Analyze Diet

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.
Clustering and Correlations amongst NEFA, Selected Adipokines and Morphological Traits-New Insights into Equine Metabolic Syndrome.
Animals : an open access journal from MDPI    October 20, 2022   Volume 12, Issue 20 2863 doi: 10.3390/ani12202863
Daradics Z, Niculae M, Crecan CM, Lupșan AF, Rus MA, Andrei S, Ciobanu DM, Cătoi FA, Pop ID, Mircean MV, Cătoi C.Obesity is a common feature in horses suffering from metabolic syndrome. While adipokines involvement as biomarkers is better established in human pathology, little data are available on horses. This study aimed to investigate the possible association and relationship between selected metabolic parameters and morphological traits in equine metabolic syndrome. Adiposity was evaluated using body condition score (BCS) and cresty neck score (CNS). Plasma levels of total cholesterol, insulin, NEFA, and adipokines (omentin and chemerin) were determined using enzyme-linked immunosorbent assays. Spear...
Preventative Care: Managing the Geriatric Horse with Integrative Therapies.
The Veterinary clinics of North America. Equine practice    October 13, 2022   Volume 38, Issue 3 475-483 doi: 10.1016/j.cveq.2022.06.005
Boldt E.Horses 15 years of age and older now account for a significant portion of the equine population. Integrative therapies can provide important diagnostic and treatment tools for managing and maintaining the health of geriatric horses. Aged horses are often afflicted with chronic disease processes that are difficult to effectively manage with conventional medicinal approaches, such as laminitis and osteoarthritis. Diagnostic and therapeutic approaches using integrative therapies, such as acupuncture and spinal manipulation, are presented in this article for managing aged horses with metabolic dis...
Equine insulin dysregulation causes tissue specific alterations of proinflammatory cytokines and acute phase proteins in a NF-kB independent manner.
Veterinary immunology and immunopathology    October 8, 2022   Volume 253 110500 doi: 10.1016/j.vetimm.2022.110500
Jayathilake WMNK, Furr M, Risco C, Lacombe VA.Similar to human diabetes, equine metabolic syndrome (EMS) causes insulin dysregulation leading to debilitating sequela including laminitis. The pathophysiological mechanisms underlying EMS and laminitis are not well known. Therefore, using an insulin-resistant equine model, we hypothesized that insulin dysregulation induces an increased expression of inflammatory proteins in a tissue specific manner. Two groups of horses (n = -5/group) were categorized as insulin-resistant (IR) or insulin-sensitive (IS), using a frequently sampled intra-venous glucose tolerance test. Biopsies from skeletal ...
A starch-rich treat affects enteroinsular responses in ponies.
Journal of the American Veterinary Medical Association    October 6, 2022   Volume 260, Issue S3 S94-S101 doi: 10.2460/javma.22.06.0272
Sibthorpe PEM, Fitzgerald DM, Chen L, Sillence MN, de Laat MA.To determine the effect of a starch-rich treat, added to the daily diet of ponies for 10 days, on enteroinsular responses to meal consumption. 10 mixed-breed adult ponies owned by Queensland University of Technology were used in the study. Six ponies were metabolically healthy, and 4 were insulin dysregulated at the start of the study, according to the results of an in-feed oral glucose test. A bread-based treat was offered twice daily for 10 days, adding 0.36 ± 0.04 g/kg body weight (BW) carbohydrates to the daily diet. Before and after treatment, the intestinal capacity for simple carbohydr...
Generic approach for the discovery of drug metabolites in horses based on data-dependent acquisition by liquid chromatography high-resolution mass spectrometry and its applications to pharmacokinetic study of daprodustat.
Analytical and bioanalytical chemistry    October 1, 2022   Volume 414, Issue 28 8125-8142 doi: 10.1007/s00216-022-04347-2
Ishii H, Shibuya M, Kusano K, Sone Y, Kamiya T, Wakuno A, Ito H, Miyata K, Sato F, Kuroda T, Yamada M, Leung GN.In drug metabolism studies in horses, non-targeted analysis by means of liquid chromatography coupled with high-resolution mass spectrometry with data-dependent acquisition (DDA) has recently become increasingly popular for rapid identification of potential biomarkers in post-administration biological samples. However, the most commonly encountered problem is the presence of highly abundant interfering components that co-elute with the target substances, especially if the concentrations of these substances are relatively low. In this study, we evaluated the possibility of expanding DDA coverag...
Metabolomic Profiles in Starved Light Breed Horses during the Refeeding Process.
Animals : an open access journal from MDPI    September 21, 2022   Volume 12, Issue 19 2527 doi: 10.3390/ani12192527
Main SC, Brown LP, Melvin KR, Campagna SR, Voy BH, Castro HF, Strickland LG, Hines MT, Jacobs RD, Gordon ME, Ivey JLZ.The large population of emaciated horses continues to be an issue troubling the equine industry. However, little is known regarding the collection of equine metabolites (metabolome) during a malnourished state and the changes that occur throughout nutritional rehabilitation. In this study, ten emaciated horses underwent a refeeding process, during which blood samples were collected for a blood chemistry panel and metabolomics analysis via ultrahigh performance liquid chromatography-high resolution mass spectrometry (UHPLC-HRMS). Significant differences among blood chemistry analytes and metabo...
Dietary Iron Unlikely to Cause Insulin Resistance in Horses.
Animals : an open access journal from MDPI    September 21, 2022   Volume 12, Issue 19 2510 doi: 10.3390/ani12192510
McLean NL, McGilchrist N, Nielsen BD.Racehorses are often supplemented extra iron with the expectation that the iron will improve overall performance and health. A survey of 120 U.S. Thoroughbred trainers, representing 1978 Thoroughbreds from various regions of the U.S., was conducted to determine the average amount of dietary iron fed to Thoroughbred racehorses per day. Survey results indicated racehorses were fed an average of 3900 mg of iron per day from hay and grain alone. This exceeds the 0.8 mg/kg BW or 400 mg for a 500 kg working horse that the NRC 2007 recommends per day. Supplements increased the daily average intake of...
Dynamics of acylcarnitines, hypoglycin A, méthylènecyclopropylglycine and their metabolites in a Kladruber stallion with atypical myopathy.
The veterinary quarterly    September 18, 2022   Volume 42, Issue 1 183-191 doi: 10.1080/01652176.2022.2126537
Jahn P, Dobešová D, Brumarová R, Tóthová K, Kopecká A, Friedecký D.Equine atypical myopathy (AM also referred to as multiple acyl-CoA dehydrogenases deficiency [MADD]) is thought to be caused by toxins metabolized from hypoglycin A (HGA) and méthylènecyclopropylglycine (MCPrG). HGA is contained in the seeds and seedlings of the sycamore tree (Acer pseudoplatanus); MCPrG has so far only been confirmed in seeds. Among other things, these substances can disrupt the fatty acids β-oxidation pathway with the subsequent accumulation of certain acylcarnitines. The tentative diagnosis is based on anamnesis and clinical signs and can be verified by the detection of ...
Photoperiod-dependent changes in oxidative stress markers in the blood of Shetland pony mares and stallions involved in recreational horseback riding.
Chronobiology international    August 31, 2022   Volume 39, Issue 11 1419-1434 doi: 10.1080/07420528.2022.2115922
The objective of the current study was to determine the photoperiod-induced variations and the impact of exercise on oxidative stress biomarkers [2-thiobarbituric acid reactive substances (TBARS), aldehydic (AD) and ketonic (KD) derivatives of oxidatively modified proteins (OMP), total antioxidant capacity (TAC), and activities of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx)] and biomarkers of metabolic alterations [glucose, urea, and uric acid and the activity of lactate dehydrogenase (LDH)] in the blood of Shetland pony mares and stallions involved in recreati...
Use of the SGLT2 inhibitor canagliflozin for control of refractory equine hyperinsulinemia and laminitis.
Open veterinary journal    August 7, 2022   Volume 12, Issue 4 511-518 doi: 10.5455/OVJ.2022.v12.i4.14
Kellon EM, Gustafson KM.Hyperinsulinemia associated with pituitary pars intermedia dysfunction (PPID) and/or equine metabolic syndrome is well documented to put horses at high risk of laminitis. While dietary control of simple sugars and starch is the most effective therapy to control hyperinsulinemia, some horses fail to respond. Ten horses with hyperinsulinemia refractory to diet control, metformin, levothyroxine, and pergolide (if diagnosed with PPID) were treated with sodium-glucose cotransporter-2 inhibitor canagliflozin (Invokana®). Nine horses were hyperglycemic (>5.5 mmol/l) or had a history of hyperglycemia...
Differential effect of two dietary protein sources on time course response of muscle anabolic signaling pathways in normal and insulin dysregulated horses.
Frontiers in veterinary science    August 1, 2022   Volume 9 896220 doi: 10.3389/fvets.2022.896220
Loos CMM, McLeod KR, Vanzant ES, Stratton SA, Bohannan AD, Coleman RJ, van Doorn DA, Urschel KL.The objective of the study was to characterize the temporal changes of phosphorylation patterns of mTOR signaling proteins in response to two dietary protein sources in insulin dysregulated (ID, n = 8) and non-ID (n = 8) horses. Horses were individually housed and fed timothy grass hay and 2 daily concentrate meals so that protein was the first limiting nutrient and the total diet provided 120% of daily DE requirements for maintenance. On sample days, horses randomly received 0.25 g CP/kg BW of a pelleted alfalfa (AP) or commercial protein supplement (PS). Blood samples were collected before a...
Comparative metabolomic analysis in horses and functional analysis of branched chain (alpha) keto acid dehydrogenase complex in equine myoblasts under exercise stress.
Journal of animal science and technology    July 31, 2022   Volume 64, Issue 4 800-811 doi: 10.5187/jast.2022.e45
Park JW, Kim KH, Kim S, So JR, Cho BW, Song KD.The integration of metabolomics and transcriptomics may elucidate the correlation between the genotypic and phenotypic patterns in organisms. In equine physiology, various metabolite levels vary during exercise, which may be correlated with a modified gene expression pattern of related genes. Integrated metabolomic and transcriptomic studies in horses have not been conducted to date. The objective of this study was to detect the effect of moderate exercise on the metabolomic and transcriptomic levels in horses. In this study, using nuclear magnetic resonance (NMR) spectroscopy, we analyzed the...
Effect of a GLP-1 mimetic on the insulin response to oral sugar testing in horses.
BMC veterinary research    July 29, 2022   Volume 18, Issue 1 294 doi: 10.1186/s12917-022-03394-2
Stefanovski D, Robinson MA, Van Eps A.Insulin dysregulation (ID) is the most important risk factor for the development of laminitis in horses and therapies to control it are needed. Objective: To assess the effects of a single dose of the synthetic GLP-1 analog exenatide on postprandial insulin dynamics. We hypothesized that exenatide would improve insulin sensitivity and lower postprandial blood insulin concentrations. Methods: Randomized, crossover, experimental study. Methods: Six horses (3 mares, 3 geldings; 2 with normal insulin regulation [NIR] and 4 with mild ID). Methods: Horses completed both study arms: subcutaneous admi...
Astaxanthin Carotenoid Modulates Oxidative Stress in Adipose-Derived Stromal Cells Isolated from Equine Metabolic Syndrome Affected Horses by Targeting Mitochondrial Biogenesis.
Biomolecules    July 27, 2022   Volume 12, Issue 8 1039 doi: 10.3390/biom12081039
Mularczyk M, Bourebaba N, Marycz K, Bourebaba L.Astaxanthin is gaining recognition as a natural bioactive component. This study aimed to test whether astaxanthin could protect adipose-derived stromal stem cells (ASCs) from apoptosis, mitochondrial dysfunction and oxidative stress. was used to extract astaxanthin, whose biocompatibility was tested after 24, 48 and 72 h of incubation with the cells; no harmful impact was found. ASCs were treated with optimal concentrations of astaxanthin. Several parameters were examined: cell viability, apoptosis, reactive oxygen levels, mitochondrial dynamics and metabolism, superoxide dismutase activity, ...
ZOOMICS : comparative metabolomics of red blood cells from dogs, cows, horses and donkeys during refrigerated storage for up to 42 days.
Blood transfusion = Trasfusione del sangue    July 25, 2022   Volume 21, Issue 4 314-326 doi: 10.2450/2022.0118-22
Miglio A, Maslanka M, Di Tommaso M, Rocconi F, Nemkov T, Buehler PW, Antognoni MT, Spitalnik SL, D'Alessandro A.The use of omics technologies in human transfusion medicine has improved our understanding of the red blood cell (RBC) storage lesion(s). Despite significant progress towards understanding the storage lesion(s) of human RBCs, a comparison of basal and post-storage RBC metabolism across multiple species using omics technologies has not yet been reported, and is the focus of this study. Blood was collected in a standard bag system (CPD-SAG-Mannitol) from dogs (n=8), horses, bovines, and donkeys (n=6). All bags were stored at 4°C for up to 42 days (i.e., the end of the shelf life in Italian vete...
Effect of Weight Change on Markers of Bone Turnover and Phosphorus Excretion.
Journal of equine veterinary science    July 16, 2022   Volume 118 104080 doi: 10.1016/j.jevs.2022.104080
Fowler AL, Pyles MB, Hayes SH, Crum AD, Harris PA, Krotky A, Lawrence LM.There is little information about how weight change in horses impacts bone turnover and the metabolism of minerals associated with bone. This study evaluated weight change in mature horses as a factor that could alter bone turnover and fecal P output. Fifteen horses (555 ± 8 kg) were assigned to three treatments: weight loss (LO; n = 5), weight maintenance (MA; n = 5), and weight gain (GA; n = 5). Diets contained 75%, 100%, and 145% of maintenance digestible energy requirements for the three treatments, respectively, but contained similar amounts of protein and minerals. At the end of t...
Investigating the Relationship Between Cardiac Function and Insulin Sensitivity in Horses: A Pilot Study.
Frontiers in veterinary science    July 8, 2022   Volume 9 899951 doi: 10.3389/fvets.2022.899951
Williams NJ, Furr M, Navas de Solis C, Campolo A, Davis M, Lacombe VA.Metabolic syndrome in humans is commonly associated with cardiovascular dysfunction, including atrial fibrillation and left ventricular diastolic dysfunction. Although many differences exist between human and equine metabolic syndrome, both of these conditions share some degree of insulin resistance. The aims of this pilot study were to investigate the relationship between insulin sensitivity and cardiac function. Seven horses (five mares, two geldings, aged 17.2 ± 4.2 years, weight 524 ± 73 kg) underwent insulin-modified frequently sampled intravenous glucose tolerance testing to determine ...
Neurologic Disorders of the Foal.
The Veterinary clinics of North America. Equine practice    July 7, 2022   Volume 38, Issue 2 283-297 doi: 10.1016/j.cveq.2022.05.005
Furr MO.Neurologic disease of foals is a diagnostic and therapeutic challenge for veterinarians. Disease conditions such as neonatal encephalopathy are seen as well as developmental and congenital defects, bacterial infections, and trauma. Neonatal encephalopathy can be considered a "syndrome" with a variety of causes resulting in a similar clinical presentation. These causes can be categorized as maladaptation, hypoxic/ischemic encephalopathy, and metabolic abnormalities, all leading to signs of cerebral and brainstem disease. Spinal cord signs may occasionally be seen, but these signs are usually ov...
Nitric oxide synthase inhibition reveals differences in the nitric oxide pathway in previously laminitic ponies.
Research in veterinary science    July 1, 2022   Volume 150 79-82 doi: 10.1016/j.rvsc.2022.05.012
Finding EJT, Elliott J, Harris PA, Menzies-Gow NJ.Previously laminitic (PL) ponies are reported to have higher blood pressure than non laminitic (NL) ponies. This relative hypertension may be related to endothelial cell dysfunction, similar to humans with metabolic syndrome. To investigate the relationship between laminitis predisposition and endothelial dysfunction, the effect of nitric oxide synthase (NOS) inhibition on the change in circulating nitric oxide (NO) concentrations and systemic blood pressure (BP) was determined. An intravenous NO sensor was used to measure changes in blood NO concentration during and after intravenous infusion...
The Role of Intestinal Microbial Metabolites in the Immunity of Equine Animals Infected With Horse Botflies.
Frontiers in veterinary science    June 22, 2022   Volume 9 832062 doi: 10.3389/fvets.2022.832062
Hu D, Tang Y, Wang C, Qi Y, Ente M, Li X, Zhang D, Li K, Chu H.The microbiota and its metabolites play an important role in regulating the host metabolism and immunity. However, the underlying mechanism is still not well studied. Thus, we conducted the LC-MS/MS analysis and RNA-seq analysis on with and without horse botfly infestation to determine the metabolites produced by intestinal microbiota in feces and differentially expressed genes (DEGs) related to the immune response in blood and attempted to link them together. The results showed that parasite infection could change the composition of microbial metabolites. These identified metabolites could b...
An in vitro model for discovery of osteoclast specific biomarkers towards identification of racehorses at risk for catastrophic fractures.
Equine veterinary journal    June 19, 2022   Volume 55, Issue 3 534-550 doi: 10.1111/evj.13600
Malek G, Richard H, Beauchamp G, Laverty S.Focal bone microcracks with osteoclast recruitment and bone lysis, may reduce fracture resistance in racehorses. As current imaging does not detect all horses at risk for fracture, the discovery of novel serum biomarkers of bone resorption or osteoclast activity could potentially address this unmet clinical need. The biology of equine osteoclasts on their natural substrate, equine bone, has never been studied in vitro and may permit identification of specific biomarkers of their activity. Objective: (1) Establish osteoclast cultures on equine bone, (2) Measure biomarkers (tartrate resistant ac...
Fueling equine performance: importance of mitochondrial phenotype in equine athletes.
Animal frontiers : the review magazine of animal agriculture    June 14, 2022   Volume 12, Issue 3 6-14 doi: 10.1093/af/vfac023
Latham CM, Guy CP, Wesolowski LT, White-Springer SH.No abstract available
Evaluation of peripheral blood polymorphonuclear cell functions after an oral carbohydrate overload in obese and insulin dysregulated horses.
Veterinary immunology and immunopathology    June 13, 2022   Volume 250 110455 doi: 10.1016/j.vetimm.2022.110455
Salinas C, Espinosa G, Morales N, Henríquez C, Morán G, Gajardo G, Burgos RA, Uberti B.Obesity and insulin dysregulation (ID) are increasingly prevalent conditions in equid populations worldwide. Immune impairment is well described in humans with metabolic dysfunction and is reported but still incompletely understood in horses. This study evaluated the effect of acute induced transient hyperglycemia on apoptosis, phagocytosis and oxidative burst activity of peripheral blood polymorphonuclear cells (PMN) of lean and obese adult horses with or without insulin dysregulation. Seventeen adult horses were allocated into three groups based on their body condition score (BCS) and metabo...
Diagnostic evaluation of insulin and glucose dynamics in light-breed horses receiving dexamethasone.
The Canadian veterinary journal = La revue veterinaire canadienne    June 4, 2022   Volume 63, Issue 6 617-626 
Timko KJ, Hostnik LD, Watts MR, Chen C, Bercz A, Toribio RE, Belknap JK, Burns TA.Insulin dysregulation is a hallmark of equine metabolic syndrome (EMS) and increases the risk for development of laminitis. Accurate diagnosis of insulin dysregulation is crucial for implementation of preventative strategies in this population. The objective was to assess the effects of dexamethasone administration on insulin and glucose dynamics in light-breed horses and assess the agreement of various diagnostic tests for insulin dysregulation [basal [insulin] (BI), oral sugar test (OST), and combined glucose-insulin test (CGIT)]. Fourteen adult light-breed horses. Prospective, experimental ...
Impact of different dietary regimens on the lipidomic profile of mare’s milk.
Food research international (Ottawa, Ont.)    April 29, 2022   Volume 156 111305 doi: 10.1016/j.foodres.2022.111305
Deng L, Yang Y, Li Z, Li J, Zhu Y, Meng Q, Liu J, Wang X.Despite mare's milk being highly nutritious and beneficial to human health, the effects of different dietary regimens on the lipid profile of mare's milk remain to be completely understood. Herein we employed targeted multiple reaction monitoring-based lipidomics with ultra-high performance liquid chromatography-quadrupole time-of-flight-mass spectrometry to compare the milk lipid profiles of mares fed: pasture grass (P), corn stover and concentrate (H), or cornsilage and concentrate (S). Overall, 461 lipids belonging to 17 subclasses were identified; 261 significantly different lipids were id...
A quantitative method for the simultaneous detection of SR9009 and SR9011 in equine plasma using liquid chromatography-electrospray ionization-tandem mass spectrometry.
Drug testing and analysis    April 19, 2022   Volume 14, Issue 8 1532-1538 doi: 10.1002/dta.3271
Kwak YB, Yu J, Yoo HH.SR9009 and SR9011 are metabolic modulators pharmacologically targeting REV-ERB receptors as synthetic agonists. A liquid chromatography-tandem mass spectrometry method for the detection of SR9009 and SR9011 in equine plasma was developed and validated. Plasma samples were pretreated by protein precipitation with methanol and were loaded onto an ACQUITY ultra performance liquid chromatography high-strength silica C18 column (2.1 × 150 mm, 1.8 μm) for chromatographic separation. The mobile phase consisted of 5-mM ammonium formate (pH 3.0) in distilled water and 0.1% formic acid in ac...
Thromboelastography in obese horses with insulin dysregulation compared to healthy controls.
Journal of veterinary internal medicine    April 16, 2022   Volume 36, Issue 3 1131-1138 doi: 10.1111/jvim.16421
Lovett AL, Gilliam LL, Sykes BW, McFarlane D.Both obesity and metabolic syndrome are associated with hypercoagulability in people, increasing the risk of cardiovascular disease and thromboembolic events. Whether hypercoagulability exists in obese, insulin-dysregulated horses is unknown. Objective: To determine if coagulation profiles differ between healthy horses and those with obesity and insulin dysregulation. Methods: Fifteen healthy horses (CON) and 15 obese, insulin-dysregulated horses (OBID). Individuals were university or client owned. Methods: Case-control study. Obesity was defined as a body condition score (BCS) ≥7.5/9 (modif...
Seasonal Insulin Responses to the Oral Sugar Test in Healthy and Insulin Dysregulated Horses.
Journal of equine veterinary science    April 8, 2022   Volume 113 103945 doi: 10.1016/j.jevs.2022.103945
Macon EL, Harris P, Barker VD, Adams AA.Seasonal effects on the oral sugar test (OST), used to monitor insulin dysregulation (ID) status to help reduce laminitis risk, are poorly understood in the ID horse. Resting, (basal) insulin (T0) and 60-minute (T60) OST (0.15 mL/Kg BW Karo Light Corn Syrup) insulin responses were evaluated, once per each season over 2 years, in ID (n = 11 14.9 ± 4.3 years; mean ± SD) and non-insulin dysregulated (NID: n = 11 16.4 ± 5.3 years; mean ± SD) horses housed on the same farm. Seasonal morphometric measurements were collected: bodyweight (BW), body-condition scores (BCS), and cresty neck score...
Predictors of laminitis development in a cohort of nonlaminitic ponies.
Equine veterinary journal    April 1, 2022   Volume 55, Issue 1 12-23 doi: 10.1111/evj.13572
Knowles EJ, Elliott J, Harris PA, Chang YM, Menzies-Gow NJ.Quantifying risk factors for laminitis development requires improvement. Objective: To identify the most useful physical examination, metabolic and management factors to predict laminitis development in client-owned, nonlaminitic ponies. Methods: Prospective cohort study. Methods: Physical examination, metabolic and management data were collected from a pony cohort 6 monthly for up to 4 years. Ponies were monitored for the development of laminitis. Metabolic data included basal plasma concentrations of ACTH ([ACTH]), adiponectin ([adiponectin]), triglycerides and glucose. Serum insulin concen...
Hepatic Enzyme Profile in Horses.
Animals : an open access journal from MDPI    March 29, 2022   Volume 12, Issue 7 doi: 10.3390/ani12070861
Satué K, Miguel-Pastor L, Chicharro D, Gardón JC.For diagnostic purposes, liver enzymes are usually classified into hepatocellular and cholestatic. These two groups of equine liver-specific enzymes include sorbitol dehydrogenase (SDH), glutamate dehydrogenase (GLDH), γ-glutamyl transferase (GGT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), and alkaline phosphatase (ALP). SDH and GLDH mostly reflect hepatocellular injury and cholestasis, while GGT expresses high values in biliary necrosis or hyperplasia. Likewise, AST, LDH, and ALP also reflect hepatocellular and biliary disease, but these enzymes are not liver specific. F...