Key result
Insulin dysregulation in Warmblood horses is linked to ~0.7 cm larger LV end-diastolic diameter.
Why the study?
Systemic hypertension and left ventricular hypertrophy are common sequelae of metabolic syndrome and pre-diabetes in humans, warranting investigation in horses with insulin dysregulation.
Does mild insulin dysregulation in Warmblood horses result in echocardiographic evidence of left ventricular remodeling, hypertension, or adipokine alterations compared to non-insulin dysregulated horses?
Cross-Sectional (n=19)
Blinded
No
Does mild insulin dysregulation in Warmblood horses result in echocardiographic evidence of left ventricular remodeling, hypertension, or adipokine alterations compared to non-insulin dysregulated horses?
Absolute Event Rate: 11.77% vs 11.1%
p-value: p=0.038
Mild, subclinical insulin dysregulation in Warmblood horses is significantly associated with left ventricular remodeling and myocardial thickening, mimicking early diabetic cardiomyopathy findings in humans.
May warrant cardiac monitoring in insulin-dysregulated horses; leaves open mechanistic parallels to human pre-diabetic remodeling.
Background In humans, systemic hypertension and left ventricular (LV) hypertrophy are common sequelae of metabolic syndrome and pre-diabetes warranting investigation in horses with insulin dysregulation (ID). Hypothesis/Objectives To compare echocardiographic variables, non-invasive blood pressure (NIBP), and adipokines between Warmblood (WB) horses with and without ID. Animals Nineteen client-owned WB horses, 5-15 years of age, presenting for elective procedures were included. Horses had no history of metabolic disease, ID, laminitis, renal or cardiac disease. Methods Blinded cross-sectional study. Horses were divided into 2 groups ID and non-ID based on an oral sugar test (T0 insulin ≥20 μIU/mL or T60 or T90 ≥ 30 μIU/mL). Each horse underwent the following: Physical examination, body condition score, body weight, cresty neck score, and measurement of serum leptin, total, and high molecular weight adiponectin concentrations, NIBP, lateromedial radiographs, retroperitoneal fat measurement, short axis M mode echocardiographic evaluation, and 2D speckle tracking (2DST). Results Eight horses were categorized as ID, 11 as non-ID. Evidence of LV remodeling was identified in ID horses (P < .05) with greater measurements of LV internal diameter at end diastole (ID 11.77 cm [11.2-12.3]; non-ID 11.10 [10.54-11.85]), interventricular septum at end diastole (ID 3.10 cm [2.81-3.39]; non-ID 2.46 [2.22-2.71]) and end systole (ID 5.18 cm [4.81-5.56]; non-ID 4.29 [4.06-4.51]). 2DST measures were significantly lower in the ID group (P < 0.05). Hypertension was identified in 2 horses, 1 from each group. Conclusions and clinical importance Horses with mild ID have evidence of LV remodeling supportive of hypertrophy. Cardiovascular changes might be included in the overarching definition of ID.
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Palmisano et al. (2026) conducted a cross-sectional in Insulin Dysregulation (n=19). Insulin dysregulation vs. No insulin dysregulation was evaluated on Left ventricular internal diameter at end diastole (LVIDd) (p=0.038). Insulin dysregulation in Warmblood horses was associated with left ventricular remodeling, demonstrated by a significantly larger left ventricular internal diameter at end diastole (11.77 cm vs 11.10 cm, p=0.038).
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