WAS: Cornell vs. BET lab results for Insulin NOW: Leptin
I've had a few private messages about the change in routinely recommending leptin testing we discussed yesterday.
We have changed the EMS calculator to remove leptin and are in the process of updating the DDT+E - diagnosis page to reflect this change.
Here is what the new diagnosis recommendations will say:
Blood tests for EMS — insulin, glucose, leptin, and adiponectin
A hallmark of EMS is high levels of insulin - hyperinsulinemia - as a result of insulin resistance. This is caused by the failure of insulin sensitive cells to respond to “normal” levels of insulin.
There are many controversies over how best to test for EMS in equines. There is a dynamic interaction between glucose and insulin that changes over the course of the day. Insulin levels change when the horse eats, sleeps, or exercises. A normal level will depend on conditions of the test. A low-sugar and starch diet can influence insulin results.
The fat-derived hormone leptin is also usually abnormally elevated in insulin resistance but because there are many other things which can lower or increase leptin, ECIR is not recommending routine testing for this hormone.
Most university and commercial labs offer serum insulin and glucose tests.
Adiponectin is used in the UK and the EU. Adiponectin helps regulate glucose and fat burning, and maintain insulin sensitivity. Low levels are associated with EMS. It has come to be preferred over leptin because it is not influenced by things like weight or exercise, and also because it was the only factor other than insulin levels that predicted laminitis risk
The EMS Calculator will calculate the G/I ratio, RISQI and MIRG, as it has before. Here is the link https://www.ecirhorse.org/EMS-calculator.php
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer 2019-2020
Join us at the 2021 NO Laminitis! Conference, August 12-15, Harrisburg, PA
Eleanor Kellon, VMD
Just for the record, I concur with Nancy's post.
Eleanor in PA