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Data from: Prevalence of insulin dysregulation in a sport horse population as determined by traditional and stall-side testing

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Jun 30, 2026 version files 43.35 KB

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Abstract

Background: The prevalence of insulin dysregulation (ID) has not been investigated in sport horses. Stall-side insulin assays offer convenience but need further validation.

Objectives: To determine the prevalence of and risk factors for ID in a sport horse population using an oral sugar test (OST), and assess agreement between stall-side and validated laboratory assays for insulin quantification.

Study design: Prospective cross-sectional study.

Methods: 180 sport horses presenting for orthopaedic evaluation at a university hospital (N=140) or local farms (N=40) were tested for ID using OST (0.15 mL/kg light corn syrup). Morphometric data were collected, and baseline serum leptin and adiponectin concentrations were measured. Insulin concentrations were measured using the validated fluorescence enzyme immunoassay (FEIA) and a stall-side lateral flow assay (LFA). ID was diagnosed if FEIA insulin was measured >20 mIU/mL at T0 or >30 mIU/mL at T60/T90. Factors associated with ID were assessed using a mixed effects binary logistic regression model. Assay agreement was assessed using Pearson’s correlation coefficient and Bland-Altman plot. Receiver operating characteristic curve analysis was performed to determine diagnostic cut-offs for LFA.

Results: ID was diagnosed in 22.8% (41/180) of horses. Only 11/41 ID horses had elevated fasted insulin. Increasing leptin/adiponectin ratio in males was the only significant predictor of ID (OR=1.102, 95% CI 1.036-1.171). Correlation between FEIA and LFA insulin measures was good (r=0.81, 95% CI 0.78–0.84), but the LFA read on average 13.62 mIU/mL higher than the FEIA and had greater variability at higher insulin concentrations. Area under the ROC curve showed the LFA was excellent at correctly classifying ID status (AUC=0.95, 95% CI 0.93–0.97).

Main limitations: Single-centre study, voluntary enrolment may overestimate ID prevalence.

Conclusions: ID is common in sport horses and often requires dynamic insulin testing to diagnose. Physical appearance does not predict ID risk. Agreement between stall-side and laboratory assays is good.

Data Summary: Complete data from all 180 enrolled horses. Abbreviations used: H-hospital, F-field, M-mare, G-gelding, S-stallion, QH-quarter horse, BCS-body condition score, CNS-cresty neck score, BCI-body condition index, PPID-pituitary pars intermedia dysfunction, FEIA-fluorescence enzyme immunoassay, LFA-lateral flow assay, Y-yes, N-no. Insulin dysregulation defined as FEIA insulin > 20 mIU/mL at T0, or >30 mIU/mL at T60 or T90. PPID status reported by owners.