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Carslake HB, Pinchbeck GL, Argo CM, Dugdale AHA, McGowan CM. Investigation of glucagon-like peptide-1 response to six oral carbohydrates in ponies. Vet J 2024; 305:106110. [PMID: 38604332 DOI: 10.1016/j.tvjl.2024.106110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 04/03/2024] [Accepted: 04/08/2024] [Indexed: 04/13/2024]
Abstract
Glucagon-like peptide-1 (GLP-1), the principal incretin in horses, may play a role in the pathophysiology of insulin dysregulation (ID). This study aimed to describe its concentration in response to three preserved forages and four dynamic tests for ID in ponies. Twelve adult ponies of mixed ID status were given a meal of hay, soaked hay or haylage, an in-feed oral glucose test (OGT), oral sugar test (OST), an oral test using a proprietary breakfast cereal (WEET) or a combined glucose-insulin tolerance test (CGIT) weekly in a randomised cross-over study. Glucose, insulin and GLP-1 concentrations were measured before and following each intervention. Ponies were designated ID or non-ID and insulin resistant (IR) or non-IR according to OGT and CGIT results, respectively. All interventions apart from the CGIT provoked a GLP-1 response within 30 min. The OGT and WEET interventions, (containing the greatest dose of non-structural carbohydrate, 1.06 and 1 g/kg BW, respectively), resulted in a greater area under the curve (AUC) for GLP-1 compared to all other interventions (P < 0.001). No difference in GLP-1 response was detected according to ID or IR status, despite there being strong positive correlations (rs [95 % CI]) between GLP-1 and insulin concentrations measured at individual time points (0.67 [0.62 - 0.71]; P < 0.001) and as AUC (0.66 [0.49-0.79], P < 0.001). These data do not support of the use of GLP-1 as an adjunctive diagnostic test for ID or IR, as defined by conventional intravenous or oral dynamic tests.
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Affiliation(s)
- H B Carslake
- Institute of Infection, Veterinary and Ecological sciences, Faculty of Health and Life Sciences, University of Liverpool, Leahurst CH64 7TE, UK.
| | - G L Pinchbeck
- Institute of Infection, Veterinary and Ecological sciences, Faculty of Health and Life Sciences, University of Liverpool, Leahurst CH64 7TE, UK
| | - C M Argo
- Scotland's Rural College, Aberdeen, Scotland AB21 9YA, UK
| | | | - C M McGowan
- Institute of Infection, Veterinary and Ecological sciences, Faculty of Health and Life Sciences, University of Liverpool, Leahurst CH64 7TE, UK
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2
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Clark BL, Norton EM, Bamford NJ, Randhawa IAS, Kemp KL, McCue ME, Bertin FR, Stewart AJ. Epidemiological investigation of insulin dysregulation in Shetland and Welsh ponies in Australia. Equine Vet J 2024; 56:281-290. [PMID: 38173146 DOI: 10.1111/evj.14044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 12/12/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Insulin dysregulation (ID) is central to equine metabolic syndrome. There are limited epidemiological studies investigating dynamic testing of ID in ponies. OBJECTIVES To evaluate prevalence and risk factors for ID through dynamic testing of hyperinsulinaemia (DHI) and insulin resistance (IR). STUDY DESIGN Cross-sectional. METHODS Sex, age, breed, height, cresty neck score (CNS), body condition score (BCS), laminitis, HMGA2:c.83G>A genotype and pituitary pars intermedia dysfunction (PPID) status were documented. Dynamic hyperinsulinaemia was diagnosed with an oral sugar test (OST) and IR with an insulin tolerance test (ITT). Owners completed surveys reporting activity, laminitis history and perception of body condition using a (1-9) visual analogue scale (VASo). Ordinal scores were converted to binary outcomes for CNS (≤2/5 or ≥3/5), BCS and VASo (≤6/9 or ≥7/9). Variables associated with insulin concentrations, glucose reduction after the ITT and laminitis were evaluated with mixed effects regression models accounting for random effects of farms. RESULTS Among 167 ponies tested, median (range) age was 9 (4-21) years and BCS was 6 (4-8). Prevalence (95% confidence interval [CI]) of ID was 61 (53-68)%. Factors associated with insulin concentrations (estimate [95% CI]; μIU/mL) 60 min post-OST were: age (1.07 [1.02-1.11]), CNS (≥3/5, 1.52 [1.04-2.23]) and VASo (≥7/9, 1.75 [1.09-2.79]); and 90 min post-OST were: age (1.08 [1.03-1.12]), CNS (≥3/5, 1.80 [1.22-2.64]), VASo (≥7/9, 2.49 [1.52-4.08]) and sex (male, 0.64 [0.45-0.91]). Factors associated with glucose reduction after the ITT (estimate [95% CI]; %) were: age (-1.34 [-2.01 to -0.67]), sex (female, -6.21 [-11.68 to -0.74]) and VASo (≥7/9, -1.74 [-18.89 to -4.78]). Factors associated with laminitis (odds ratio [95% CI]) were DHI (4.60 [1.68-12.58]), IR (3.66 [1.26-10.61]) and PPID (11.75 [1.54-89.40]). MAIN LIMITATIONS Single time-point sampling, laminitis definition and diet analysis. CONCLUSIONS Ageing, being female and owner-perceived obesity were associated with ID.
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Affiliation(s)
- Brianna L Clark
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia
| | - Elaine M Norton
- College of Agricultural and Life Sciences, The University of Arizona, Tucson, Arizona, USA
| | - Nicholas J Bamford
- Melbourne Veterinary School, The University of Melbourne, Parkville, Victoria, Australia
| | - Imtiaz A S Randhawa
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia
| | - Kate L Kemp
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia
| | - Molly E McCue
- College of Veterinary Medicine, The University of Minnesota, St Paul, Minnesota, USA
| | - François-René Bertin
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia
| | - Allison J Stewart
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia
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3
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Mendoza FJ, Toribio RE, Perez-Ecija A. Metabolic and Endocrine Insights in Donkeys. Animals (Basel) 2024; 14:590. [PMID: 38396558 PMCID: PMC10885905 DOI: 10.3390/ani14040590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 02/02/2024] [Accepted: 02/08/2024] [Indexed: 02/25/2024] Open
Abstract
Donkey medicine is gaining attention due to their increased use as companion animals, in shows, asinotherapy, etc. The increasing demand and unique aspects call for specialized care, requiring new information (physiology, infectious disorders, pharmacology, etc.). Since obesity is common in this species, hyperlipemia, metabolic syndrome and insulin dysregulation (ID) are common disorders in donkeys, in some cases with high mortality, either directly (multiorgan dysfunction) or indirectly due to poor quality of life (chronic laminitis). Donkeys have long-life expectancy and are often afflicted with pituitary pars intermedia dysfunction (PPID), a neurodegenerative and endocrine disease. Hyperlipemia is diagnosed based on high plasma triglyceride concentration in association with clinical findings and laboratory abnormalities from affected tissues (liver, kidney and pancreas). The measurement of resting serum insulin and plasma ACTH concentrations is the first step in ID and PPID diagnosis. In donkeys with clinical signs of ID (obesity or recurrent laminitis) or PPID (hypertrichosis, regional adiposity, laminitis and weight loss), where these hormones are in the normal or non-diagnostic range (donkey-specific cut-off values and reference ranges need to be established), dynamic tests are recommended (oral sugar test or thyrotropin-releasing hormone, respectively). Equine treatment protocols apply to donkeys, although pharmacological studies for most drugs, except pergolide, are lacking.
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Affiliation(s)
- Francisco J. Mendoza
- Department of Animal Medicine and Surgery, University of Cordoba, Cordoba 14014, Spain;
| | - Ramiro E. Toribio
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210, USA;
| | - Alejandro Perez-Ecija
- Department of Animal Medicine and Surgery, University of Cordoba, Cordoba 14014, Spain;
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4
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Macon EL, Harris P, McClendon M, Perron B, Adams A. Insulin dysregulated horses metabolic responses to forage pellets. J Equine Vet Sci 2024; 133:104991. [PMID: 38159582 DOI: 10.1016/j.jevs.2023.104991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/22/2023] [Accepted: 12/28/2023] [Indexed: 01/03/2024]
Abstract
Hyperinsulinemia-associated laminitis (HAL) is the primary concern for insulin dysregulated (ID) equids and their insulin response to the consumption of oral, nonstructural carbohydrates (NSC) has been shown to be a risk predictor for HAL development. This randomized, crossover study's objective was to examine the insulinemic responses to 3 forage pellets (1 g/kg BW) (timothy hay, TH, 9.5 % CP & 10 % NSC DM; alfalfa hay, AH, 16.3 % CP & 9.8 % NSC DM; timothy-alfalfa hay; TAH, 17.2 % CP & 9.8 % NSC DM) along with a positive (dehulled oats; OG, 14.7 % CP & 59.7 % NSC DM) and negative dietary challenge control (low-NSC; LNSC, 12.8 % CP & 5.4 % NSC DM) of ID (n = 8; 16.1 ± 2.2 yr; 565.4 ± 99.1 kgs.) and non-ID (NID; n = 7; 17.0 ± 2.8 yr; 583.6 ± 57.9 kgs.) horses. ID horses had higher positive incremental area under the curve for insulin (IAUCi) (ID: 890 ± 925 µIU/mL*minute vs. NID: 225 ± 228 µIU/mL*minute), peak (ID: 101.5 ± 80.72 µIU/mL vs. NID: 25.7 ± 7.2 µIU/mL), and delta (ID: 45.5 ± 77.1 µIU/mL vs. NID: 4.9 ± 5.3 µIU/mL) insulin for all forage pellets compared to NID (p < 0.01). ID horses IAUCi for the forage pellets was not different compared to the LNSC (218 ± 327 µIU/mL*minute) but was different from OG (10,522 ± 4,565 µIU/mL*minute). ID horses' lack of an augmented insulinemic response to the low NSC forage pellets (fed in small amounts) indicates that they could be a safe feedstuff for ID animals.
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Affiliation(s)
- Erica Lyn Macon
- Department of Animal Science, College of Agriculture and Life Sciences, Texas A&M University, College Station, TX, USA.
| | - Patricia Harris
- Equine studies Group, Waltham Petcare Science Institute, Freeby Lane, Waltham-on-the-Wold, Leics. LE14 4RT
| | - Margaret McClendon
- 108 M. H. Gluck Equine Research Center, Department of Veterinary Science, University of Kentucky, Lexington, KY, 40546, USA
| | - Brittany Perron
- 108 M. H. Gluck Equine Research Center, Department of Veterinary Science, University of Kentucky, Lexington, KY, 40546, USA
| | - Amanda Adams
- Department of Veterinary Science, M. H. Gluck Equine Research Center, University of Kentucky, Lexington, KY, 40546, USA
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5
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Carslake HB, Pinchbeck GL, Argo CM, Dugdale AHA, McGowan CM. Comparison of one novel and four established diagnostic tests for insulin dysregulation in ponies. Vet J 2024; 303:106059. [PMID: 38103885 DOI: 10.1016/j.tvjl.2023.106059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 12/19/2023]
Abstract
Several tests have been advocated for diagnosis of insulin dysregulation (ID). Tests using simple sugars may not reflect the response to naturally ingested carbohydrates. This study aimed to evaluate agreement between the oral glucose test (OGT), the oral sugar test (OST), a novel oral test using a proprietary cereal (WEET), the IV combined glucose-insulin tolerance test (CGIT) and fasted basal insulin (FI) for diagnosis of ID. Each of the five tests above was performed on a group of six normal and six insulin dysregulated mixed-breed ponies in a randomised crossover study. Area under the curve (AUC) and maximum concentration of insulin from OGT, OST and WEET showed strong to very strong bivariate correlations (r = 0.85-0.94, and r = 0.87-0.92, respectively; P ≤ 0.001) and were significantly different between tests (associated with dose of carbohydrate) and between CGIT-positive and -negative ponies. Dichotomous results showed substantial agreement between OST and both WEET (κ = 0.65; P = 0.02) and OGT (κ = 0.67; P = 0.01) and between CGIT and both OST (κ = 0.63; P = 0.03) and OGT (κ = 0.67; P = 0.01), and no agreement between FI, which had low sensitivity, and all other tests (κ = 0.15 - 0.31; P > 0. 05). Palatability of WEET was variable, resulting in one pony being excluded for analysis of WEET data. Further work on development of an oral test using a more palatable feedstuff and appropriate cut-offs or diagnostic thresholds for tests of ID is warranted.
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Affiliation(s)
- H B Carslake
- Institute of Infection, Veterinary and Ecological sciences, Faculty of Health and Life Sciences, University of Liverpool, Leahurst, UK CH64 7TE, UK.
| | - G L Pinchbeck
- Institute of Infection, Veterinary and Ecological sciences, Faculty of Health and Life Sciences, University of Liverpool, Leahurst, UK CH64 7TE, UK
| | - C M Argo
- Scotland's Rural College, Aberdeen, Scotland AB21 9YA, UK
| | - A H A Dugdale
- Paragon Veterinary referrals, Wakefield UK WF1 2DF, UK
| | - C M McGowan
- Institute of Infection, Veterinary and Ecological sciences, Faculty of Health and Life Sciences, University of Liverpool, Leahurst, UK CH64 7TE, UK
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6
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Diez de Castro E, Fernandez-Molina JM. Environmental Management of Equine Asthma. Animals (Basel) 2024; 14:446. [PMID: 38338089 PMCID: PMC10854533 DOI: 10.3390/ani14030446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/18/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
Environmental practices related to the inhalation of airborne dust have been identified as the main cause of equine asthma (EA) and reasonably, they are truly relevant in its treatment and control, especially for horses with its severe form. Vast research regarding environmental recommendations has been conducted in recent years. However, no recent exhaustive reviews exist that gather all this new evidence. The aim of this review is to report and compare the most pertinent information concerning the environmental management of EA. The main findings highlight the importance of the type of forage used for feeding but also its method of production and possible contamination during manufacture and/or storage. Procedures to reduce this, such as soaking and steaming hay, improve its hygienic quality, although they also decrease forage's nutritional value, making dietetic supplementation necessary. Regarding stabling, despite some conflicting results, avoiding straw as bedding and improving barn ventilation continue to be the common recommendations if turning to pasture is not feasible. Finally, owners' compliance has been identified as the most critical point in correct environmental control. Educating owners about the genuine benefits of these measures should be a cornerstone of EA management.
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Affiliation(s)
- Elisa Diez de Castro
- Veterinary Teaching Hospital, University of Cordoba, 14014 Córdoba, Spain
- Department of Animal Medicine and Surgery, University of Cordoba, 14014 Córdoba, Spain
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7
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Lindåse S, Nostell K, Forslund A, Bergsten P, Bröjer J. Short-term effects of canagliflozin on glucose and insulin responses in insulin dysregulated horses: A randomized, placebo-controlled, double-blind, study. J Vet Intern Med 2023; 37:2520-2528. [PMID: 37864426 PMCID: PMC10658518 DOI: 10.1111/jvim.16906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 10/06/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Decreasing hyperinsulinemia is crucial in preventing laminitis in insulin dysregulated (ID) horses. Complementary pharmacological treatments that efficiently decrease postprandial hyperinsulinemia in ID horses are needed. OBJECTIVES Compare short-term effects of canagliflozin vs placebo on glucose and insulin responses to an oral sugar test (OST) as well as the effects on body weight and triglyceride concentrations in horses with ID. ANIMALS Sixteen privately-owned ID horses. METHODS A single-center, randomized, double-blind, placebo-controlled, parallel design study. The horses were randomized (ratio 1:1) to either once daily PO treatment with 0.6 mg/kg canagliflozin or placebo. The study consisted of an initial 3-day period for obtaining baseline data, a 3-week double-blind treatment period at home, and a 3-day follow-up period similar to the initial baseline period but with continued double-blind treatment. Horses were subjected to an 8-sample OST in the morning of the third day on both visits. RESULTS Maximal geometric least square (LS) mean insulin concentration (95% confidence interval [CI]) during the OST decreased after 3 weeks of canagliflozin treatment compared with placebo (83.2; 55.4-125.0 vs 215.2; 143.2-323.2 μIU/mL). The geometric LS mean insulin response (insulin AUC0-180 ) for canagliflozin-treated horses was >66% lower compared with placebo. Least square mean body weight decreased by 11.1 (4-18.1) kg and LS mean triglyceride concentrations increased by 0.99 (0.47-1.5) mmol/L with canagliflozin treatment. CONCLUSIONS AND CLINICAL IMPORTANCE Canagliflozin is a promising drug for treatment of ID horses that requires future studies.
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Affiliation(s)
- Sanna Lindåse
- Department of Clinical SciencesSwedish University of Agricultural SciencesUppsalaSweden
| | - Katarina Nostell
- Department of Clinical SciencesSwedish University of Agricultural SciencesUppsalaSweden
| | - Anders Forslund
- Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
| | - Peter Bergsten
- Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
- Department of Medical Cell BiologyUppsala UniversityUppsalaSweden
| | - Johan Bröjer
- Department of Clinical SciencesSwedish University of Agricultural SciencesUppsalaSweden
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8
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Ward AB, Harris PA, Argo CM, Watson CA, Burns NM, Neacsu M, Russell WR, Grove-White D, Morrison PK. Confidence does not mediate a relationship between owner experience and likelihood of using weight management approaches for native ponies. PLoS One 2023; 18:e0292886. [PMID: 37824555 PMCID: PMC10569591 DOI: 10.1371/journal.pone.0292886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 10/01/2023] [Indexed: 10/14/2023] Open
Abstract
Native ponies are at increased risk of obesity and metabolic perturbations, such as insulin dysregulation (ID), a key risk factor for endocrinopathic laminitis. Management and feeding practices can be adapted to maintain healthy body condition and support metabolic health, but owners may inadvertently provide their ponies with inappropriate management leading to obesity and exacerbating risk of metabolic disease. Adoption of preventative weight management approaches (WMAs), including regular monitoring of body condition, providing appropriate preserved forage, promoting seasonal weight loss, and using exercise accordingly, are key in supporting native ponies' metabolic health. The factors influencing the adoption of WMAs, such as owners' experience and confidence, require exploration. The aim of the current study was to understand factors influencing owners' likelihood to undertake certain WMAs, to develop our understanding of suitable intervention targets. A total of 571 responses to an online cross-sectional questionnaire were analysed. Mediation analysis revealed that whilst long term (≥20 years) experience caring for native ponies was associated with owners increased, self-reported confidence in identifying disease and managing their native ponies, this did not translate to an increased likelihood of implementing WMAs. Conversely, respondents who managed ponies with dietary requirements related to obesity, laminitis, or equine metabolic syndrome were more likely to use WMAs related to feeding, seasonal weight management and exercise. Owner confidence was assessed and rejected as a mediator of the relationship between experience and WMA use. These results highlight the need for further work that elucidates the pathways leading owners to undertake action against obesity without the need for ponies to develop overt disease, as well as suggesting a need for long term managers of native ponies to update management practices with preventative care as the focus.
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Affiliation(s)
- Ashley B. Ward
- Scotland’s Rural College, Bucksburn, Aberdeen, United Kingdom
- School of Medicine, Medical Sciences and Nutrition, The Rowett Institute, University of Aberdeen, Foresterhill, Aberdeen, United Kingdom
| | - Patricia A. Harris
- Equine Studies Group, Waltham Petcare Science Institute, Leicestershire, United Kingdom
| | | | | | - Neil M. Burns
- Department of Rural Economy, Environment and Society, Scotland’s Rural College, Edinburgh, United Kingdom
| | - Madalina Neacsu
- School of Medicine, Medical Sciences and Nutrition, The Rowett Institute, University of Aberdeen, Foresterhill, Aberdeen, United Kingdom
| | - Wendy R. Russell
- School of Medicine, Medical Sciences and Nutrition, The Rowett Institute, University of Aberdeen, Foresterhill, Aberdeen, United Kingdom
| | - Dai Grove-White
- Faculty of Health and Life Sciences, University of Liverpool, Wirral, United Kingdom
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9
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Clark BL, Bamford NJ, Stewart AJ, McCue ME, Rendahl A, Bailey SR, Bertin FR, Norton EM. Evaluation of an HMGA2 variant contribution to height and basal insulin concentrations in ponies. J Vet Intern Med 2023; 37:1186-1192. [PMID: 37148171 DOI: 10.1111/jvim.16723] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 04/08/2023] [Indexed: 05/08/2023] Open
Abstract
BACKGROUND The HMGA2:c.83G>A variant was identified in Welsh ponies having pleiotropic effects on height and insulin concentration. OBJECTIVE Determine whether the HMGA2:c.83G>A variant is associated with decreased height and higher basal insulin concentrations across pony breeds. ANIMALS Two hundred thirty-six ponies across 6 breeds. METHODS Cross-sectional study. Ponies were genotyped for the HMGA2:c.83G>A variant and phenotyped for height and basal insulin concentrations. Stepwise regression was performed for model analysis using a linear regression model for height and mixed linear model for insulin with farm as a random effect. Coefficient of determination, pairwise comparison of the estimated marginal means and partial correlation coefficients (parcor) were calculated to assess the relationship between HMGA2 genotype and height or insulin. RESULTS Breed and genotype accounted for 90.5% of the variation in height across breeds, and genotype explained 21% to 44% of the variation within breeds. Breed, genotype, cresty neck score, sex, age, and farm accounted for 45.5% of the variation in insulin, with genotype accounting for 7.1%. The HMGA2 A allele frequency was 62% and correlated with both height (parcor = -0.39; P < .001) and insulin (parcor = 0.22; P = .02). Pairwise comparisons found A/A ponies were >10 cm shorter than other genotypes. Compared with G/G individuals, A/A and G/A individuals had 4.3 μIU/mL (95% confidence interval [CI]: 1.8-10.5) and 2.7 μIU/mL (95% CI: 1.4-5.3) higher basal insulin concentrations, respectively. CONCLUSIONS AND CLINICAL IMPORTANCE These data demonstrate the pleiotropic effects of the HMGA2:c.83G>A variant and its role in identifying ponies at increased risk for insulin dysregulation.
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Affiliation(s)
- Brianna L Clark
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia
| | - Nicholas J Bamford
- Melbourne Veterinary School, The University of Melbourne, Parkville, Victoria, Australia
| | - Allison J Stewart
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia
| | - Molly E McCue
- College of Veterinary Medicine, The University of Minnesota, St Paul, Minnesota, USA
| | - Aaron Rendahl
- College of Veterinary Medicine, The University of Minnesota, St Paul, Minnesota, USA
| | - Simon R Bailey
- Melbourne Veterinary School, The University of Melbourne, Parkville, Victoria, Australia
| | - François-René Bertin
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia
| | - Elaine M Norton
- College of Agricultural and Life Sciences, The University of Arizona, Tucson, Arizona, USA
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10
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McGowan CM, Ireland JL. Equine Endocrine Disease: Challenges With Case Definition for Research. J Equine Vet Sci 2023; 124:104491. [PMID: 37236726 DOI: 10.1016/j.jevs.2023.104491] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/06/2023] [Accepted: 04/12/2023] [Indexed: 05/28/2023]
Abstract
Equine endocrine disease is an important area for equine research, requiring an appropriate case definition for inclusion and criteria for exclusion from disease. Defining a case for research may be different from criteria for clinical diagnosis. Further, clinical diagnosis recommendations have been changing regularly, making this area challenging for equine scientists. This review discusses the diagnosis of major equine endocrine diseases, pituitary pars intermedia dysfunction, equine metabolic syndrome and insulin dysregulation, focusing on the most appropriate diagnostic methods for research case definitions. Different diagnostic methods, including use of reference intervals and clinical decision limits, will be discussed with their relative merits for use in case definition for research.
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Affiliation(s)
- Catherine M McGowan
- School of Veterinary Science, Institute of Infection, Ecological and Veterinary Sciences, the University of Liverpool, Neston, UK.
| | - Joanne L Ireland
- School of Veterinary Science, Institute of Infection, Ecological and Veterinary Sciences, the University of Liverpool, Neston, UK
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11
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Galinelli NC, Bailey SR, Bamford NJ, Harris PA. Nutritional considerations for the management of equine pituitary
pars intermedia
dysfunction. EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- N. C. Galinelli
- Melbourne Veterinary School The University of Melbourne Parkville Victoria Australia
| | - S. R. Bailey
- Melbourne Veterinary School The University of Melbourne Parkville Victoria Australia
| | - N. J. Bamford
- Melbourne Veterinary School The University of Melbourne Parkville Victoria Australia
| | - P. A. Harris
- Equine Studies Group Waltham Petcare Science Institute Melton Mowbray UK
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12
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Burns TA. "Feeding the Foot": Nutritional Influences on Equine Hoof Health. Vet Clin North Am Equine Pract 2021; 37:669-684. [PMID: 34674915 DOI: 10.1016/j.cveq.2021.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Nutrition plays an important role in equine health, including that of the foot. Deficiencies and excesses of dietary components can affect the growth and function of the foot and have been associated with important podiatric diseases. The recognition, prevention, and treatment of specific notable nutritional diseases of the foot are discussed, as well as information regarding specific ingredients included in supplements meant to improve equine hoof quality. Ensuring provision of a balanced diet, maintaining horses in appropriate body condition, and seeking guidance from an equine nutritionist when creating dietary recommendations will prevent most equine foot disease related to nutrition.
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Affiliation(s)
- Teresa A Burns
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, USA.
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13
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Macon EL, Harris P, Bailey S, Barker VD, Adams A. Postprandial insulin responses to various feedstuffs differ in insulin dysregulated horses compared with non-insulin dysregulated controls. Equine Vet J 2021; 54:574-583. [PMID: 34053111 DOI: 10.1111/evj.13474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/25/2021] [Accepted: 05/20/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Controlling postprandial hyperinsulinaemia is important in insulin dysregulated (ID) horses to reduce the risk of laminitis. OBJECTIVES To evaluate postprandial insulin responses of ID versus non-insulin dysregulated (NID) horses to feedstuffs varying in nonstructural carbohydrate (NSC) and crude protein (CP). STUDY DESIGN Randomised crossover. METHODS Eighteen adult mixed-breed horses (13.3 ± 2.2 years; 621 ± 78.8 kg) were individually fed [~1 g/kg body weight (BW)] specific feedstuffs within two crossover studies. Eight ID and eight NID were used in Study A, and 11 ID and 5 NID in Study B. In Study A, all horses were randomly fed once: cracked corn (CC: ~74% NSC & ~9% CP), ration balancer with low protein (RB-LP: ~15% NSC & ~17% CP), ration balancer with high protein (RB-HP: ~14% NSC and ~37% CP) and 50:50 mixture of RB-LP:RB-HP (MIX-P). In Study B, horses were randomly fed once: CC, RB-HP, steam-flaked corn (SF: ~73% NSC & ~10% CP), oat groats (OG: ~64% NSC & ~14% CP) and a low NSC pellet (L-NSC: ~6% NSC & ~12% CP). Blood was collected for insulin determination [radioimmunoassay (RIA)] before and 30, 60, 75, 90, 105, 120, 150, 180, 210 and 240-minute post-feeding in Study A and at 60-minute in Study B. Data were analysed via analysis of variance (ANOVA) for repeated measures after any required transformations. RESULTS ID horses had significantly greater insulin responses (AUCi) than NID for all diets in both studies (P < .001; ID 22 362 ± 10 298 µIU/mL/min & NID 6145 ± 1922 µIU/mL/min). No effect of diet on AUCi for NID (P = .2), but in ID, the CC (32 000 ± 13 960 µIU/mL/min) AUCi was higher than RB-LP (P = .01; 18 977 ± 6731 µIU/mL/min). ID insulin (T60) was lower for the L-NSC (57.8 ± 18.5 µIU/mL) versus all other diets (P < .02; 160.1 ± 91.5 µIU/mL). MAIN LIMITATIONS Small numbers of horses; no ponies. CONCLUSIONS NSC appears to be the main driver of the postprandial insulin response. ID horses respond disproportionately to feeding even small amounts of low/moderate NSC feedstuffs. Data on possible dietary thresholds for postprandial insulin responses cannot be extrapolated from NID horses.
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Affiliation(s)
- Erica L Macon
- Department of Veterinary Science, M. H. Gluck Equine Research Center, University of Kentucky, Lexington, KY, USA
| | - Patricia Harris
- Equine Studies Group, WALTHAM Petcare Science Institute, Leicestershire, UK
| | - Simon Bailey
- Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Parkville, Vic., Australia
| | - Virginia D Barker
- Department of Veterinary Science, M. H. Gluck Equine Research Center, University of Kentucky, Lexington, KY, USA
| | - Amanda Adams
- Department of Veterinary Science, M. H. Gluck Equine Research Center, University of Kentucky, Lexington, KY, USA
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Abstract
Equine obesity is common, reducing quality of life and requiring dietary energy restriction. Equine obesity is identified using subjective body condition scoring. Considerations are given for life stage and health status when managing obese equines. Every effort should be made to maximize feeding duration, and minimize time spent without feed while meeting all essential nutrient requirements. Limiting total daily dry matter intake to 2% of current bodyweight per day of a low caloric, forage-based diet may result in adequate body weight loss. Weight loss and weight management plans should be monitored for success and potential gastrointestinal, metabolic, and/or behavioral complications.
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15
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Lindåse S, Nostell K, Bergsten P, Forslund A, Bröjer J. Evaluation of fasting plasma insulin and proxy measurements to assess insulin sensitivity in horses. BMC Vet Res 2021; 17:78. [PMID: 33588833 PMCID: PMC7885592 DOI: 10.1186/s12917-021-02781-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 01/31/2021] [Indexed: 11/24/2022] Open
Abstract
Background Proxies are mathematical calculations based on fasting glucose and/or insulin concentrations developed to allow prediction of insulin sensitivity (IS) and β-cell response. These proxies have not been evaluated in horses with insulin dysregulation. The first objective of this study was to evaluate how fasting insulin (FI) and proxies for IS (1/Insulin, reciprocal of the square root of insulin (RISQI) and the quantitative insulin sensitivity check index (QUICKI)) and β-cell response (the modified insulin-to-glucose ratio (MIRG) and the homeostatic model assessment of β-cell function (HOMA-β)) were correlated to measures of IS (M index) using the euglycemic hyperinsulinemic clamp (EHC) in horses with insulin resistance (IR) and normal IS. A second objective was to evaluate the repeatability of FI and proxies in horses based on sampling on consecutive days. The last objective was to investigate the most appropriate cut-off value for the proxies and FI. Results Thirty-four horses were categorized as IR and 26 as IS based on the M index. The proxies and FI had coefficients of variation (CVs) ≤ 25.3 % and very good reliability (intraclass correlation coefficients ≥ 0.89). All proxies and FI were good predictors of the M index (r = 0.76–0.85; P < 0.001). The proxies for IS had a positive linear relationship with the M index whereas proxies for β-cell response and FI had an inverse relationship with the M index. Cut-off values to distinguish horses with IR from horses with normal IS based on the M index were established for all proxies and FI using receiver operating characteristic curves, with sensitivity between 79 % and 91 % and specificity between 85 % and 96 %. The cut-off values to predict IR were < 0.32 (RISQI), < 0.33 (QUICKI) and > 9.5 µIU/mL for FI. Conclusions All proxies and FI provided repeatable estimates of horses’ IS. However, there is no advantage of using proxies instead of FI to estimate IR in the horse. Due to the heteroscedasticity of the data, proxies and FI in general are more suitable for epidemiological studies and larger clinical studies than as a diagnostic tool for measurement of IR in individual horses.
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Affiliation(s)
- Sanna Lindåse
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Box 7054, 750 07, Uppsala, Sweden.
| | - Katarina Nostell
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Box 7054, 750 07, Uppsala, Sweden
| | - Peter Bergsten
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden
| | - Anders Forslund
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Johan Bröjer
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Box 7054, 750 07, Uppsala, Sweden
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16
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Olley RB, Carslake HB, Ireland JL, McGowan CM. Comparison of fasted basal insulin with the combined glucose-insulin test in horses and ponies with suspected insulin dysregulation. Vet J 2019; 252:105351. [PMID: 31554591 DOI: 10.1016/j.tvjl.2019.105351] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 07/31/2019] [Accepted: 07/31/2019] [Indexed: 01/23/2023]
Abstract
Fasting horses for measurement of basal serum insulin concentration (fasting insulin; FI) has been recommended to standardise testing for insulin dysregulation (ID), yet limited data exist comparing it to dynamic tests. This study aimed to compare FI with the combined glucose-insulin test (CGIT) in horses suspect for ID. We hypothesised that FI would have poor sensitivity for detecting ID compared to CGIT using conventional cut-offs. Records were retrieved from CGITs performed in horses fasted for approximately 8h. Serum insulin and glucose concentrations were measured before and for 150min following an IV bolus of glucose followed by insulin. Correlations between FI and CGIT values were assessed. Youden's index analysis was used to determine the optimal cut-off for FI. Logistic regression and Mann-Whitney U tests were used to determine factors affecting the results. CGITs (n=130) from 62 horses were evaluated. Compared to CGIT, sensitivity and specificity of FI for diagnosis of ID were 14.6% and 100% at a cut-off of 20μIU/mL and 63.4% and 87.2% at a cut-off of 5.2μIU/mL, respectively. FI was significantly correlated with insulin at 45min (rs=0.66) and 75min (rs=0.72); area under the curve for insulin (AUCinsulin; rs=0.67); glucose at 45min (rs=0.53); and AUCglucose (rs=0.50). Obesity was significantly associated with increased odds of a positive CGIT and horses with a positive CGIT were significantly older (P<0.05). In conclusion, FI correlated well with CGIT results and had adequate sensitivity and specificity at lower cut-offs, despite poor sensitivity at conventional cut-off values. Further research to derive cut-off values relevant to the fasting period is warranted.
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Affiliation(s)
- R B Olley
- Institute of Veterinary Science, Faculty of Health and Life Sciences, University of Liverpool, Leahurst, Cheshire CH64 7TE, UK
| | - H B Carslake
- Institute of Veterinary Science, Faculty of Health and Life Sciences, University of Liverpool, Leahurst, Cheshire CH64 7TE, UK
| | - J L Ireland
- Institute of Veterinary Science, Faculty of Health and Life Sciences, University of Liverpool, Leahurst, Cheshire CH64 7TE, UK
| | - C M McGowan
- Institute of Veterinary Science, Faculty of Health and Life Sciences, University of Liverpool, Leahurst, Cheshire CH64 7TE, UK.
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17
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MacLeod C. ECEIM consensus statement on equine metabolic syndrome. J Vet Intern Med 2019; 33:1123-1124. [PMID: 31001892 PMCID: PMC6524109 DOI: 10.1111/jvim.15501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 04/04/2019] [Indexed: 06/09/2023] Open
Affiliation(s)
- Clare MacLeod
- Independent Registered Equine Nutritionist, Stroud, United Kingdom
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18
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Durham AE, Frank N, McGowan CM, Menzies-Gow NJ, Roelfsema E, Vervuert I, Feige K, Fey K. Response to letter to editor regarding ECEIM consensus statement on equine metabolic syndrome. J Vet Intern Med 2019; 33:1125-1126. [PMID: 30990917 PMCID: PMC6524088 DOI: 10.1111/jvim.15503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 04/04/2019] [Indexed: 11/30/2022] Open
Affiliation(s)
| | - Nicholas Frank
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts
| | - Cathy M McGowan
- Institute of Veterinary Science, University of Liverpool, United Kingdom
| | - Nicola J Menzies-Gow
- Department of clinical sciences and services, Royal Veterinary College, Herts, United Kingdom
| | - Ellen Roelfsema
- Utrecht University, Department of Equine Sciences, Utrecht, The Netherlands
| | - Ingrid Vervuert
- Institute of Animal Nutrition, Nutrition Diseases and Dietetics, Faculty of Veterinary Medicine, University of Leipzig, Leipzig, Germany
| | - Karsten Feige
- Clinic for Horses, University of Veterinary Medicine Hannover, Hanover, Germany
| | - Kersten Fey
- Equine Clinic, Internal Medicine, Faculty of Veterinary Medicine, Justus-Liebig-University of Giessen, Giessen, Germany
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19
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Durham AE, Frank N, McGowan CM, Menzies-Gow NJ, Roelfsema E, Vervuert I, Feige K, Fey K. ECEIM consensus statement on equine metabolic syndrome. J Vet Intern Med 2019; 33:335-349. [PMID: 30724412 PMCID: PMC6430910 DOI: 10.1111/jvim.15423] [Citation(s) in RCA: 144] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 01/11/2019] [Indexed: 12/26/2022] Open
Abstract
Equine metabolic syndrome (EMS) is a widely recognized collection of risk factors for endocrinopathic laminitis. The most important of these risk factors is insulin dysregulation (ID). Clinicians and horse owners must recognize the presence of these risk factors so that they can be targeted and controlled to reduce the risk of laminitis attacks. Diagnosis of EMS is based partly on the horse's history and clinical examination findings, and partly on laboratory testing. Several choices of test exist which examine different facets of ID and other related metabolic disturbances. EMS is controlled mainly by dietary strategies and exercise programs that aim to improve insulin regulation and decrease obesity where present. In some cases, pharmacologic aids might be useful. Management of an EMS case is a long‐term strategy requiring diligence and discipline by the horse's carer and support and guidance from their veterinarians.
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Affiliation(s)
| | - Nicholas Frank
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts
| | - Cathy M McGowan
- Institute of Veterinary Science, University of Liverpool, Neston, United Kingdom
| | - Nicola J Menzies-Gow
- Department of clinical sciences and services, Royal Veterinary College, Herts, United Kingdom
| | - Ellen Roelfsema
- Department of Equine Sciences, Utrecht University, Utrecht, The Netherlands
| | - Ingrid Vervuert
- Faculty of Veterinary Medicine, University of Leipzig, Institute of Animal Nutrition, Nutrition Diseases and Dietetics, Leipzig, Germany
| | - Karsten Feige
- Clinic for Horses, University of Veterinary Medicine Hannover, Germany
| | - Kerstin Fey
- Equine Clinic, Internal Medicine, Faculty of Veterinary Medicine, Justus-Liebig-University of Giessen, Giessen, Germany
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