Diagnostic utility and validity of 1,2-o-dilauryl-rac-glycero-3-glutaric acid-(6'-methylresorufin) ester (DGGR) lipase activity in horses with colic.

Lanz, S; Howard, J; Gerber, V; Peters, L M (2022). Diagnostic utility and validity of 1,2-o-dilauryl-rac-glycero-3-glutaric acid-(6'-methylresorufin) ester (DGGR) lipase activity in horses with colic. The veterinary journal, 288(105887), p. 105887. Elsevier 10.1016/j.tvjl.2022.105887

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Little is known about the clinical usefulness in horses of the 1,2-o-dilauryl-rac-glycero-3-glutaric acid-(6'-methylresorufin) ester (DGGR) lipase assay, a biomarker used in other species for the detection of pancreatitis. The main objectives of this study were to evaluate the prevalence of increased DGGR-lipase activity in horses with signs of colic and investigate its association with, and validity to diagnose, underlying gastrointestinal diseases, treatment method (medical or surgical), and outcome (survival or non-survival). Clinical data from 192 horses presented for colic to a teaching hospital were analysed retrospectively. DGGR-lipase activity was measured in frozen plasma collected within 24h of presentation. Non-parametric tests and Chi-squared or Fisher's exact tests were used to evaluate differences and associations between DGGR-lipase activity and continuous and categorical variables or outcomes, respectively. Measures of the validity of DGGR-lipase as a diagnostic test were also calculated. Increased DGGR-lipase activity above published reference limits was demonstrated in 30.2% of horses with signs of colic, and was above 2x the upper reference limit (URL) in 15.6%. The median DGGR-lipase activity in horses with large bowel displacement or torsion was significantly higher than the median activity for large bowel impaction and for gastric impaction, dilation, or ulceration. DGGR-lipase activity >2x URL was significantly associated with surgical treatment, strangulating disease, and non-survival. However, as a diagnostic or screening test for these target outcomes, DGGR-lipase activity was poor to fair consequent to poor sensitivity, poor negative likelihood ratio, and an area under the receiver operating characteristic curve, with optimal cut-offs based on the Youden Index, within reference limits.

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