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Topic:Metabolic Health

Metabolic health in horses refers to the physiological processes that manage energy production, utilization, and storage in equine bodies. These processes are critical for maintaining overall health, performance, and well-being. Metabolic health encompasses various aspects, including glucose metabolism, insulin sensitivity, and lipid regulation. Conditions such as Equine Metabolic Syndrome (EMS) and insulin dysregulation are common metabolic disorders that affect horses, impacting their ability to process and store energy efficiently. This topic compiles peer-reviewed research studies and scholarly articles that explore the mechanisms, diagnostic approaches, and management strategies related to metabolic health in horses.
Pituitary Pars Intermedia Dysfunction.
The Veterinary clinics of North America. Equine practice    September 1, 2026   S0749-0739(26)00059-3 doi: 10.1016/j.cveq.2026.07.012
Vaughn SA, Hart KA.Pituitary pars intermedia dysfunction (PPID) is one of the most common equine endocrine disorders. It is caused by oxidative damage to dopaminergic neurons in the hypothalamus and results in loss of inhibition of the pituitary pars intermedia. This leads to increased circulating concentrations of adrenocorticotropic hormone (ACTH) and related peptides. Diagnosis is based on increased resting and/or thyrotropin releasing hormone-stimulated ACTH concentrations. Assessment of insulin regulation is also important, as insulin dysregulation occurs in at least one-third of PPID cases and is associate...
Icterus in a 3-day-old Quarter Horse foal.
Journal of the American Veterinary Medical Association    August 26, 2026   1-3 doi: 10.2460/javma.26.06.0489
Lewis E, Badial P.No abstract available
High molecular weight adiponectin as an adjunct biomarker for insulin dysregulation in equids.
Journal of veterinary internal medicine    August 26, 2026   Volume 40, Issue 4 aalag186 doi: 10.1093/jvimsj/aalag186
de Laat MA, Fitzgerald DM, Li FI, Sillence MN, McGree JM.Total adiponectin concentration is associated with hyperinsulinemia and laminitis risk in ponies but the high molecular weight (HMW) multimer is a more sensitive indicator of metabolic disease in other species and could be a useful biomarker for insulin dysregulation (ID). Objective: To determine a cut-off value for using HMW adiponectin as an adjunct diagnostic tool for ID. Methods: Cohort of 127 privately and university-owned horses and ponies of various breeds with 55 classified as ID positive and 72 as ID negative. Methods: Cohort study. Baseline and postprandial blood samples from an in-f...
Adaptive variation in butyrylcholinesterase-influenced lipid metabolism during horse domestication.
Cell reports    August 20, 2026   Volume 45, Issue 9 117879 doi: 10.1016/j.celrep.2026.117879
Zhang Y, Liu X, Wang X, Yu Y, Jia Y, Pu Y, Ma Y, Orlando L, Jiang L.Lipid metabolism influences horse athletic performance, yet its genetic basis remains unclear. Here, we investigate the genetic basis of lipid metabolic traits by quantifying key metabolic parameters and sequencing the genomes of 298 horses. We identify a missense mutation (ECA19:9,198,989, G>C) in the BCHE gene that is strongly associated with lipid metabolism, especially butyrylcholinesterase (BChE) activity. The "C" allele is associated with increased BChE activity and reduced intracellular triglyceride levels, hepatic adiposity, and overall fat mass, highlighting a central role for BCHE in...
In Vivo Metabolite Formation and In Vitro Cytochrome P450-Mediated Metabolism of Vonoprazan in Horses.
Metabolites    August 18, 2026   Volume 16, Issue 8 584 doi: 10.3390/metabo16080584
Morales CJ, Mckemie DS, Neupane JB, Knych HK. Vonoprazan is a potassium-competitive acid blocker with potential for the treatment of equine gastric ulcer syndrome. Vonoprazan metabolic pathways in horses have not been characterized. This study aimed to identify vonoprazan metabolites following oral administration and to determine the metabolic enzymes responsible for their metabolism using in vitro models. Six healthy adult Thoroughbred horses received vonoprazan (0.5 and 1 mg/kg PO) in a randomized crossover design. Plasma concentrations of vonoprazan-N-oxide (M-I) and vonoprazan-nitrone (M-III) were quantified using a validated liquid...
Energy Metabolism Dysregulation in Horses and Foals.
The Veterinary clinics of North America. Equine practice    August 12, 2026   S0749-0739(26)00052-0 doi: 10.1016/j.cveq.2026.07.005
Hostnik LD.Dysregulation of energy metabolism occurs in horses and foals with transient systemic illness, malnutrition, or chronic metabolic diseases. The pathophysiologic processes resulting in energy dysregulation are important to interpret, understand, and appropriately monitor laboratory abnormalities associated with various disease states (hypoglycemia and hyperglycemia), as well as to aid in the management of energy dysregulation through nutritional and medical management.
Infrared Thermographic Assessment of Exercise-Induced Changes in Local Surface Temperature in Horses Following Treadmill Training: Preliminary Findings.
Animals : an open access journal from MDPI    August 12, 2026   Volume 16, Issue 16 2517 doi: 10.3390/ani16162517
Physical exercise induces physiological adaptations associated with increased muscular activity, metabolic heat production, and changes in body surface temperature. Infrared thermography has emerged as a non-invasive technique for assessing these thermal responses in horses. The present study aimed to evaluate the ability of infrared thermography to detect changes in mean local surface temperature and to qualitatively assess alterations in thermal distribution patterns following treadmill exercise. Methods: Three clinically healthy Warmblood horses were monitored over 10 consecutive training s...
Body Condition, Metabolic Parameters and Semen Traits in Purebred Spanish Horses.
Animals : an open access journal from MDPI    August 1, 2026   Volume 16, Issue 15 2347 doi: 10.3390/ani16152347
Latorre N, Gómez-Cuétara C, Cañizares E, Crespo F, Pérez-Aguilera V, Laborda-Gomariz JÁ, Soler AJ, Sanchez-Rodriguez A, Roldan ERS.The growing relevance of the Purebred Spanish horse has driven the extensive use of assisted reproductive technologies to preserve elite stallion genetics. Optimal reproductive performance is intrinsically linked to systemic health and high semen quality. This study aimed to evaluate the impact of body condition on the stallion's metabolic and endocrine profiles and their seminal parameters. Semen and blood samples were collected from 26 stallions (February-May in 2024-2025) whose body condition score (BCS) was assessed using the Henneke scale. They were classified into two groups, low BCS wit...
Hypothalamic-pituitary-adrenal axis response and glucose homeostasis during exercise to fatigue before and after training in old and young adult Standardbred mares.
Journal of equine veterinary science    July 28, 2026   106103 doi: 10.1016/j.jevs.2026.106103
Liburt NR, Herbst AC, Malinowski K, McKeever KH.While reduced cortisol responses to exercise have been described in older horses, the effects of aging and training on the hypothalamic-pituitary-adrenal axis (HPA axis) and downstream metabolic signaling are currently unknown. Unassigned: This study tested the hypothesis that age and exercise training alter the response of the HPA axis, insulin, and glucose during an acute exercise challenge to fatigue. Methods: Six old (22.0±0.7 years) and six young adult (7.3±0.6 years) unfit Standardbred mares were tested. Mares ran a graded exercise test before (GXT1) and after (GXT2) 8 weeks of trainin...
Evaluation of an Immunoturbidometric Assay for Measurement of Total Adiponectin Concentration in Equine Serum Samples.
Veterinary clinical pathology    July 22, 2026   doi: 10.1111/vcp.70118
Nolen-Walston RD, Lowndes CR, Kulp JC, Luethy D, Stefanovski D, Van Eps AW.Total adiponectin (TA) is a marker of metabolic health in equids, with values below a critical decision point of < 7.9 μg/mL conferring increased risk of laminitis. Objective: To evaluate an IT assay to measure serum [TA] in equids and to assess its correlation with [high molecular weight adiponectin] (HMWA) measured by ELISA. Methods: Total serum adiponectin concentrations from 207 adult horses were measured using both an IT assay for TA and HMWA using a previously validated ELISA assay. Data were analyzed using Spearman correlation and Passing-Bablok regression. Intra- and inter-assa...
Preliminary investigation of ghrelin in horses and ponies: receptor expression and associations with prandial state, morphometry and signalment.
BMC veterinary research    July 9, 2026   doi: 10.1186/s12917-026-05700-8
Andrews KE, Smith HL, Spence RJ, Sillence MN, de Laat MA.The hormone ghrelin has had limited attention in Equidae, despite connections with appetite and metabolic health in other species. Ghrelin influences hunger and food intake, energy expenditure and storage, glucose metabolism, and thermoregulation, through its receptor-mediated effects on tissues and via interaction with other hormones. There are two circulating forms, acylated and des-acylated ghrelin, considered to have distinct effects on metabolism in other species. The aims of this study were to confirm the presence of ghrelin receptors in equine tissues, to validate an assay for the measu...
Circulating microRNAs as potential predictive biomarkers of equine metabolic syndrome.
Veterinary journal (London, England : 1997)    July 5, 2026   106764 doi: 10.1016/j.tvjl.2026.106764
Espinosa-López EM, Ortiz-Guisado B, Rangel-Zúñiga OA, López-Lozano A, Diez de Castro E, Aguilera-Tejero E, Gómez-Baena G.Equine Metabolic Syndrome (EMS) is a complex endocrine disorder characterized by insulin dysregulation (ID), and an increased risk of developing laminitis, often accompanied by generalized or regional adiposity. Despite growing awareness of EMS, early and accurate diagnosis remains challenging. In this pilot study, we investigated changes in the levels of circulating microRNAs (miRNAs) in plasma samples from horses diagnosed with EMS (n=13), compared to overweight/obese (OW/OB) non-ID horses (n=16) and healthy controls (n=16). Using a targeted OpenArray, followed by a Kruskal-Wallis and Dunn's...
Conserved skeletal muscle transcriptomic responses to pacing strategies in Thoroughbred horses.
Biology open    July 3, 2026   bio.062724 doi: 10.1242/bio.062724
Takahashi K, Mukai K, Shirai T, Ebisuda Y, Sugiyama F, Yoshida T, Hatta H, Kitaoka Y.This study investigated whether different pacing patterns during high-intensity exercise elicit distinct transcriptional responses in equine skeletal muscle. Eight Thoroughbred horses completed two treadmill exercise sessions in a randomized crossover design. In the positive-pacing condition, horses exercised at 110% maximal O₂ uptake (V˙O₂max) for 1 min followed by 90% V˙O₂max for 1 min, whereas in the negative-pacing condition, the order was reversed. At 4 h after exercise, the positive-pacing protocol resulted in upregulation of 1,989 genes and downregulation of 840 genes, whereas t...
Circulating Elements in the Bloodstream of Growing Foals: Focus on Heavy Metals and Bone Remodeling Across Growth Stages.
Biological trace element research    June 19, 2026   doi: 10.1007/s12011-026-05186-3
Hulitká D, Coradduzza D, Sanna A, Biggio GP, Taras A, Cannas A, Carru C, Medici S, Cherchi R, Cappai MG.Bone tissue undergoes continuous remodelling throughout the life of the individual, and growth is the most impacting phase. In fact, tightly coordinated processes of resorption, synthesis, and mineralization of the bone matrix under systemic hormonal, biomechanical, and metabolic control occur for variable periods of time across species. The horse is a fast-growing animal and for this reason identified as precocial. It was hypothesized that blood serum levels of minerals in growing foals at different stages of accretion may vary over time. This investigation aimed to assess the dynamics of cir...
Mitochondrial Adaptations to Exercise Training in Equine Skeletal Muscle: A Narrative Review.
Life (Basel, Switzerland)    June 16, 2026   Volume 16, Issue 6 1008 doi: 10.3390/life16061008
The horse represents one of the most physiologically specialized athletic mammals, capable of sustaining both high-intensity and prolonged exercise. Central to this remarkable performance capacity is the metabolic adaptability of skeletal muscle and its mitochondrial network. This narrative review synthesizes current evidence from equine, human, and rodent studies on exercise-induced mitochondrial remodeling in equine skeletal muscle. A comprehensive literature search was conducted across PubMed, Web of Science, and Scopus using terms related to equine exercise physiology, mitochondrial biolog...
Serum adipokines are useful for predicting hyperinsulinemia secondary to corticosteroid treatment in horses.
American journal of veterinary research    June 11, 2026   1-9 doi: 10.2460/ajvr.26.03.0123
van Eps AW, Bertin FR, Stefanovski D.To evaluate pretreatment biomarkers for predicting the severity of corticosteroid-induced hyperinsulinemia. Unassigned: Oral glucose tests were performed before (day 1) and after (day 8) a dexamethasone course (0.08 mg/kg, q 48 h) in 24 healthy adult Standardbreds. Associations between day 8 oral glucose test insulin parameters (baseline [T0insulin], maximal [Cmaxinsulin], and area under the curve [AUCinsulin]) and day 1 serum markers (insulin, glucose, adiponectin, leptin, and their ratios) were examined using Spearman correlation, log-linked generalized linear models. Relative risk of exceed...
Effect of Antioxidant Supplementation on Systemic Oxidative Status in Breeding Stallions During Intensive Semen Collection.
Animals : an open access journal from MDPI    June 11, 2026   Volume 16, Issue 12 1804 doi: 10.3390/ani16121804
Del Prete C, Ruggiero A, Longobardi C, Cutrignelli MI, Vastolo A.Breeding stallions are subjected to increased metabolic and physiological demands during the reproductive season, which may lead to enhanced production of reactive oxygen species and disruption of redox balance. The present study evaluated the effects of dietary antioxidant supplementation on oxidative status, metabolic profile, and hindgut fermentation in stallions undergoing intensive semen collection activity. Ten adult breeding stallions were assigned either to a control group or to a treatment group receiving a commercial antioxidant supplement (Oxyliver) for 60 days, followed by a 60-day...
Metabolic effects and pharmacokinetics of oral cannabidiol (CBD) in Connemara ponies following 21 days of treatment.
Frontiers in veterinary science    May 14, 2026   Volume 13 1813917 doi: 10.3389/fvets.2026.1813917
Wermer K, Berkecz R, Ilisz I, Csupor D, Ágh N, Sztojkov-Ivanov A, Cserhalmi D, Jerzsele Á, Korbacska-Kutasi O.Cannabidiol (CBD) has gained interest in equine medicine due to its potential therapeutic effects. Preclinical studies suggest that CBD may influence metabolic pathways relevant to metabolic syndrome, which present in both human and equine populations. The aim of this study was to evaluate the effects of oral CBD on metabolic parameters in Connemara ponies and to characterize its pharmacokinetics. Unassigned: A total of 13 Connemara ponies [seven with equine metabolic syndrome (EMS)] were stratified by EMS status and age and randomly assigned to a CBD-treated group (2 mg/kg orally, twice dai...
Short-term clinical responses in horses and ponies treated with canagliflozin: A clinical field study.
Equine veterinary journal    May 10, 2026   doi: 10.1002/evj.70181
Hällbom M, Lindåse ST, Wartel M, Bröjer J.Treatment with the sodium-glucose co-transporter 2 (SGLT2) inhibitor canagliflozin in insulin dysregulated (ID) horses has shown promising results in randomised clinical trials. Larger field studies are needed to further evaluate treatment responses and potential adverse effects under real-world conditions. Objective: To assess the short-term effects of canagliflozin on postprandial glucose and insulin responses in client-owned horses and ponies with ID using a single-sample feed-challenge test (FCT), and to characterise treatment-associated changes in bodyweight, liver enzyme activities, and ...
Integrating clinical and rna-seq findings in a mare with recurrent endocrinopathic laminitis linked to equine metabolic syndrome.
Journal of equine veterinary science    April 22, 2026   Volume 163 105906 doi: 10.1016/j.jevs.2026.105906
Isgrigg J, Marchio S, Brown H, Norton P, Boakari YL, Macon E.Equine metabolic syndrome (EMS) is characterized by insulin dysregulation and obesity, which increase the risk of the development of hyperinsulinemia-induced laminitis (HAL). The present report describes a case of severe endocrinopathic laminitis associated with EMS, refractory to treatment. A 5-year-old mare with recurrent HAL presented transient relief upon a low nonstructural carbohydrate diet and conventional therapy. An SGLT2 inhibitor was introduced to reduce resting insulin levels, and improvement was observed until October 2024, when the most severe episode started. Despite adding perg...
Evaluation of the tolerance and effects of 1-deoxynojirimycin on insulin and glucose dynamics in healthy horses and horses at risk for insulin dysregulation.
Journal of veterinary internal medicine    April 21, 2026   Volume 40, Issue 2 aalag074 doi: 10.1093/jvimsj/aalag074
Whitfield-Cargile C, Coleman M, Hart K, Gomes D, Berghaus L, Duberstein KJ, Ellis K, Tinkle A, Shirzad R.Insulin dysregulation (ID) is common and diminishes welfare of horses. Current management relies on diet and exercise, with variable responses and limited medical options. Alpha-glucosidase inhibitors (AGIs) might provide adjunctive therapy. Objective: To evaluate the tolerance and effects of Reducose®, a Morus alba leaf extract standardized to 5% 1-deoxynojirimycin (DNJ), in healthy horses and horses at risk of ID. We hypothesized DNJ would be well-tolerated and reduce insulin responses to oral sugar tests (OSTs). Methods: Twenty-seven horses: 6 healthy (Phase I), 5 at risk for ID (Phase II)...
Integrative Phosphoproteomic Profiling Reveals Stage-Specific Signalling and Metabolism in Equine Melanocytic Neoplasm.
Veterinary and comparative oncology    April 16, 2026   doi: 10.1111/vco.70070
Srimontri P, Kingkaw A, Prapaiwan N, Sujittosakul R, Iamkaewprasert N, Piputwat J, Isama-Al P, Munkongdee T, Chotikaprakal T, Yanyongsirikarn P....Equine melanocytic neoplasms (EMN) are aggressive tumours characterised by high metastatic potential and limited therapeutic options available. However, the molecular mechanisms underlying their progression remain poorly understood. This study therefore presents the integrative phosphoproteomic analysis of EMN tissue, with the aim of elucidating stage-specific alterations in signalling pathways and metabolism. Nineteen tissue samples from grey horses were categorised as normal-stage (n = 6), early-stage EMN (n = 7), and severe-stage EMN (n = 6) and subjected to in-depth analysis us...
Proteomic Insights into the Mechanism by Which Ferulic Acid Promotes Skeletal Muscle Fiber Type Conversion in Mongolian Horses.
Biology    March 18, 2026   Volume 15, Issue 6 481 doi: 10.3390/biology15060481
Gong W, Ding W, Bou T, Shi L, Lin Y, Shi X, Li Z, Wu H, Dugarjaviin M, Bai D.Ferulic acid is a bioactive phenolic compound with potential benefits for skeletal muscle health. In this study, Mongolian horses were used as experimental subjects and were orally administered ferulic acid at doses of 5, 10, or 15 g per horse per day for 40 consecutive days. Muscle biopsy samples were analyzed using proteomics to assess fiber type composition and regulatory protein expression. Ferulic acid supplementation increased the proportion of fast-twitch fibers and upregulated key differentiation factors such as MUSTN1, while modulating glycolysis, ECM remodeling, and calcium signaling...
Equine models in translational medicine: A comparative approach to human health.
Animal models and experimental medicine    March 16, 2026   doi: 10.1002/ame2.70180
Boozarjomehri Amnieh S, Ropka-Molik K.The horse is a distinctive translational model for bridging mechanistic discovery and clinically relevant investigation because of its physiological complexity, long lifespan, athletic phenotype, and broad spectrum of naturally occurring conditions that parallel aspects of human health and disease. Its utility extends from musculoskeletal and joint research to immunology, metabolic disorders, and exercise physiology, particularly where naturally developed disease, clinically applicable imaging, and longitudinal sampling are required. Additionally, it offers opportunities to examine both chroni...
Treatment with ertugliflozin mitigates the hyperinsulinemic response to intra-articular triamcinolone acetonide.
Equine veterinary journal    February 1, 2026   doi: 10.1002/evj.70150
Page AE, McPeek JL, McGreevy E, Carattini S, Adam EN.Intra-articular (IA) corticosteroids can cause hyperinsulinemia, which can subsequently increase the risk of laminitis, particularly in horses with insulin dysregulation (ID). Sodium glucose cotransporter 2 inhibitors (SGLT2i), a drug class that is being utilised more commonly in horses with insulin dysregulation, could potentially be used to control post-IA corticosteroid hyperinsulinemia. Objective: To determine whether treatment with the SGLT2i drug ertugliflozin decreases hyperinsulinemia following intra-articular corticosteroid administration in metabolically normal horses. Methods: Prosp...
Integrated targeted metabolomics and transcriptomics analysis reveals heterogeneity of subcutaneous and pericardial adipose tissues in Yili horses.
Food chemistry. Molecular sciences    January 26, 2026   Volume 12 100365 doi: 10.1016/j.fochms.2026.100365
Yang L, Shen Z, Song L, Lu Z, Zeng Y, Wang J, Ren W, Yao X, Meng J.Fat deposition is a key economic trait in livestock, yet distinct adipose depots often display marked functional heterogeneity. The molecular basis underlying this divergence in Yili horses, however, remains poorly understood. Therefore, we hypothesized that the heterogeneity in fatty acid composition between subcutaneous (SAT) and pericardial adipose tissues (PCAT) in Yili horses is associated with distinct transcriptional programs, which can be explored using an integrated multi-omics approach. Using targeted metabolomics, we found that PCAT contained significantly higher levels of total, sa...
The Effect of Seasonal Changes in Non-Structural Carbohydrates in Pasture on the Metabolic Profile of Horses with Laminitis.
Animals : an open access journal from MDPI    January 15, 2026   Volume 16, Issue 2 267 doi: 10.3390/ani16020267
Mlyneková E, Zaťko S, Halo M, Imrich I, Halo M.This study aimed to examine the seasonal dynamics of non-structural carbohydrates in pasture and their relationship to metabolic indicators in horses with a history of laminitis. Thirty Hucul mares were divided into a laminitis group (LG, = 15) and a control group (CG, = 15). Insulin, glucose, fructosamines concentrations and body weight were monitored during four sampling periods (S0-S3), while pasture variables were analyzed during three periods (S1-S3). The concentration of water-soluble carbohydrates was highest in May (126.8 g/kg DM) and measured lower in October (57.9 g/kg DM), while s...
Metabolomics of stallion seminal plasma: Identification of potential fertility biomarkers based on differences between high and low pregnancy stallions.
Journal of equine veterinary science    January 6, 2026   Volume 158 105780 doi: 10.1016/j.jevs.2026.105780
Bueno VLC, Bastos HBA, Centeno LAM, Schmitt F, Larentis G, Mattos RC, Fiala-Rechsteiner S.The seminal plasma (SP), a fluid originating from the testes, epididymis, and accessory sex glands, represents 98 % of the volume of stallion ejaculate. Metabolomic analysis enables the identification of final products of metabolic pathways, providing insights into reproductive physiology. Objective: This study aimed to investigate the metabolomic profile of stallion seminal plasma and to investigate metabolic differences between stallions with high and low pregnancy rates, in order to identify potential biomarkers associated with fertility. Methods: Twenty-four Criollo stallions, were sampled...
Single-cell metabolic profiling of stallion spermatozoa by flow cytometry using NADH and FAD autofluorescence†.
Biology of reproduction    January 5, 2026   Volume 114, Issue 6 2023-2036 doi: 10.1093/biolre/ioaf294
Becerro-Rey L, Martín-Cano FE, Ortega-Ferrusola C, da Silva-Álvarez E, Tapia JA, Gil MC, Peña FJ.The metabolic activity of stallion spermatozoa was assessed using flow cytometry to detect NAD(P)H and FAD fluorescence without labels. Sperm were incubated with different energy sources-glucose, lactate, and pyruvate-individually or combined, and measurements of NAD(P)H, FAD, NAD(P)H/FAD ratio, and optical redox ratio (ORR) were taken. Additionally, a metabolic assay based on resazurin reduction and flow cytometry detection was developed. Changes in NAD(P)H and FAD fluorescence, the NAD(P)H/FAD ratio, and ORR were observed. The NAD(P)H/FAD ratio increased significantly, especially when glucos...
Exercise-specific plasma proteomic signatures in racehorses: Candidates for training adaptation and peak load monitoring.
Equine veterinary journal    December 29, 2025   doi: 10.1002/evj.70146
Grzędzicka J, Świderska B, Sitkiewicz E, Dąbrowska I, Witkowska-Piłaszewicz O.Racehorses undergo profound physiological changes with training and competition, but current biomarkers inadequately capture the complex molecular dynamics of exercise. This study aimed to identify novel plasma biomarkers of training adaptation and peak load using high-throughput proteomics. Objective: We hypothesised that systematic training and racing induce distinct plasma proteomic signatures, enabling the discovery of candidate biomarkers linked to training status, oxidative stress, inflammation and metabolic remodelling. Methods: In vivo longitudinal study. Methods: Forty-nine Arabian an...
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