Increased plasma fructosamine concentrations in laminitic horses.
Authors: Knowles, Withers, Mair
Journal: Equine veterinary journal
Summary
# Editorial Summary: Fructosamine as a Marker of Metabolic Dysfunction in Laminitis Knowles, Withers and Mair investigated whether plasma fructosamine—a marker reflecting average blood glucose over the preceding 2–3 weeks—could help identify metabolic dysfunction underlying laminitis, as fasting insulin and glucose measurements alone often fail to detect insulin resistance in affected horses. The researchers measured fructosamine, fasting insulin and glucose in 30 laminitic horses at presentation, comparing these values to 19 healthy controls, and correlated findings with insulin resistance proxies (RISQI and MIRG) and clinical outcomes. Laminitic horses displayed significantly elevated mean fructosamine concentrations compared to controls (P<0.001), and fructosamine showed statistically significant correlations with both fasting glucose and insulin levels as well as with established insulin resistance indices. Whilst associations between elevated fructosamine at presentation and negative prognosis did not reach significance, the findings suggest fructosamine warrants consideration as a complementary diagnostic tool for identifying abnormal glycaemic control in laminitic cases—particularly valuable given that only 13 of 30 laminitic horses showed fasting hyperinsulinaemia, highlighting how single-point glucose and insulin measurements can miss metabolic disease. For practitioners managing laminitis, fructosamine may offer improved detection of chronic hyperglycaemia when standard markers appear equivocal.
Read the full abstract on PubMed
Practical Takeaways
- •Plasma fructosamine may be a useful clinical marker to identify abnormal glucose homeostasis in laminitic horses, potentially helping identify insulin resistance as an underlying cause
- •Measuring fructosamine alongside insulin and glucose could improve detection of metabolic dysfunction in laminitis cases and support targeted management strategies
- •While fructosamine shows promise as a diagnostic marker, it did not predict outcome in this study, so clinical assessment must remain multifactorial
Key Findings
- •Laminitic horses had significantly higher mean plasma fructosamine concentrations than normal horses (P<0.001)
- •13 of 30 laminitic horses (43%) demonstrated fasting hyperinsulinaemia, indicating underlying insulin resistance
- •Plasma fructosamine correlated statistically with fasting glucose, insulin, and insulin resistance proxies (RISQI and MIRG)
- •Trends for association between fructosamine concentration and negative outcome did not reach statistical significance