Metabolic disorders

Metabolic Syndrome in humans is a well-recognized complex of risk factors that are correlated with various cardiovascular diseases and diabetes mellitus. Clinical diagnosis is based on obesity, dysregulation of the fat metabolism, increased blood pressure, and elevated fasting glucose (Alberti et al., 2009). Metabolic Syndrome has been associated with a variety of cardio vascular abnormalities including atherosclerosis, myocardial infarct, stroke, arrhythmias, hypertension and cardiac failure amongst others (Isomaa et al. 2001; Watanabe et al. 2008).

In 2002 the term Equine Metabolic Syndrome was first introduced to equine medicine. It is characterized by regional or general obesity, insulin dysregulation and an increased risk of laminitis.  Other components that have been associated with EMS include changes of the fat metabolism, endocrine dysregulations, alterations in reproductive cycles of mares, upregulation of inflammatory markers and hypertension (Frank et al., 2010).   

Up to now there are few contributions addressing the cardiovascular effects of EMS in horses and ponies. It has been shown that there exists a tendency towards hypertension and that hypertension can have associated changes in the heart structure (Rugh et al., 1987; Bailey et al., 2008; Navas de Solis et al., 2013).

The work performed at the University of Bern includes assessment of metabolic and cardiovascular blood parameters, blood pressure measurements, heart rhythm analysis and ultrasonographic examination of the heart and vasculature. All the tests are performed at the horse’s stable and are non-invasive. The aim is to develop a better understanding of EMS to enable earlier clinical recognition of risk, more extensive diagnostic approaches and consequently improved therapeutic and preventive strategies.

References

Alberti, K. G. M. M., Eckel, R. H., Grundy, S. M., Zimmet, P. Z., Cleeman, J. I., Donato, K. A., ... & Smith, S. C. (2009). Harmonizing the Metabolic Syndrome A Joint Interim Statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation, 120(16), 1640-1645.

Bailey, S. R., Habershon-Butcher, J. L., Ransom, K. J., Elliott, J., & Menzies-Gow, N. J. (2008). Hypertension and insulin resistance in a mixed-breed population of ponies predisposed to laminitis. American journal of veterinary research, 69(1), 122-129.

Frank, N., Geor, R. J., Bailey, S. R., Durham, A. E., & Johnson, P. J. (2010). Equine metabolic syndrome. Journal of Veterinary Internal Medicine, 24(3), 467-475.

Isomaa, B. O., Almgren, P., Tuomi, T., Forsén, B., Lahti, K., Nissen, M., ... & Groop, L. (2001). Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes care, 24(4), 683-689.

Navas de Solis, C., Slack, J., Boston, R. C., & Reef, V. B. (2013). Hypertensive cardiomyopathy in horses: 5 cases (1995–2011). Journal of the American Veterinary Medical Association, 243(1), 126-130.

Rugh, K. S., Garner, H. E., Sprouse, R. F., & Hatfield, D. G. (1987). Left ventricular hypertrophy in chronically hypertensive ponies. Laboratory animal science, 37(3), 335-338.

Watanabe, H., Tanabe, N., Watanabe, T., Darbar, D., Roden, D. M., Sasaki, S., & Aizawa, Y. (2008). Metabolic syndrome and risk of development of atrial fibrillation The Niigata preventive medicine study. Circulation, 117(10), 1255-1260.