Morphometric, metabolic, and inflammatory markers across a cohort of client-owned horses and ponies on the insulin dysregulation spectrum.
Authors: Ragno Valentina M, Klein Colby D, Sereda Nicole S, Uehlinger Fabienne D, Zello Gordon A, Robinson Katherine A, Montgomery Julia B
Journal: Journal of equine veterinary science
Summary
# Editorial Summary Equine metabolic syndrome (EMS) shares pathophysiological features with human metabolic syndrome, yet validated biomarkers for equine insulin dysregulation remain elusive. This cross-sectional study of 32 client-owned horses compared morphometric measures, resting insulin concentrations, and a panel of metabolic and inflammatory markers (methylglyoxal, D-lactate, L-lactate, TNF-α, IL-6, and MCP-1) between horses classified as insulin dysregulated or insulin sensitive via combined glucose and insulin testing. Cresty neck score emerged as the only significant discriminator: horses with a CNS ≥3 demonstrated 11.3 times higher odds of insulin dysregulation, whilst baseline insulin, body condition score, and circulating inflammatory cytokines showed no significant differences between groups. The authors propose that these seemingly paradoxical findings may reflect either a phenotypic subtype of EMS distinct from overt systemic inflammation, or suggest that affected horses in this cohort had not yet progressed to metabolic decompensation characterised by elevated inflammatory markers. For practitioners, these results underscore the clinical utility of cresty neck scoring as a practical screening tool for insulin dysregulation, whilst cautioning against reliance on baseline insulin concentration or inflammatory biomarkers alone for EMS diagnosis in milder cases—emphasising the continued importance of provocative testing such as CGIT for definitive classification.
Read the full abstract on PubMed
Practical Takeaways
- •Cresty neck score is a practical clinical indicator for identifying horses at risk of insulin dysregulation; horses with CNS ≥3 warrant metabolic screening
- •Traditional morphometric assessment (BCS, CNS) remains more reliable than emerging biomarkers for identifying EMS in this population; body condition evaluation should guide management decisions
- •Horses with mild-moderate EMS signs may not show elevated inflammatory markers, so absence of elevated cytokines does not exclude metabolic dysfunction
Key Findings
- •38% (12/32) of client-owned horses were classified as insulin dysregulated via combined glucose and insulin test
- •Cresty neck score ≥3 was strongly associated with insulin dysregulation (OR 11.3, 95% CI 2.04-63.08, P=0.006)
- •Biomarkers including methylglyoxal, D-lactate, L-lactate, TNF-α, IL-6, and MCP-1 showed no significant differences between insulin dysregulated and insulin sensitive horses
- •Baseline insulin was significantly associated with insulin dysregulation in univariate analysis (P=0.02) but not in the final logistic regression model