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Open veterinary journal2019; 9(4); 287-293; doi: 10.4314/ovj.v9i4.2

Possible dysmetabolic hyperferritinemia in hyperinsulinemic horses.

Abstract: Hyperinsulinemia associated with equine metabolic syndrome and pituitary pars intermedia dysfunction is a risk factor for laminitis. Research in other species has shown elevated body iron levels as both a predictor and consequence of insulin resistance. In humans, this is known as dysmetabolic hyperferritinemia. To explore the relationship between equine hyperinsulinemia and body iron levels. We reviewed case histories and laboratory results from an open access database maintained by the Equine Cushing's and Insulin Resistance Group Inc. (ECIR). We identified 33 horses with confirmed hyperinsulinemia and laboratory results for serum iron, total iron binding capacity, and ferritin. Pearson correlation was used to test the relationship between insulin and iron indices. Additionally, we performed a secondary analysis of a previously reported controlled trial that was originally designed to test the correlation between iron status and the insulin response in horses. Here, we used a -test to compare the mean values of insulin and ferritin between horses we categorized as normal or hyperinsulinemic based on their response to an oral challenge. Serum ferritin exceeded published reference range in 100% of the horses identified from the ECIR database. There were no statistically significant associations between insulin indices (RISQI, log insulin) and iron indices (log serum iron, log TSI%, log ferritin). There were trends for a negative association between RISQI and log iron [(31) = -0.33, = 0.058] and a positive association between age and ferritin [(30) = 0.34, = 0.054]. From the secondary data analysis of published data, we found significantly elevated ferritin ( = 0.05) in horses considered hyperinsulinemic by dynamic insulin testing compared to horses with a normal response. These results suggest the potential for iron overload in hyperinsulinemic horses, a feature documented in other species and should stimulate further study into the relationship between insulin and iron dysregulation in the horse.
Publication Date: 2019-10-21 PubMed ID: 32042647PubMed Central: PMC6971364DOI: 10.4314/ovj.v9i4.2Google Scholar: Lookup
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  • Journal Article

Summary

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The research explores the link between high insulin levels, referred to as hyperinsulinemia, and high body iron levels in horses. The study finds that hyperinsulinemia could potentially lead to an iron overload condition similar to what is known as dysmetabolic hyperferritinemia in humans.

Study Methodology

  • The researchers utilized an open access database maintained by the Equine Cushing’s and Insulin Resistance Group Inc. (ECIR), where they reviewed case histories and lab results involving horses with hyperinsulinemia.
  • They zeroed in on 33 horses that had confirmed hyperinsulinemia and had undergone tests for serum iron, total iron binding capacity, and ferritin (a protein that stores iron).
  • Statistical tools called Pearson correlation and t-tests were used to investigate the potential links between insulin and iron levels in these horses.

Findings

  • The results showed that in all of the horses identified from the ECIR database, serum ferritin levels were higher than what is considered normal.
  • However, they found no statistically significant correlations between insulin indices and iron indices. There were some trends observed, including a negative relationship between the insulin measure RISQI and log iron, and a positive relationship between age and ferritin.
  • Reviewing previously published data, a secondary analysis revealed an uptick in ferritin levels in horses identified as hyperinsulinemic compared to those with a normal insulin level.

Conclusion

This study puts forward the possibility that hyperinsulinemia in horses may lead to dysmetabolic hyperferritinemia, an iron overload condition. However, while a relationship was noticed between increased insulin and higher ferritin levels, no significant correlation was found between insulin and iron levels. This calls for further research to fully understand the relationship between insulin and iron dysregulation in horses. The findings, if further confirmed, could have potential implications in treating conditions resulting from iron overload in horses. These could include laminitis, a condition that often affects hyperinsulinemic horses.

Cite This Article

APA
Kellon EM, Gustafson KM. (2019). Possible dysmetabolic hyperferritinemia in hyperinsulinemic horses. Open Vet J, 9(4), 287-293. https://doi.org/10.4314/ovj.v9i4.2

Publication

ISSN: 2218-6050
NlmUniqueID: 101653182
Country: Libya
Language: English
Volume: 9
Issue: 4
Pages: 287-293

Researcher Affiliations

Kellon, Eleanor M
  • Equine Cushing's and Insulin Resistance Group, Inc, 2307 Rural Road, Tempe, AZ 85282, USA.
Gustafson, Kathleen M
  • Equine Cushing's and Insulin Resistance Group, Inc, 2307 Rural Road, Tempe, AZ 85282, USA.

MeSH Terms

  • Animals
  • Female
  • Ferritins / blood
  • Horse Diseases / blood
  • Horses
  • Hyperinsulinism / complications
  • Hyperinsulinism / veterinary
  • Insulin / blood
  • Iron Overload / blood
  • Iron Overload / veterinary
  • Male

References

This article includes 35 references
  1. Asplin KE, Sillence MN, Pollitt CC, McGowan CM. Induction of laminitis by prolonged hyperinsulinaemia in clinically normal ponies.. Vet J 2007 Nov;174(3):530-5.
    pubmed: 17719811doi: 10.1016/j.tvjl.2007.07.003google scholar: lookup
  2. Clauss M, Paglia DE. Iron storage disorders in captive wild mammals: the comparative evidence.. J Zoo Wildl Med 2012 Sep;43(3 Suppl):S6-18.
    pubmed: 23156701doi: 10.1638/2011-0152.1google scholar: lookup
  3. Durham AE, Frank N, McGowan CM, Menzies-Gow NJ, Roelfsema E, Vervuert I, Feige K, Fey K. ECEIM consensus statement on equine metabolic syndrome.. J Vet Intern Med 2019 Mar;33(2):335-349.
    pmc: PMC6430910pubmed: 30724412doi: 10.1111/jvim.15423google scholar: lookup
  4. Fargion S, Dongiovanni P, Guzzo A, Colombo S, Valenti L, Fracanzani A.L.. Equine laminitis: Induced by 48h hyperinsulinaemia in Standardbred horses.. EVJ Equine Vet. J. 2005;42:129–135.
  5. de Laat MA, Sillence MN. The repeatability of an oral glucose test in ponies.. Equine Vet J 2017 Mar;49(2):238-243.
    pubmed: 27038020doi: 10.1111/evj.12579google scholar: lookup
  6. Fargion S, Dongiovanni P, Guzzo A, Colombo S, Valenti L, Fracanzani AL. Iron and insulin resistance.. Aliment Pharmacol Ther 2005 Nov;22 Suppl 2:61-3.
  7. Fernández-Real JM, McClain D, Manco M. Mechanisms Linking Glucose Homeostasis and Iron Metabolism Toward the Onset and Progression of Type 2 Diabetes.. Diabetes Care 2015 Nov;38(11):2169-76.
    pubmed: 26494808doi: 10.2337/dc14-3082google scholar: lookup
  8. Fernández-Real JM, Peñarroja G, Castro A, García-Bragado F, Hernández-Aguado I, Ricart W. Blood letting in high-ferritin type 2 diabetes: effects on insulin sensitivity and beta-cell function.. Diabetes 2002 Apr;51(4):1000-4.
    pubmed: 11916918doi: 10.2337/diabetes.51.4.1000google scholar: lookup
  9. Frank N, Tadros EM. Insulin dysregulation.. Equine Vet J 2014 Jan;46(1):103-12.
    pubmed: 24033478doi: 10.1111/evj.12169google scholar: lookup
  10. Gancz AY, Wellehan JF, Boutette J, Malka S, Lee SE, Smith DA, Taylor M. Diabetes mellitus concurrent with hepatic haemosiderosis in two macaws (Ara severa, Ara militaris).. Avian Pathol 2007 Aug;36(4):331-6.
    pubmed: 17620181doi: 10.1080/03079450701466093google scholar: lookup
  11. Houschyar KS, Lüdtke R, Dobos GJ, Kalus U, Broecker-Preuss M, Rampp T, Brinkhaus B, Michalsen A. Effects of phlebotomy-induced reduction of body iron stores on metabolic syndrome: results from a randomized clinical trial.. BMC Med 2012 May 30;10:54.
    pmc: PMC3386865pubmed: 22647517doi: 10.1186/1741-7015-10-54google scholar: lookup
  12. Hua NW, Stoohs RA, Facchini FS. Low iron status and enhanced insulin sensitivity in lacto-ovo vegetarians.. Br J Nutr 2001 Oct;86(4):515-9.
    pubmed: 11591239doi: 10.1079/bjn2001421google scholar: lookup
  13. Huang J, Karnchanasorn R, Ou HY, Feng W, Chuang LM, Chiu KC, Samoa R. Association of insulin resistance with serum ferritin and aminotransferases-iron hypothesis.. World J Exp Med 2015 Nov 20;5(4):232-43.
    pmc: PMC4655253pubmed: 26618110doi: 10.5493/wjem.v5.i4.232google scholar: lookup
  14. Hyyppä S, Höyhtyä M, Nevalainen M, Pösö AR. Effect of exercise on plasma ferritin concentrations: implications for the measurement of iron status.. Equine Vet J Suppl 2002 Sep;(34):186-90.
  15. Kellon E.M.. Iron status of hyperinsulimemic/insulin resistant horses.. 3rd Annual European Equine Health and Nutrition Congress, 1–2; Ghent University; Belgium. 2006.
  16. Kunutsor SK, Apekey TA, Walley J, Kain K. Ferritin levels and risk of type 2 diabetes mellitus: an updated systematic review and meta-analysis of prospective evidence.. Diabetes Metab Res Rev 2013 May;29(4):308-18.
    pubmed: 23381919doi: 10.1002/dmrr.2394google scholar: lookup
  17. McLean L.M, Hall M.E, Bell J.E. Evaluation of serum iron, total iron binding capacity, unbound iron binding capacity, percent saturation and serum ferritin in the equine. Proceedings of the 10th Equine Nutrition and Physiology Society Symposium Ft. Collins, Colorado. 1987. pp. 443–446.
  18. Minamiyama Y, Takemura S, Kodai S, Shinkawa H, Tsukioka T, Ichikawa H, Naito Y, Yoshikawa T, Okada S. Iron restriction improves type 2 diabetes mellitus in Otsuka Long-Evans Tokushima fatty rats.. Am J Physiol Endocrinol Metab 2010 Jun;298(6):E1140-9.
    pubmed: 20215574doi: 10.1152/ajpendo.00620.2009google scholar: lookup
  19. Morgan R, Keen J, McGowan C. Equine metabolic syndrome.. Vet Rec 2015 Aug 15;177(7):173-9.
    pmc: PMC4552932pubmed: 26273009doi: 10.1136/vr.103226google scholar: lookup
  20. Nielsen BD, Vick MM, Dennis PM. A potential link between insulin resistance and iron overload disorder in browsing rhinoceroses investigated through the use of an equine model.. J Zoo Wildl Med 2012 Sep;43(3 Suppl):S61-5.
    pubmed: 23156707doi: 10.1638/2011-0145.1google scholar: lookup
  21. Rambod M, Kovesdy CP, Kalantar-Zadeh K. Combined high serum ferritin and low iron saturation in hemodialysis patients: the role of inflammation.. Clin J Am Soc Nephrol 2008 Nov;3(6):1691-701.
    pmc: PMC2572292pubmed: 18922994doi: 10.2215/cjn.01070308google scholar: lookup
  22. Root H.F.. Insulin resistance and bronze diabetes.. New Engl. J. Med. 1929;201:201–206.
  23. Ryan BJ, Van Pelt DW, Guth LM, Ludzki AC, Gioscia-Ryan RA, Ahn C, Foug KL, Horowitz JF. Plasma ferritin concentration is positively associated with in vivo fatty acid mobilization and insulin resistance in obese women.. Exp Physiol 2018 Nov;103(11):1443-1447.
    pmc: PMC6212303pubmed: 30178895doi: 10.1113/ep087283google scholar: lookup
  24. Schook MW, Wildt DE, Raghanti MA, Wolfe BA, Dennis PM. Increased inflammation and decreased insulin sensitivity indicate metabolic disturbances in zoo-managed compared to free-ranging black rhinoceros (Diceros bicornis).. Gen Comp Endocrinol 2015 Jun-Jul;217-218:10-9.
    pubmed: 25980685doi: 10.1016/j.ygcen.2015.05.003google scholar: lookup
  25. Simcox JA, McClain DA. Iron and diabetes risk.. Cell Metab 2013 Mar 5;17(3):329-41.
    pmc: PMC3648340pubmed: 23473030doi: 10.1016/j.cmet.2013.02.007google scholar: lookup
  26. Smith JE, Moore K, Cipriano JE, Morris PG. Serum ferritin as a measure of stored iron in horses.. J Nutr 1984 Apr;114(4):677-81.
    pubmed: 6716170doi: 10.1093/jn/114.4.677google scholar: lookup
  27. Stechemesser L, Eder SK, Wagner A, Patsch W, Feldman A, Strasser M, Auer S, Niederseer D, Huber-Schönauer U, Paulweber B, Zandanell S, Ruhaltinger S, Weghuber D, Haschke-Becher E, Grabmer C, Rohde E, Datz C, Felder TK, Aigner E. Metabolomic profiling identifies potential pathways involved in the interaction of iron homeostasis with glucose metabolism.. Mol Metab 2017 Jan;6(1):38-47.
  28. Theelen MJP, Beukers M, Grinwis GCM, Sloet van Oldruitenborgh-Oosterbaan MM. Chronic iron overload causing haemochromatosis and hepatopathy in 21 horses and one donkey.. Equine Vet J 2019 May;51(3):304-309.
    pubmed: 30269378doi: 10.1111/evj.13029google scholar: lookup
  29. Treiber KH, Kronfeld DS, Hess TM, Boston RC, Harris PA. Use of proxies and reference quintiles obtained from minimal model analysis for determination of insulin sensitivity and pancreatic beta-cell responsiveness in horses.. Am J Vet Res 2005 Dec;66(12):2114-21.
    pubmed: 16379656doi: 10.2460/ajvr.2005.66.2114google scholar: lookup
  30. Tsuchiya H, Ebata Y, Sakabe T, Hama S, Kogure K, Shiota G. High-fat, high-fructose diet induces hepatic iron overload via a hepcidin-independent mechanism prior to the onset of liver steatosis and insulin resistance in mice.. Metabolism 2013 Jan;62(1):62-9.
    pubmed: 22854109doi: 10.1016/j.metabol.2012.06.008google scholar: lookup
  31. Turner S.P, Hess T.M, Treiber K, Mello E.B, Souza B.G, Almeida F.Q.. Comparison of Insulin Sensitivity of Horses Adapted to Different Exercise Intensities.. J. Equine Vet. Sci. 2011;31:645–649.
  32. Venn-Watson S, Smith CR, Stevenson S, Parry C, Daniels R, Jensen E, Cendejas V, Balmer B, Janech M, Neely BA, Wells R. Blood-Based Indicators of Insulin Resistance and Metabolic Syndrome in Bottlenose Dolphins (Tursiops truncatus).. Front Endocrinol (Lausanne) 2013;4:136.
    pmc: PMC3793200pubmed: 24130551doi: 10.3389/fendo.2013.00136google scholar: lookup
  33. Wang X, Fang X, Wang F. Pleiotropic actions of iron balance in diabetes mellitus.. Rev Endocr Metab Disord 2015 Mar;16(1):15-23.
    pubmed: 25520048doi: 10.1007/s11154-014-9303-ygoogle scholar: lookup
  34. Weeks BR, Smith JE, DeBowes RM, Smith JM. Decreased serum iron and zinc concentrations in cattle receiving intravenous dexamethasone.. Vet Pathol 1989 Jul;26(4):345-6.
    pubmed: 2763425doi: 10.1177/030098588902600412google scholar: lookup
  35. Zafar U, Qureshi HJ, Imran M. COMPARISON OF IRON STATUS AND INSULIN RESISTANCE BETWEEN NON-DIABETIC OFFSPRINGS OF TYPE 2 DIABETICS AND NON-DIABETICS.. J Ayub Med Coll Abbottabad 2015 Apr-Jun;27(2):307-11.
    pubmed: 26411103

Citations

This article has been cited 2 times.
  1. Satué K, Fazio E, La Fauci D, Medica P. Hematological indexes and iron status in pregnant mares.. Arch Anim Breed 2023;66(3):197-205.
    doi: 10.5194/aab-66-197-2023pubmed: 37560356google scholar: lookup
  2. Sullivan KE, Lavin SR, Livingston S, Knutson M, Valdes EV, Warren LK. Safety and efficacy of a novel iron chelator (HBED; (N,N'-Di(2-hydroxybenzyl)ethylenediamine-N,N'-diacetic acid)) in equine (Equus caballus) as a model for black rhinoceros (Diceros bicornis).. J Anim Physiol Anim Nutr (Berl) 2022 Sep;106(5):1107-1117.
    doi: 10.1111/jpn.13745pubmed: 35894091google scholar: lookup