Diabetes & Metabolism Journal

Original Articles

Clinical Care/Education
Pregnancy Outcomes of Women Additionally Diagnosed as Gestational Diabetes by the International Association of the Diabetes and Pregnancy Study Groups Criteria: Min Hyoung Kim, Soo Heon Kwak, Sung-Hoon Kim, Joon Seok Hong, Hye Rim Chung, Sung Hee Choi, Moon Young Kim, Hak C. Jang; Diabetes Metab J. 2019;43(6):766-775. Published online February 28, 2019; DOI: https://doi.org/10.4093/dmj.2018.0192

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Background

We investigated the pregnancy outcomes in women who were diagnosed with gestational diabetes mellitus (GDM) by the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria but not by the Carpenter-Coustan (CC) criteria.

Methods

A total of 8,735 Korean pregnant women were identified at two hospitals between 2014 and 2016. Among them, 2,038 women participated in the prospective cohort to investigate pregnancy outcomes. Diagnosis of GDM was made via two-step approach with 50-g glucose challenge test for screening followed by diagnostic 2-hour 75-g oral glucose tolerance test. Women were divided into three groups: non-GDM, GDM diagnosed exclusively by the IADPSG criteria, and GDM diagnosed by the CC criteria.

Results

The incidence of GDM was 2.1% according to the CC criteria, and 4.1% by the IADPSG criteria. Women diagnosed with GDM by the IADPSG criteria had a higher body mass index (22.0±3.1 kg/m² vs. 21.0±2.8 kg/m², P<0.001) and an increased risk of preeclampsia (odds ratio [OR], 6.90; 95% confidence interval [CI], 1.84 to 25.87; P=0.004) compared to non-GDM women. Compared to neonates of the non-GDM group, those of the IADPSG GDM group had an increased risk of being large for gestational age (OR, 2.39; 95% CI, 1.50 to 3.81; P<0.001), macrosomia (OR, 2.53; 95% CI, 1.26 to 5.10; P=0.009), and neonatal hypoglycemia (OR, 3.84; 95% CI, 1.01 to 14.74; P=0.049); they were also at an increased risk of requiring phototherapy (OR, 1.57; 95% CI, 1.07 to 2.31; P=0.022) compared to the non-GDM group.

Conclusion

The IADPSG criteria increased the incidence of GDM by nearly three-fold, and women diagnosed with GDM by the IADPSG criteria had an increased risk of adverse pregnancy outcomes in Korea.

Citations

Citations to this article as recorded by

Gestational diabetes mellitus and adverse maternal and perinatal outcomes in twin and singleton pregnancies: a systematic review and meta-analysis
Elena Greco, Maria Calanducci, Kypros H. Nicolaides, Eleanor V.H. Barry, Mohammed S.B. Huda, Stamatina Iliodromiti
American Journal of Obstetrics and Gynecology.2024; 230(2): 213. CrossRef
Neonatal outcomes according to different glucose threshold values in gestational diabetes: a register-based study
Kaisa Kariniemi, Marja Vääräsmäki, Tuija Männistö, Sanna Mustaniemi, Eero Kajantie, Sanna Eteläinen, Elina Keikkala, Anneli Pouta, Risto Kaaja, Johan G Eriksson, Hannele Laivuori, Mika Gissler
BMC Pregnancy and Childbirth.2024;[Epub] CrossRef
The problem of diabetes mellitus in obstetrics
E.V. Popova-Petrosyan, A.A. Dovgan’, E.R. Kulieva
Russian Bulletin of Obstetrician-Gynecologist.2024; 24(3): 25. CrossRef
2023 Clinical Practice Guidelines for Diabetes Management in Korea: Full Version Recommendation of the Korean Diabetes Association
Jun Sung Moon, Shinae Kang, Jong Han Choi, Kyung Ae Lee, Joon Ho Moon, Suk Chon, Dae Jung Kim, Hyun Jin Kim, Ji A Seo, Mee Kyoung Kim, Jeong Hyun Lim, Yoon Ju Song, Ye Seul Yang, Jae Hyeon Kim, You-Bin Lee, Junghyun Noh, Kyu Yeon Hur, Jong Suk Park, Sang
Diabetes & Metabolism Journal.2024; 48(4): 546. CrossRef
Pregnancy complications in women with pregestational and gestational diabetes mellitus
Lukas Reitzle, Christin Heidemann, Jens Baumert, Matthias Kaltheuner, Heinke Adamczewski, Andrea Icks, Christa Scheidt-Nave
Deutsches Ärzteblatt international.2023;[Epub] CrossRef
Predicting the Risk of Insulin-Requiring Gestational Diabetes before Pregnancy: A Model Generated from a Nationwide Population-Based Cohort Study in Korea
Seung-Hwan Lee, Jin Yu, Kyungdo Han, Seung Woo Lee, Sang Youn You, Hun-Sung Kim, Jae-Hyoung Cho, Kun-Ho Yoon, Mee Kyoung Kim
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Treatment of women with mild gestational diabetes mellitus decreases the risk of adverse perinatal outcomes
Fanny Goyette, Bi Lan Wo, Marie-Hélène Iglesias, Evelyne Rey, Ariane Godbout
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Maternal and fetal outcomes of pregnancies associated with single versus double abnormal values in 100 gr glucose tolerance test
Mohammadali Shahriari, Ali Shahriari, Maryam Khooshideh, Anahita Dehghaninezhad, Arezoo Maleki-Hajiagha, Rana Karimi
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Diagnosis and management of gestational diabetes mellitus
Tae Jung Oh
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Update on gestational diabetes and adverse pregnancy outcomes
Bryan Ugwudike, ManHo Kwok
Current Opinion in Obstetrics & Gynecology.2023; 35(5): 453. CrossRef
Effects of early standardized management on the growth trajectory of offspring with gestational diabetes mellitus at 0–5 years old: a preliminary longitudinal study
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Can Triglyceride/Glucose Index (TyG) and Triglyceride/HDL-Cholesterol Ratio (TG/HDL-c) Predict Gestational Diabetes Mellitus?
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Review of the Screening Guidelines for Gestational Diabetes Mellitus: How to Choose Wisely
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Risk and Risk Factors for Postpartum Type 2 Diabetes Mellitus in Women with Gestational Diabetes: A Korean Nationwide Cohort Study
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N. I. Volkova, S. O. Panenko
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Gestational diabetes mellitus and adverse pregnancy outcomes: systematic review and meta-analysis
Wenrui Ye, Cong Luo, Jing Huang, Chenglong Li, Zhixiong Liu, Fangkun Liu
BMJ.2022; : e067946. CrossRef
Effect of Different Types of Diagnostic Criteria for Gestational Diabetes Mellitus on Adverse Neonatal Outcomes: A Systematic Review, Meta-Analysis, and Meta-Regression
Fahimeh Ramezani Tehrani, Marzieh Saei Ghare Naz, Razieh Bidhendi-Yarandi, Samira Behboudi-Gandevani
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Triglyceride and glucose index and the risk of gestational diabetes mellitus: A nationwide population-based cohort study
Jung A Kim, Jinsil Kim, Eun Roh, So-hyeon Hong, You-Bin Lee, Sei Hyun Baik, Kyung Mook Choi, Eunjin Noh, Soon Young Hwang, Geum Joon Cho, Hye Jin Yoo
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Effect of the IADPSG screening strategy for gestational diabetes on perinatal outcomes in Switzerland
Evelyne M. Aubry, Luigi Raio, Stephan Oelhafen
Diabetes Research and Clinical Practice.2021; 175: 108830. CrossRef
Estimated impact of introduction of new diagnostic criteria for gestational diabetes mellitus
Leon de Wit, Anna B Zijlmans, Doortje Rademaker, Christiana A Naaktgeboren, J Hans DeVries, Arie Franx, Rebecca C Painter, Bas B van Rijn
World Journal of Diabetes.2021; 12(6): 868. CrossRef
The Clinical Characteristics of Gestational Diabetes Mellitus in Korea: A National Health Information Database Study
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Fetal Abdominal Obesity Detected At 24 to 28 Weeks of Gestation Persists Until Delivery Despite Management of Gestational Diabetes Mellitus
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Nonalcoholic fatty liver disease and the risk of insulin-requiring gestational diabetes
Sang Youn You, Kyungdo Han, Seung-Hawn Lee, Mee Kyoung Kim
Diabetology & Metabolic Syndrome.2021;[Epub] CrossRef
Maternal Hyperglycemia during Pregnancy Increases Adiposity of Offspring
Hye Rim Chung, Joon Ho Moon, Jung Sub Lim, Young Ah Lee, Choong Ho Shin, Joon-Seok Hong, Soo Heon Kwak, Sung Hee Choi, Hak Chul Jang
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Prepregnancy smoking and the risk of gestational diabetes requiring insulin therapy
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Scientific Reports.2020;[Epub] CrossRef
Gestational Diabetes Mellitus: Diagnosis and Glycemic Control
Tae Jung Oh, Hak Chul Jang
The Journal of Korean Diabetes.2020; 21(2): 69. CrossRef
New Diagnostic Criteria for Gestational Diabetes Mellitus and Pregnancy Outcomes in Korea
Kyu Yeon Hur
Diabetes & Metabolism Journal.2019; 43(6): 763. CrossRef

Clinical Diabetes & Therapeutics
Progression to Gestational Diabetes Mellitus in Pregnant Women with One Abnormal Value in Repeated Oral Glucose Tolerance Tests: Sunyoung Kang, Min Hyoung Kim, Moon Young Kim, Joon-Seok Hong, Soo Heon Kwak, Sung Hee Choi, Soo Lim, Kyong Soo Park, Hak C. Jang; Diabetes Metab J. 2019;43(5):607-614. Published online February 28, 2019; DOI: https://doi.org/10.4093/dmj.2018.0159

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Abstract PDF PubReader

Background

Women with one abnormal value (OAV) in a 100 g oral glucose tolerance test (OGTT) during pregnancy are reported to have an increased risk of adverse pregnancy outcomes. However, there is limited data about whether women with OAV will progress to gestational diabetes mellitus (GDM) when the OGTT is repeated.

Methods

To identify clinical and metabolic predictors for GDM in women with OAV, we conducted a retrospective study and identified women with OAV in the OGTT done at 24 to 30 weeks gestational age (GA) and repeated the second OGTT between 32 and 34 weeks of GA.

Results

Among 137 women with OAV in the initial OGTT, 58 (42.3%) had normal, 40 (29.2%) had OAV and 39 (28.5%) had GDM in the second OGTT. Maternal age, prepregnancy body mass index, weight gain from prepregnancy to the second OGTT, GA at the time of the OGTT, and parity were similar among normal, OAV, and GDM groups. Plasma glucose levels in screening tests were different (151.8±15.7, 155.8±14.6, 162.5±20.3 mg/dL, P<0.05), but fasting, 1-, 2-, and 3-hour glucose levels in the initial OGTT were not. Compared to women with screen negative, women with untreated OAV had a higher frequency of macrosomia.

Conclusion

We demonstrated that women with OAV in the initial OGTT significantly progressed to GDM in the second OGTT. Clinical parameters predicting progression to GDM were not found. Repeating the OGTT in women with OAV in the initial test may be helpful to detect GDM progression.

Citations

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Analysis of the gut microflora in women with gestational diabetes mellitus
Xuping Wang, Bingfeng Bian, Fuman Du, Chaofeng Xiang, Yu Liu, Na Li, Binhong Duan
International Journal of Diabetes in Developing Countries.2024; 44(S1): 38. CrossRef
Fetal abdominal obesity in women with one value abnormality on diagnostic test for gestational diabetes mellitus
Wonjin Kim, Soo Kyung Park, Yoo Lee Kim, Clive J. Petry
PLOS ONE.2024; 19(6): e0304875. CrossRef
Maternal and fetal outcomes of pregnancies associated with single versus double abnormal values in 100 gr glucose tolerance test
Mohammadali Shahriari, Ali Shahriari, Maryam Khooshideh, Anahita Dehghaninezhad, Arezoo Maleki-Hajiagha, Rana Karimi
Journal of Diabetes & Metabolic Disorders.2023; 22(2): 1347. CrossRef
One abnormal value or vomiting after oral glucose tolerance test in pregnancy: incidence and impact on maternal-fetal outcomes
Humberto Navarro-Martinez, Juana-Antonia Flores-Le Roux, Gemma Llauradó, Lucia Gortazar, Antonio Payà, Laura Mañé, Juan Pedro-Botet, David Benaiges
Gynecological Endocrinology.2023;[Epub] CrossRef
The association between gestational impaired glucose tolerance and hyperglycemic markers: A prospective study
Ohad Gluck, Hadas Ganer Herman, Nataly Fainstein, Neri Katz, Jacob Bar, Michal Kovo
International Journal of Gynecology & Obstetrics.2022; 156(1): 82. CrossRef
Association of abnormal-glucose tolerance during pregnancy with exposure to PM2.5 components and sources
Dejian Mai, Chengfang Xu, Weiwei Lin, Dingli Yue, Shaojie Fu, Jianqing Lin, Luan Yuan, Yan Zhao, Yuhong Zhai, Huiying Mai, Xiaoling Zeng, Tingwu Jiang, Xuejiao Li, Jiajia Dai, Boning You, Qin Xiao, Qing Wei, Qiansheng Hu
Environmental Pollution.2022; 292: 118468. CrossRef
Postprandial Free Fatty Acids at Mid-Pregnancy Increase the Risk of Large-for-Gestational-Age Newborns in Women with Gestational Diabetes Mellitus
So-Yeon Kim, Young Shin Song, Soo-Kyung Kim, Yong-Wook Cho, Kyung-Soo Kim
Diabetes & Metabolism Journal.2022; 46(1): 140. CrossRef
The Clinical Characteristics of Gestational Diabetes Mellitus in Korea: A National Health Information Database Study
Kyung-Soo Kim, Sangmo Hong, Kyungdo Han, Cheol-Young Park
Endocrinology and Metabolism.2021; 36(3): 628. CrossRef
Gestational Diabetes Mellitus: Diagnosis and Glycemic Control
Tae Jung Oh, Hak Chul Jang
The Journal of Korean Diabetes.2020; 21(2): 69. CrossRef
Health literacy and diabetes control in pregnant women
Azar Pirdehghan, Mohammad Eslahchi, Farzaneh Esna-Ashari, Shiva Borzouei
Journal of Family Medicine and Primary Care.2020; 9(2): 1048. CrossRef

Epidemiology
Oral Glucose Tolerance Testing Allows Better Prediction of Diabetes in Women with a History of Gestational Diabetes Mellitus: Tae Jung Oh, Yeong Gi Kim, Sunyoung Kang, Joon Ho Moon, Soo Heon Kwak, Sung Hee Choi, Soo Lim, Kyong Soo Park, Hak C. Jang, Joon-Seok Hong, Nam H. Cho; Diabetes Metab J. 2019;43(3):342-349. Published online December 7, 2018; DOI: https://doi.org/10.4093/dmj.2018.0086

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Background

We aimed to identify the postpartum metabolic factors that were associated with the development of diabetes in women with a history of gestational diabetes mellitus (GDM). In addition, we examined the role of the oral glucose tolerance test (OGTT) in the prediction of future diabetes.

Methods

We conducted a prospective study of 179 subjects who previously had GDM but did not have diabetes at 2 months postpartum. The initial postpartum examination including a 75-g OGTT and the frequently sampled intravenous glucose tolerance test (FSIVGTT) was performed 12 months after delivery, and annual follow-up visits were made thereafter.

Results

The insulinogenic index (IGI30) obtained from the OGTT was significantly correlated with the acute insulin response to glucose (AIRg) obtained from the FSIVGTT. The disposition indices obtained from the OGTT and FSIVGTT were also significantly correlated. Women who progressed to diabetes had a lower insulin secretory capacity including IGI30, AIRg, and disposition indices obtained from the FSIVGTT and OGTT compared with those who did not. However, the insulin sensitivity indices obtained from the OGTT and FSIVGTT did not differ between the two groups. Multivariate logistic regression analysis showed that the 2-hour glucose and disposition index obtained from the FSIVGTT were significant postpartum metabolic risk factors for the development of diabetes.

Conclusion

We identified a crucial role of β-cell dysfunction in the development of diabetes in Korean women with previous GDM. The 2-hour glucose result from the OGTT is an independent predictor of future diabetes. Therefore, the OGTT is crucial for better prediction of future diabetes in Korean women with previous GDM.

Citations

Citations to this article as recorded by

The problem of diabetes mellitus in obstetrics
E.V. Popova-Petrosyan, A.A. Dovgan’, E.R. Kulieva
Russian Bulletin of Obstetrician-Gynecologist.2024; 24(3): 25. CrossRef
Postpartum glucose intolerance after gestational diabetes mellitus: tailored prediction according to data-driven clusters and BMI-categories
Anna Lesniara-Stachon, Emmanuel Cosson, Alain Lacroix, Sybille Schenk, Dan Yedu Quansah, Jardena J. Puder
Frontiers in Endocrinology.2024;[Epub] CrossRef
2023 Clinical Practice Guidelines for Diabetes Management in Korea: Full Version Recommendation of the Korean Diabetes Association
Jun Sung Moon, Shinae Kang, Jong Han Choi, Kyung Ae Lee, Joon Ho Moon, Suk Chon, Dae Jung Kim, Hyun Jin Kim, Ji A Seo, Mee Kyoung Kim, Jeong Hyun Lim, Yoon Ju Song, Ye Seul Yang, Jae Hyeon Kim, You-Bin Lee, Junghyun Noh, Kyu Yeon Hur, Jong Suk Park, Sang
Diabetes & Metabolism Journal.2024; 48(4): 546. CrossRef
Diagnosis and management of gestational diabetes mellitus
Tae Jung Oh
Journal of the Korean Medical Association.2023; 66(7): 414. CrossRef
Risk factors for women with gestational diabetes mellitus developing type 2 diabetes and the impact on children's health
Yi‐Ling Chiou, Chich‐Hsiu Hung, Ching‐Yun Yu, Te‐Fu Chan, Ming‐Gwo Liu
Journal of Clinical Nursing.2022; 31(7-8): 1005. CrossRef
Postprandial Free Fatty Acids at Mid-Pregnancy Increase the Risk of Large-for-Gestational-Age Newborns in Women with Gestational Diabetes Mellitus
So-Yeon Kim, Young Shin Song, Soo-Kyung Kim, Yong-Wook Cho, Kyung-Soo Kim
Diabetes & Metabolism Journal.2022; 46(1): 140. CrossRef
Gestational Diabetes Mellitus: Diagnostic Approaches and Maternal-Offspring Complications
Joon Ho Moon, Hak Chul Jang
Diabetes & Metabolism Journal.2022; 46(1): 3. CrossRef
Higher Muscle Mass Protects Women with Gestational Diabetes Mellitus from Progression to Type 2 Diabetes Mellitus
Yujin Shin, Joon Ho Moon, Tae Jung Oh, Chang Ho Ahn, Jae Hoon Moon, Sung Hee Choi, Hak Chul Jang
Diabetes & Metabolism Journal.2022; 46(6): 890. CrossRef
Pancreatic fat accumulation is associated with decreased β‐cell function and deterioration in glucose tolerance in Korean adults
Sang Ouk Chin, You‐Cheol Hwang, In‐Jin Cho, In‐Kyung Jeong, Kyu Jeung Ahn, Ho Yeon Chung
Diabetes/Metabolism Research and Reviews.2021;[Epub] CrossRef
The Clinical Characteristics of Gestational Diabetes Mellitus in Korea: A National Health Information Database Study
Kyung-Soo Kim, Sangmo Hong, Kyungdo Han, Cheol-Young Park
Endocrinology and Metabolism.2021; 36(3): 628. CrossRef
Bihormonal dysregulation of insulin and glucagon contributes to glucose intolerance development at one year post-delivery in women with gestational diabetes: a prospective cohort study using an early postpartum 75-g glucose tolerance test
Riyoko Shigeno, Ichiro Horie, Masaki Miwa, Ayako Ito, Ai Haraguchi, Shoko Natsuda, Satoru Akazawa, Ai Nagata, Yuri Hasegawa, Shoko Miura, Kiyonori Miura, Atsushi Kawakami, Norio Abiru
Endocrine Journal.2021; 68(8): 919. CrossRef
Risk factors during the early postpartum period for type 2 diabetes mellitus in women with gestational diabetes
Maki Kawasaki, Naoko Arata, Naoko Sakamoto, Anna Osamura, Siori Sato, Yoshihiro Ogawa, Ichiro Yasuhi, Masako Waguri, Yuji Hiramatsu
Endocrine Journal.2020; 67(4): 427. CrossRef
Cod-Liver Oil Improves Metabolic Indices and hs-CRP Levels in Gestational Diabetes Mellitus Patients: A Double-Blind Randomized Controlled Trial
Shuli Yang, Ruixin Lin, Lihui Si, Zhuo Li, Wenwen Jian, Qing Yu, Yan Jia
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Others
Rg3 Improves Mitochondrial Function and the Expression of Key Genes Involved in Mitochondrial Biogenesis in C2C12 Myotubes: Min Joo Kim, Young Do Koo, Min Kim, Soo Lim, Young Joo Park, Sung Soo Chung, Hak C. Jang, Kyong Soo Park; Diabetes Metab J. 2016;40(5):406-413. Published online August 12, 2016; DOI: https://doi.org/10.4093/dmj.2016.40.5.406

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Abstract PDF PubReader

Background

Panax ginseng has glucose-lowering effects, some of which are associated with the improvement in insulin resistance in skeletal muscle. Because mitochondria play a pivotal role in the insulin resistance of skeletal muscle, we investigated the effects of the ginsenoside Rg3, one of the active components of P. ginseng, on mitochondrial function and biogenesis in C2C12 myotubes.

Methods

C2C12 myotubes were treated with Rg3 for 24 hours. Insulin signaling pathway proteins were examined by Western blot. Cellular adenosine triphosphate (ATP) levels and the oxygen consumption rate were measured. The protein or mRNA levels of mitochondrial complexes were evaluated by Western blot and quantitative reverse transcription polymerase chain reaction analysis.

Results

Rg3 treatment to C2C12 cells activated the insulin signaling pathway proteins, insulin receptor substrate-1 and Akt. Rg3 increased ATP production and the oxygen consumption rate, suggesting improved mitochondrial function. Rg3 increased the expression of peroxisome proliferator-activated receptor γ coactivator 1α, nuclear respiratory factor 1, and mitochondrial transcription factor, which are transcription factors related to mitochondrial biogenesis. Subsequent increased expression of mitochondrial complex IV and V was also observed.

Conclusion

Our results suggest that Rg3 improves mitochondrial function and the expression of key genes involved in mitochondrial biogenesis, leading to an improvement in insulin resistance in skeletal muscle. Rg3 may have the potential to be developed as an anti-hyperglycemic agent.

Citations

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