{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T10:04:50Z","timestamp":1789639490109,"version":"4.0.0"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,9,5]],"date-time":"2016-09-05T00:00:00Z","timestamp":1473033600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"The Mellon Fund"},{"name":"WALTHAM"}],"content-domain":{"domain":["beva.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Equine Veterinary Journal"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      It is recommended that the oral sugar test (\n                      <jats:styled-content style=\"fixed-case\">OST<\/jats:styled-content>\n                      ) for insulin dysregulation (\n                      <jats:styled-content style=\"fixed-case\">ID<\/jats:styled-content>\n                      ) be performed after an overnight fast, but fasting is impractical in ponies kept solely at pasture. There are few data on\n                      <jats:styled-content style=\"fixed-case\">OST<\/jats:styled-content>\n                      repeatability and reliability in ponies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      To report 1) whether\n                      <jats:styled-content style=\"fixed-case\">OST<\/jats:styled-content>\n                      results obtained in the morning after an overnight fast or without fasting in the afternoon (\n                      <jats:styled-content style=\"fixed-case\">FASTING<\/jats:styled-content>\n                      \/\n                      <jats:styled-content style=\"fixed-case\">FED<\/jats:styled-content>\n                      ) can be used interchangeably, 2) time of highest insulin concentration\n                      <jats:italic>T<\/jats:italic>\n                      <jats:sub>max<\/jats:sub>\n                      [insulin], repeatability and reliability of insulin response to the\n                      <jats:styled-content style=\"fixed-case\">OST<\/jats:styled-content>\n                      when\n                      <jats:styled-content style=\"fixed-case\">FASTING<\/jats:styled-content>\n                      or\n                      <jats:styled-content style=\"fixed-case\">FED<\/jats:styled-content>\n                      and 3) dichotomous agreement (\n                      <jats:styled-content style=\"fixed-case\">ID<\/jats:styled-content>\n                      \/normal) within a small sample when\n                      <jats:styled-content style=\"fixed-case\">FASTING<\/jats:styled-content>\n                      or\n                      <jats:styled-content style=\"fixed-case\">FED<\/jats:styled-content>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study design<\/jats:title>\n                    <jats:p>Method comparison study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Oral sugar tests were performed on four occasions in 10 adult native British ponies, twice\n                      <jats:styled-content style=\"fixed-case\">FASTING<\/jats:styled-content>\n                      and twice\n                      <jats:styled-content style=\"fixed-case\">FED<\/jats:styled-content>\n                      . Insulin concentrations were measured by radioimmunoassay at 0\u2013120 min (\n                      <jats:italic>T<\/jats:italic>\n                      <jats:sub>0,30,60,75,90,120<\/jats:sub>\n                      ). Differences between\n                      <jats:styled-content style=\"fixed-case\">FASTING<\/jats:styled-content>\n                      and\n                      <jats:styled-content style=\"fixed-case\">FED<\/jats:styled-content>\n                      results were assessed using mixed effects models. Indices of repeatability and reliability were calculated; dichotomous agreement was reported using kappa statistics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Serum [insulin] was significantly (P\u22640.05) higher at\n                      <jats:italic>T<\/jats:italic>\n                      <jats:sub>60<\/jats:sub>\n                      \u2013\n                      <jats:italic>T<\/jats:italic>\n                      <jats:sub>90<\/jats:sub>\n                      with prior fasting (estimated differences [95% confidence intervals]):\n                      <jats:italic>T<\/jats:italic>\n                      <jats:sub>60<\/jats:sub>\n                      : 23.5\n                      <jats:italic>\u03bc<\/jats:italic>\n                      iu\/ml (8.7\u201338.4\n                      <jats:italic>\u03bc<\/jats:italic>\n                      iu\/ml),\n                      <jats:italic>T<\/jats:italic>\n                      <jats:sub>75<\/jats:sub>\n                      : 27.1\n                      <jats:italic>\u03bc<\/jats:italic>\n                      iu\/ml (12.3\u201341.8\n                      <jats:italic>\u03bc<\/jats:italic>\n                      iu\/ml),\n                      <jats:italic>T<\/jats:italic>\n                      <jats:sub>90<\/jats:sub>\n                      : 15.1 (0.36\u201329.9\n                      <jats:italic>\u03bc<\/jats:italic>\n                      iu\/ml). Most frequently,\n                      <jats:italic>T<\/jats:italic>\n                      <jats:sub>max<\/jats:sub>\n                      [ins] occurred at\n                      <jats:italic>T<\/jats:italic>\n                      <jats:sub>30<\/jats:sub>\n                      . At any single time point, within\u2010subject coefficients of variation were:\n                      <jats:styled-content style=\"fixed-case\">FASTING<\/jats:styled-content>\n                      : 40% and\n                      <jats:styled-content style=\"fixed-case\">FED<\/jats:styled-content>\n                      : 31%. The 95% limits for repeatability were\n                      <jats:styled-content style=\"fixed-case\">FASTING<\/jats:styled-content>\n                      : 29\u2013340%,\n                      <jats:styled-content style=\"fixed-case\">FED<\/jats:styled-content>\n                      : 41\u2013240%. Test reliabilities were\n                      <jats:styled-content style=\"fixed-case\">FASTING<\/jats:styled-content>\n                      : 0.70 and\n                      <jats:styled-content style=\"fixed-case\">FED<\/jats:styled-content>\n                      : 0.67. For dichotomous interpretation similar results (kappa = 0.7) were obtained using cut\u2010offs of [Insulin] &gt;60\n                      <jats:italic>\u03bc<\/jats:italic>\n                      iu\/ml at\n                      <jats:italic>T<\/jats:italic>\n                      <jats:sub>60<\/jats:sub>\n                      or\n                      <jats:italic>T<\/jats:italic>\n                      <jats:sub>90<\/jats:sub>\n                      for\n                      <jats:styled-content style=\"fixed-case\">FASTING<\/jats:styled-content>\n                      and [Insulin] &gt;51\n                      <jats:italic>\u03bc<\/jats:italic>\n                      iu\/ml at\n                      <jats:italic>T<\/jats:italic>\n                      <jats:sub>30<\/jats:sub>\n                      or\n                      <jats:italic>T<\/jats:italic>\n                      <jats:sub>60<\/jats:sub>\n                      for\n                      <jats:styled-content style=\"fixed-case\">FED<\/jats:styled-content>\n                      samples.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main limitations<\/jats:title>\n                    <jats:p>Oral sugar tests were performed on a small number of animals on one pasture during one season (spring).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Clinicians should beware of interpreting changes in absolute\n                      <jats:styled-content style=\"fixed-case\">OST<\/jats:styled-content>\n                      results owing to poor repeatability. When stabling is unavailable,\n                      <jats:styled-content style=\"fixed-case\">OST<\/jats:styled-content>\n                      s of ponies at pasture may yield similar dichotomous results without prior fasting.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/evj.12607","type":"journal-article","created":{"date-parts":[[2016,7,6]],"date-time":"2016-07-06T04:13:25Z","timestamp":1467778405000},"page":"519-524","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Use of the oral sugar test in ponies when performed with or without prior fasting"],"prefix":"10.1111","volume":"49","author":[{"given":"E. J.","family":"Knowles","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences and Services Royal Veterinary College London UK"},{"name":"Bell Equine Veterinary Clinic Mereworth Kent UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. 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