567-75.
- de Laat MA, McGowan CM, Sillence MN, Pollitt CC. Equine laminitis: induced by 48 h hyperinsulinaemia in Standardbred horses.. Equine Vet J 2010 Mar;42(2):129-35.
- Reeves HJ, Lees R, McGowan CM. Measurement of basal serum insulin concentration in the diagnosis of Cushing's disease in ponies.. Vet Rec 2001 Oct 13;149(15):449-52.
- McGowan CM, Frost R, Pfeiffer DU, Neiger R. Serum insulin concentrations in horses with equine Cushing's syndrome: response to a cortisol inhibitor and prognostic value.. Equine Vet J 2004 Apr;36(3):295-8.
- Arroyo MG, Slovis NM, Moore GE, Taylor SD. Factors Associated with Survival in 97 Horses with Septic Pleuropneumonia.. J Vet Intern Med 2017 May;31(3):894-900.
- McFarlane D. Equine pituitary pars intermedia dysfunction.. Vet Clin North Am Equine Pract 2011 Apr;27(1):93-113.
- Frank N, Geor RJ, Bailey SR, Durham AE, Johnson PJ. Equine metabolic syndrome.. J Vet Intern Med 2010 May-Jun;24(3):467-75.
- Reimers TJ, Cowan RG, McCann JP, Ross MW. Validation of a rapid solid-phase radioimmunoassay for canine, bovine, and equine insulin.. Am J Vet Res 1982 Jul;43(7):1274-8.
- de Laat MA, McGree JM, Sillence MN. Equine hyperinsulinemia: investigation of the enteroinsular axis during insulin dysregulation.. Am J Physiol Endocrinol Metab 2016 Jan 1;310(1):E61-72.
- Bertin FR, de Laat MA. The diagnosis of equine insulin dysregulation.. Equine Vet J 2017 Sep;49(5):570-576.
- Frank N, Bailey S, Durham A, Kritchevsky J, Menzies‐Gow N, Tadros L. The Equine Endocrinology Group 2015 Recommendations for the Diagnosis and Treatment of EMS. 2015.
- Frank N. Equine metabolic syndrome.. Vet Clin North Am Equine Pract 2011 Apr;27(1):73-92.
- Menzies-Gow NJ, Harris PA, Elliott J. Prospective cohort study evaluating risk factors for the development of pasture-associated laminitis in the United Kingdom.. Equine Vet J 2017 May;49(3):300-306.
- Frank N, Tadros EM. Insulin dysregulation.. Equine Vet J 2014 Jan;46(1):103-12.
- Toribio RE, Kohn CW, Hardy J, Rosol TJ. Alterations in serum parathyroid hormone and electrolyte concentrations and urinary excretion of electrolytes in horses with induced endotoxemia.. J Vet Intern Med 2005 Mar-Apr;19(2):223-31.
- van Waardenburg DA, Jansen TC, Vos GD, Buurman WA. Hyperglycemia in children with meningococcal sepsis and septic shock: the relation between plasma levels of insulin and inflammatory mediators.. J Clin Endocrinol Metab 2006 Oct;91(10):3916-21.
- Leininger MT, Portocarrero CP, Schinckel AP, Spurlock ME, Bidwell CA, Nielsen JN, Houseknecht KL. Physiological response to acute endotoxemia in swine: effect of genotype on energy metabolites and leptin.. Domest Anim Endocrinol 2000 Jan;18(1):71-82.
- O'Kell AL, Wasserfall C, Catchpole B, Davison LJ, Hess RS, Kushner JA, Atkinson MA. Comparative Pathogenesis of Autoimmune Diabetes in Humans, NOD Mice, and Canines: Has a Valuable Animal Model of Type 1 Diabetes Been Overlooked?. Diabetes 2017 Jun;66(6):1443-1452.
- Chandler M, Cunningham S, Lund EM, Khanna C, Naramore R, Patel A, Day MJ. Obesity and Associated Comorbidities in People and Companion Animals: A One Health Perspective.. J Comp Pathol 2017 May;156(4):296-309.
- Navas de Solis C, Foreman JH. Transient diabetes mellitus in a neonatal Thoroughbred foal.. J Vet Emerg Crit Care (San Antonio) 2010 Dec;20(6):611-5.
- Suematsu Y, Sato H, Ohtsuka T, Kotsuka Y, Araki S, Takamoto S. Predictive risk factors for delayed extubation in patients undergoing coronary artery bypass grafting.. Heart Vessels 2000;15(5):214-20.
- Sung J, Bochicchio GV, Joshi M, Bochicchio K, Tracy K, Scalea TM. Admission hyperglycemia is predictive of outcome in critically ill trauma patients.. J Trauma 2005 Jul;59(1):80-3.
- Bochicchio GV, Sung J, Joshi M, Bochicchio K, Johnson SB, Meyer W, Scalea TM. Persistent hyperglycemia is predictive of outcome in critically ill trauma patients.. J Trauma 2005 May;58(5):921-4.
- Bertin FR, Reising A, Slovis NM, Constable PD, Taylor SD. Clinical and clinicopathological factors associated with survival in 44 horses with equine neorickettsiosis (Potomac horse Fever).. J Vet Intern Med 2013 Nov-Dec;27(6):1528-34.
- Stewart MC, Hodgson JL, Kim H, Hutchins DR, Hodgson DR. Acute febrile diarrhoea in horses: 86 cases (1986-1991).. Aust Vet J 1995 Feb;72(2):41-4.
- de Laat MA, van Eps AW, McGowan CM, Sillence MN, Pollitt CC. Equine laminitis: comparative histopathology 48 hours after experimental induction with insulin or alimentary oligofructose in standardbred horses.. J Comp Pathol 2011 Nov;145(4):399-409.
- Beech J, Boston R, Lindborg S. Comparison of cortisol and ACTH responses after administration of thyrotropin releasing hormone in normal horses and those with pituitary pars intermedia dysfunction.. J Vet Intern Med 2011 Nov-Dec;25(6):1431-8.
- Bertin FR, Sojka-Kritchevsky JE. Comparison of a 2-step insulin-response test to conventional insulin-sensitivity testing in horses.. Domest Anim Endocrinol 2013 Jan;44(1):19-25.
- de Laat MA, Sillence MN. The repeatability of an oral glucose test in ponies.. Equine Vet J 2017 Mar;49(2):238-243.
Citations
This article has been cited 4 times.- Hicks GR, Fraser NS, Bertin FR. Changes Associated with the Peri-Ovulatory Period, Age and Pregnancy in ACTH, Cortisol, Glucose and Insulin Concentrations in Mares. Animals (Basel) 2021 Mar 20;11(3).
- Kritchevsky JE, Muir GS, Leschke DHZ, Hodgson JK, Hess EK, Bertin FR. Blood glucose and insulin concentrations after alpha-2-agonists administration in horses with and without insulin dysregulation. J Vet Intern Med 2020 Mar;34(2):902-908.
- Stewart AJ, Hackett E, Bertin FR, Towns TJ. Cortisol and adrenocorticotropic hormone concentrations in horses with systemic inflammatory response syndrome. J Vet Intern Med 2019 Sep;33(5):2257-2266.
- Omidi A, Rasooli A, Nazifi S, Heydari A, Seirafinia M. Relationship between morphometric measurements and blood parameters in horses with varying adiposity levels and physiological conditions. Vet Med Sci 2024 Nov;10(6):e70024.
Use Nutrition Calculator
Check if your horse's diet meets their nutrition requirements with our easy-to-use tool Check your horse's diet with our easy-to-use tool
Talk to a Nutritionist
Discuss your horse's feeding plan with our experts over a free phone consultation Discuss your horse's diet over a phone consultation
Submit Diet Evaluation
Get a customized feeding plan for your horse formulated by our equine nutritionists Get a custom feeding plan formulated by our nutritionists