Serum insulin concentrations in horses with equine Cushing's syndrome: response to a cortisol inhibitor and prognostic value

Mcgowan, C. M., Frost, R., Pfeiffer, D. U. and Neiger, R. (2004) Serum insulin concentrations in horses with equine Cushing's syndrome: response to a cortisol inhibitor and prognostic value. Equine Veterinary Journal, 36 3: 295-298. doi:10.2746/0425164044877288

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Author Mcgowan, C. M.
Frost, R.
Pfeiffer, D. U.
Neiger, R.
Title Serum insulin concentrations in horses with equine Cushing's syndrome: response to a cortisol inhibitor and prognostic value
Journal name Equine Veterinary Journal   Check publisher's open access policy
ISSN 0425-1644
2042-3306
Publication date 2004-04-01
Sub-type Critical review of research, literature review, critical commentary
DOI 10.2746/0425164044877288
Open Access Status Not yet assessed
Volume 36
Issue 3
Start page 295
End page 298
Total pages 4
Place of publication Newmarket, United Kingdom
Publisher Equine Veterinary Journal
Language eng
Subject 0707 Veterinary Sciences
0799 Other Agricultural and Veterinary Sciences
Formatted abstract
Reasons for performing study:
Serum insulin concentration and its use as a prognostic indicator in horses with equine Cushing's syndrome (ECS) have been poorly documented.

Objectives:
To examine daily insulin variations in horses with ECS and the effect of treatment using trilostane, a competitive inhibitor of 3β-hydroxysteroid dehydrogenase. Further, we aimed to examine the relationship between baseline serum insulin concentration and survival in horses with ECS.

Methods:
Basal serum insulin concentrations were measured in 20 confirmed ECS cases by taking blood at regular 4 h intervals for 24 h (1200, 1600, 2000, 2400, 0400 and 0800 h) before treatment (Day 0) and 10 days, and 30 days and 1–2 years after the onset of trilostane therapy. The temporal pattern of insulin was analysed using a linear mixed model approach, and the prognostic value of measurements on Day 0 assessed using receiver-operating characteristic analysis.

Results:
Horses with ECS showed a diurnal pattern of serum insulin concentration, highest value at 1200 h, and this pattern was not altered by treatment with trilostane. Furthermore, despite a mild increase of serum insulin concentrations after 10 days of trilostane therapy, insulin concentration was unaffected in the long term. Low serum insulin concentrations at the beginning of the trial were significantly associated with improved survival to 1–2 years. The 1200 h sampling before treatment had the highest prognostic value for prediction of survival with a sensitivity and specificity of at least 90% for serum insulin at <62 and >188 μu/ml to predict survival and nonsurvival, respectively.

Conclusions and potential relevance:
Insulin is a useful prognostic indicator for ECS, but potentially large variations can occur throughout a 24 h period, indicating a single sample may not be representative. Serum insulin concentration did not increase over 1–2 years in horses receiving trilostane therapy. 
Keyword Horse
Hyperadrenocortiscism
Laminitis
Pony
Prognosis
Trilostane
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Excellence in Research Australia (ERA) - Collection
2005 Higher Education Research Data Collection
School of Veterinary Science Publications
 
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Created: Thu, 06 Apr 2006, 23:16:58 EST