{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T18:49:30Z","timestamp":1791226170139,"version":"4.1.0"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"vor","delay-in-days":2347,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,8,20]],"date-time":"2019-08-20T00:00:00Z","timestamp":1566259200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Raymond Firestone Trust Research Grant"},{"name":"Tamworth Research Fund"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The use of parallel dynamic tests to identify insulin dysregulation (ID) and pituitary pars intermedia dysfunction (PPID) in horses could have better diagnostic utility than measuring baseline hormone concentrations, if the tests do not alter diagnostic interpretation of one another.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Hypothesis<\/jats:title>\n                    <jats:p>Performing a thyrotropin-releasing hormone (TRH) stimulation test before an oral sugar test (OST) would not affect results of OST.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Animals<\/jats:title>\n                    <jats:p>Twenty-six healthy university-owned horses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective randomized placebo-controlled, crossover design was used to evaluate 3 OST protocols: OST alone, TRH followed by OST (TRH\u2009+\u2009OST), and placebo followed by OST (placebo\u2009+\u2009OST). Agreement for plasma insulin concentrations and diagnostic interpretation were assessed with Bland-Altman and logistic regression analyses, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Bland-Altman analysis of TRH\u2009+\u2009OST versus OST alone showed good agreement between testing protocols, with bias \u00b1 SD for insulin concentrations at baseline 0.4\u2009\u00b1\u20094.7 \u03bcIU\/mL (95% limits of agreement [LOA], \u22128.8 to 9.7), 60\u2009minute \u22120.5\u2009\u00b1\u200922.6 \u03bcIU\/mL (95% LOA, \u221244.7 to 43.8), and 90\u2009minute 1.9\u2009\u00b1\u200920.6 \u03bcIU\/mL (95% LOA, \u221238.5 to 42.4) after OST, similar to placebo\u2009+\u2009OST versus OST alone. Diagnostic interpretation (positive\/negative) was not different between protocols (TRH\u2009+\u2009OST versus OST alone [P = .78], placebo\u2009+\u2009OST versus OST alone [P = .77], or TRH\u2009+\u2009OST versus placebo\u2009+\u2009OST [P = .57]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Clinical Importance<\/jats:title>\n                    <jats:p>Concurrent testing for PPID and ID with a TRH stimulation test before an OST is an acceptable diagnostic tool for investigation of endocrinopathies in horses and allows accurate testing to be performed efficiently in 1 visit.<\/jats:p>\n                  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