최근 사람연구에서는 심부전과 관련하여 발생하는 인슐린 저항성이나 공복혈당 이상과 같은 혈당 대사 이상 중요한 예후인자로 받아들여지고 있다. 그러나 심부전이 있는 개에서 이와 관련된 연구는 매우 드물다. 따라서 본 연구는 혈당대사이상이 이첨판 폐쇄 부전증이 있는 개에서도 나타날 것이라고 가정하였다. 총 113마리의 보호자가 있는 개를 대상으로 혈중 insulin, glucagon, fructosamine, glucose 를 측정하였으며, 인슐린 저항성은 homeostatic model assessment (HOMA) score를 이용하였다. 실험결과 혈중 인슐린 농도는 심장병이 심해짐에 따라서 유의성 있게 감소함을 확인하였다. 반면, fructosamine, HOMA score, and 공복 혈당은 심부전의 심각도와 어떠한 상관성도 보이지 않았다. 인슐린 농도, fructosamine, HOMA 의 경우 body condition scores (BCS)와 양의 유의적 상관관계를 보였으나, 혈당의 경우 그러지 않았다. 심부전과 BCS와의 음의 유의적 상관관계 또한 확인 되었다. 본 연구를 바탕으로 자연적으로 발생한 이첨판 폐쇄부전증에 따른 심부전 환자에서 심장 병이 심해짐에 따라서 인슐린 분비 기능이 감소함을 확인하였다.
최근 사람연구에서는 심부전과 관련하여 발생하는 인슐린 저항성이나 공복혈당 이상과 같은 혈당 대사 이상 중요한 예후인자로 받아들여지고 있다. 그러나 심부전이 있는 개에서 이와 관련된 연구는 매우 드물다. 따라서 본 연구는 혈당대사이상이 이첨판 폐쇄 부전증이 있는 개에서도 나타날 것이라고 가정하였다. 총 113마리의 보호자가 있는 개를 대상으로 혈중 insulin, glucagon, fructosamine, glucose 를 측정하였으며, 인슐린 저항성은 homeostatic model assessment (HOMA) score를 이용하였다. 실험결과 혈중 인슐린 농도는 심장병이 심해짐에 따라서 유의성 있게 감소함을 확인하였다. 반면, fructosamine, HOMA score, and 공복 혈당은 심부전의 심각도와 어떠한 상관성도 보이지 않았다. 인슐린 농도, fructosamine, HOMA 의 경우 body condition scores (BCS)와 양의 유의적 상관관계를 보였으나, 혈당의 경우 그러지 않았다. 심부전과 BCS와의 음의 유의적 상관관계 또한 확인 되었다. 본 연구를 바탕으로 자연적으로 발생한 이첨판 폐쇄부전증에 따른 심부전 환자에서 심장 병이 심해짐에 따라서 인슐린 분비 기능이 감소함을 확인하였다.
Glucose metabolism abnormalities secondary to heart failure, including insulin resistance (IR) and impaired fasting glucose, have been gradually recognized as important prognostic factors in disease progression. However, to date, no study has investigated glucose abnormalities in dogs with chronic m...
Glucose metabolism abnormalities secondary to heart failure, including insulin resistance (IR) and impaired fasting glucose, have been gradually recognized as important prognostic factors in disease progression. However, to date, no study has investigated glucose abnormalities in dogs with chronic mitral valve insufficiency (CMVD). Thus, we hypothesized that glucose metabolism abnormalities due to heart failure may develop in dogs with CMVD. A prospective study was performed on 113 client-owned dogs with variable CMVD severities. Serum insulin, glucagon, fructosamine, and glucose concentrations were measured, and insulin resistance was determined using the homeostatic model assessment (HOMA) score. The serum insulin concentration had a significant inverse association with the heart failure severity. However, there was no significant association between the heart failure severity and fructosamine, HOMA score, and fasting blood glucose. Insulin, fructosamine, and HOMA had a significant positive association with body condition scores (BCS), whereas glucose had no association. This study found that insulin secretion in dogs with naturally occurring heart failure due to CMVD might be compromised as the disease worsens.
Glucose metabolism abnormalities secondary to heart failure, including insulin resistance (IR) and impaired fasting glucose, have been gradually recognized as important prognostic factors in disease progression. However, to date, no study has investigated glucose abnormalities in dogs with chronic mitral valve insufficiency (CMVD). Thus, we hypothesized that glucose metabolism abnormalities due to heart failure may develop in dogs with CMVD. A prospective study was performed on 113 client-owned dogs with variable CMVD severities. Serum insulin, glucagon, fructosamine, and glucose concentrations were measured, and insulin resistance was determined using the homeostatic model assessment (HOMA) score. The serum insulin concentration had a significant inverse association with the heart failure severity. However, there was no significant association between the heart failure severity and fructosamine, HOMA score, and fasting blood glucose. Insulin, fructosamine, and HOMA had a significant positive association with body condition scores (BCS), whereas glucose had no association. This study found that insulin secretion in dogs with naturally occurring heart failure due to CMVD might be compromised as the disease worsens.
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제안 방법
The present study examined IR characteristics in dogs with heart failure according to the disease severity and has several notable advantages. All of the animals were prospectively investigated in a single hospital by trained practitioners using a standardized protocol and standardized radiography, ultrasonography, and hematologic diagnostic facilities. In addition, the number of dogs included was relatively high compared to other veterinary prospective studies.
대상 데이터
The study included 113 dogs (75 males and 38 females) with CMVD. The majority was adult-age, male, and small breed (Table 1).
데이터처리
, San Diego, CA, USA). Correlations between the heart failure severities, BCS, glucose profiles, HOMA scores, and hormone (insulin and glucagon) concentrations were determined by Pearson correlation analysis. For all comparisons, a P < 0.
성능/효과
In conclusion, our results suggest that insulin secretion in dogs with naturally occurring heart failure secondary to CMVD may be compromised as heart failure worsens, rather than becoming hyperinsulinemic as supported by previous reports. In contrast, of the association between BCS and glucose abnormalities were similar to those reported in previous human and veterinary studies.
후속연구
Accordingly, it would be important to measure the insulin concentration in dogs with heart failure as a prognostic factor. Further studies are needed to elucidate the role of decreased insulin secretion in dogs with heart failure.
In addition, the previous study subjects experienced heart failure for a shorter period than the present patient population. Given these discrepancies, further study is needed to elucidate possible mechanisms causing reduced insulin secretion in dogs with heart failure.
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