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вce журналы << Клиническая и экспериментальная тиреоидология << 2009 год << №2 <<
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ГИПОТИРЕОЗ, СУБКЛИНИЧЕСКИЙ ГИПОТИРЕОЗ, ВЫСОКОНОРМАЛЬНЫЙ УРОВЕНЬ ТТГ

А.В. Подзолков, В.В. Фадеев
Вы можете загрузить полный текст статьи в формате pdf
Кафедра эндокринологии ММА им. И.М. Сеченова
Адрес для корреспонденции: 117036, Москва, ул. Дм. Ульянова, д. 11, Эндокринологический Научный Центр, Фадееву В.В. walfad@mail.ru

В обзоре обсуждаются проблемы диагностики и лечения субклинического гипотиреоза, а также референсного интервала для уровня ТТГ. Обсуждается вопрос о целесообразности изменения референсного интервала и целевого диапазона для уровня ТТГ на фоне заместительной терапии гипотиреоза.

Ключевые слова:
гипотиреоз, субклинический гипотиреоз, тиреотропный гормон.

Литература:
. Homocysteine and risk of ischemic heart disease and stroke: a meta-analysis // JAMA. 2002. V. 288. N 16. P. 2015–2022.
2. Althaus B.U., Staub J.J., Ryff-De Leche A. et al. LDL/HDL-changes in subclinical hypothyroidism: possible risk factors for coronary heart disease // Clin. Endocrinol. 1988. V. 28. N 2. P. 157–163.
3. Baloch Z., Carayon P., Conte-Devolx B. et al. Laboratory medicine practice guidelines. Laboratory support for the diagnosis and monitoring of thyroid disease // Thyroid 2003. V. 13. N 1. P. 3–126.
4. Bataille R., Klein B. C-reactive protein levels as a direct indicator of interleukin-6 levels in humans in vivo // Arthrit. Rheumatism 1992. V. 35. N 8. P. 982–984.
5. Benson E. S. The concept of the normal range // Human pathol. 1972. V. 3. N 2. P. 152–155.
6. Benvenga S., Bartolone L., Pappalardo M.A. et al. Altered intestinal absorption of L-thyroxine caused by coffee // Thyroid. 2008. V. 18. N 3. P. 293–301.
7. Bono G., Fancellu R., Blandini F., Santoro G., Mauri M. Cognitive and affective status in mild hypothyroidism and interactions with L-thyroxine treatment // Acta Neurol. Scandinav. 2004. V. 110. N 1. P. 59–66.
8. Bottner M., Christoffel J., Rimoldi G., Wuttke W. Effects of long-term treatment with resveratrol and subcutaneous and oral estradiol administration on the pituitary-thyroid-axis // Exp. Clin. Endocrinol. Diabetes. 2006. V. 114. N 2. P. 82–90.
9. Brabant G., Beck-Peccoz P., Jarzab B. et al. Is there a need to redefine the upper normal limit of TSH? European journal of endocrinology / Eur. Feder. Endocr. Societ. 2006. V. 154. N 5. P. 633–637.
10. Brabant G., Bergmann P., Kirsch C. M. et al. Early adaptation of thyrotropin and thyroglobulin secretion to experimentally decreased iodine supply in man // Metab. Clin. Experiment. 1992. V. 41. N 10. P. 1093–1096.
11. Buxton O.M., Frank S.A., L’Hermite-Baleriaux M. et al. Roles of intensity and duration of nocturnal exercise in causing phase delays of human circadian rhythms // Am. J. Physio. 1997. V. 273. N 3. P. E536–542.
12. Canaris G.J., Manowitz N.R., Mayor G., Ridgway E. C. The Colorado thyroid disease prevalence study // Arch. Intern. Med. 2000. V. 160. N 4. P. 526–534.
13. Caron P., Calazel C., Parra H. J. et al. Decreased HDL cholesterol in subclinical hypothyroidism: the effect of L-thyroxine therapy // Clin. Endocrinol. 1990. V. 33. N 4. P. 519–523.
14. Christ-Crain M., Meier C., Guglielmetti M. et al. Elevated C-reactive protein and homocysteine values: cardiovascular risk factors in hypothyroidism? A cross-sectional and a double-blind, placebo-controlled trial // Atheroscler. 2003. V. 166. N 2. P. 379–386.
15. Cook D.G., Mendall M.A., Whincup P.H. et al. C-reactive protein concentration in children: relationship to adiposity and other cardiovascular risk factors // Atheroscler. 2000. V. 149. N 1. P. 139–150.
16. Cooper D.S., Halpern R., Wood L.C. et al. L-Thyroxine therapy in subclinical hypothyroidism. A double-blind, placebo-controlled trial // Ann. Intern. Med. 1984. V. 101. N 1. P. 18–24.
17. Cushing G.W. Subclinical hypothyroidism. Understanding is the key to decision making // Postgrad. Med. 1993. V. 94. N 1. P. 95–97, 100–102, 106–107.
18. Custro N., Scafidi V., Lo Baido R. et al. A. Subclinical hypothyroidism resulting from autoimmune thyroiditis in female patients with endogenous depression // J. Endocrinol. Iinvestig. 1994. V. 17. N 8. P. 641–646.
19. Cтроев Е.А., Касаткина Э.П., Дмитриева Н.В., Филимонова А.Ю. Состояние липидного обмена и гормонального статуса у больных сахарным диабетом I типа в сочетании с субклиническим гипотиреозом // Пробл. эндокринол. 1996. V. 4. P. 9–11.
20. d’Herbomez M., Jarrige V., Darte C. Reference intervals for serum thyrotropin (TSH) and free thyroxine (FT4) in adults using the Access Immunoassay System // Clin. Chem. Lab. Med. 2005. V. 43. N 1. P. 102–105.
21. Danese M.D., Powe N.R., Sawin C.T., Ladenson P.W. Screening for mild thyroid failure at the periodic health examination: a decision and cost-effectiveness analysis // Jama. 1996. V. 276.N 4. P. 285–292.
22. Danesh J., Whincup P., Walker M., Lennon L., Thomson A., Appleby P., Gallimore J.R., Pepys M.B. Low grade inflammation and coronary heart disease: prospective study and updated meta-analyses // B.M.J. 2000. V. 321. N 7255. P. 199–204.
23. Davis J.D., Tremont G. Neuropsychiatric aspects of hypothyroidism and treatment reversibility // Minerva Endocrinol. 2007. V. 32. N 1. P. 49–65.
24. Diez J.J., Iglesias P., Burman K.D. Spontaneous normalization of thyrotropin concentrations in patients with subclinical hypothyroidism // J. Clin. Endocrinol. Metab. 2005. V. 90. N 7. P. 4124–4127.
25. Elmlinger M.W., Kuhnel W., Lambrecht H.G., Ranke M.B. Reference intervals from birth to adulthood for serum thyroxine (T4), triiodothyronine (T3), free T3, free T4, thyroxine binding globulin (TBG) and thyrotropin (TSH) // Clin. Chem. Lab. Med. 2001. V. 39. N 10. P. 973–979.
26. Ford E.S., Giles W.H. Serum C-reactive protein and self-reported stroke: findings from the Third National Health and Nutrition Examination Survey // Arterioscleros. Thrombos. Vascul. Biol. 2000. V. 20. N 4. P. 1052–1056.
27. Fu W.Y., Dudman N.P., Perry M.A., Wang X.L. Homocysteine attenuates hemodynamic responses to nitric oxide in vivo // Atheroscleros. 2002. V. 161. N 1. P. 169–176.
28. Gabay C., Kushner I. Acute-phase proteins and other systemic responses to inflammation // N. England J. Med. 1999. V. 340. N 6. P. 448–454.
29. Genser D., Prachar H., Hauer R. et. Relation of homocysteine, vitamin B(12), and folate to coronary in-stent restenosis // Am. J. Cardiol. 2002. V. 89. N 5. P. 495–499.
30. Glass CK., Witztum JL. Atherosclerosis. the road ahead // Cell. 2001. V. 104. N 4. P. 503–516.
31. Graham I.M., Refsum H.M., Robinson K. et al. Plasma homocysteine as a risk factor for vascular disease. The European Concerted Action Project // JAMA. 1997. V. 2. (77). N 22. P. 1775–1781.
32. Gulseren S., Gulseren L., Hekimsoy Z. et al. Depression, anxiety, health-related quality of life, and disability in patients with overt and subclinical thyroid dysfunction // Archiv. Medic. Research. 2006. V. 37. N 1. P. 133–139.
33. Gupta A., Sinha R.S. Echocardiographic changes and alterations in lipid profile in cases of subclinical and overt hypothyroidism // J. Associat. Physic. India. 1996. V. 44. N 8. P. 546, 551–553.
34. Gursoy A., Ozduman Cin M., Kamel N., Gullu S. Which thyroid-stimulating hormone level should be sought in hypothyroid patients under L-thyroxine replacement therapy? // Internat. J. Clin. Pract. 2006. V. 60. N 6. P. 655–659.
35. Haggerty J.J., Garbutt J.C., Evans D.L. et al. Subclinical hypothyroidism: a review of neuropsychiatric aspects // Internat. J. Psych. Med. 1990. V. 20. N 2. P. 193–208.
36. Haggerty J.J., Stern R.A., Mason G.A. et al. Subclinical hypothyroidism: a modifiable risk factor for depression? // Am. J. Psych. 1993. V. 150. N 3. P. 508–510.
37. Hamilton T.E., Davis S., Onstad L., Kopecky K.J. Thyrotropin levels in a population with no clinical, autoantibody, or ultrasonographic evidence of thyroid disease: implications for the diagnosis of subclinical hypothyroidism // J. Clin. Endocrinol. Metab. 2008. V. 93. N 4. P. 1224–1230.
38. Hansen P.S., Brix T.H., Sorensen T.I. et al. Major genetic influence on the regulation of the pituitary-thyroid axis: a study of healthy Danish twins // J. Clin. Endocrinol. Metab. 2004. V. 89. N 3. P. 1181–1187.
39. Harris T.B., Ferrucci L., Tracy R.P. et al. Associations of elevated interleukin-6 and C-reactive protein levels with mortality in the elderly // Am. J. Med. 1999. V. 106. N 5. P. 506–512.
40. Hayden M.R., Tyagi S.C. Homocysteine and reactive oxygen species in metabolic syndrome, type 2 diabetes mellitus, and atheroscleropathy: the pleiotropic effects of folate supplementation // Nutrit. J. 2004. V. 3. P. 4.
41. Henny J. The IFCC recommendations for determining reference intervals: strengths and limitations // Laborator. Med. 2009. V. 33. N 2. P. 45–51.
42. Hollowell J.G., Staehling N.W., Flanders W.D. et al. Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III) // J. Clin. Endocrinol. Metab. 2002. V. 87. N 2. . P. 489–499.
43. Howland R.H. Thyroid dysfunction in refractory depression: implications for pathophysiology and treatment // J. Clin. Psych. 1993. V. 54. N 2. P. 47–54.
44. Jensen E., Hyltoft–Petersen P., Blaabjerg O. et al. Establishment of a serum thyroid stimulating hormone (TSH) reference interval in healthy adults. The importance of environmental factors, including thyroid antibodies // Clin. Chem. Lab. Med. 2004. V. 42. N 7. P. 824–832.
45. Jensovsky J., Ruzicka E., Spackova N., Hejdukova B. Changes of event related potential and cognitive processes in patients with subclinical hypothyroidism after thyroxine treatment // Endocrin. Regulat. 2002. V. 36. N 3. P. 115–122.
46. Joffe R.T., Levitt A.J. Major depression and subclinical (grade 2) hypothyroidism // Psychoneuroendocrinol. 1992. V. 17. N 2–3. P. 215–221.
47. Kahaly G.J. Cardiovascular and atherogenic aspects of subclinical hypothyroidism // Thyroid. 2000. V. 10. N 8. P. 665–679.
48. Karmisholt J., Andersen S., Laurberg P. Interval between tests and thyroxine estimation method influence outcome of monitoring of subclinical hypothyroidism // J. Clin. Endocrinol. Metab. 2008. V. 93. N 5. P. 1634–1640.
49. Karmisholt J., Andersen S., Laurberg P. Variation in thyroid function tests in patients with stable untreated subclinical hypothyroidism // Thyroid. 2008. V. 18. N 3. P. 303–308.
50. Knudsen N., Bulow I., Jorgensen T. et al. Comparative study of thyroid function and types of thyroid dysfunction in two areas in Denmark with slightly different iodine status // Eur. J. Endocrinol. Eur. Federat. Endocr. Societ. 2000. V. 143. N 4. P. 485–491.
51. Knudsen N., Laurberg P., Rasmussen L.B. et al. Small differences in thyroid function may be important for body mass index and the occurrence of obesity in the population // J. Clin. Endocrinol. Metab. 2005. V. 90. N 7. P. 4019–4024.
52. Koenig W., Sund M., Frohlich M. et al. C-Reactive protein, a sensitive marker of inflammation, predicts future risk of coronary heart disease in initially healthy middle-aged men: results from the MONICA (Monitoring Trends and Determinants in Cardiovascular Disease) Augsburg Cohort Study, 1984 to 1992 // Circulat. 1999. V. 99. N 2. P. 237–242.
53. Kraus R.P., Phoenix E., Edmonds M.W. et al. Exaggerated TSH responses to TRH in depressed patients with “normal” baseline TSH // J. Clin. Psych. 1997. V. 58. N 6. P. 266–270.
54. Kung A.W., Pang R.W., Janus E.D. Elevated serum lipoprotein(a) in subclinical hypothyroidism // Clin. Endocrinol. 1995. V. 43. N 4. P. 445–449.
55. Laryea E.A. Subclinical hypothyroidism. To treat or not to treat // Canad. Family Pphys. Med. Famil. Canad. 1993. V. 39. P. 1997–1998, 2001–1993.
56. Lekakis J., Papamichael C., Alevizaki M. et al. Flow-mediated, endothelium-dependent vasodilation is impaired in subjects with hypothyroidism, borderline hypothyroidism, and high-normal serum thyrotropin (TSH) values // Thyroid. 1997. V. 7. N 3. P. 411–414.
57. Lilja J.J., Laitinen K., Neuvonen P.J. Effects of grapefruit juice on the absorption of levothyrroxine // Brit. J. Clin. Pharmacol. 2005. V. 60. N 3. P. 337–341.
58. Luboshitzky R., Aviv A., Herer P., Lavie L. Risk factors for cardiovascular disease in women with subclinical hypothyroidism // Thyroid. 2002. V. 12. N 5. P. 421–425.
59. Luboshitzky R., Herer P. Cardiovascular risk factors in middle-aged women with subclinical hypothyroidism // Neur. Endocrinol. Letters. 2004. V. 25. N 4. P. 262–266.
60. Malvano R., Chiecchio A., Borsa M., Messeri G. The uncertainty associated with the predictive value of test results // Clin. Chem. Lab. Med. 1998. V. 36. N 7. P. 463–468.
61. Margaglione M., Cappucci G., Colaizzo D. et al. C-reactive protein in offspring is associated with the occurrence of myocardial infarction in first-degree relatives // Arterioscleros.Thrombos. Vascul. Bbiol. 2000. V. 20. N 1. P. 198–203.
62. Mayer E.L., Jacobsen D.W., Robinson K. Homocysteine and coronary atherosclerosis // J. Am. Colleg. Cardiol. 1996. V. 27. N 3. P. 517–527.
63. Mazokopakis E.E., Chatzipavlidou V. Hashimoto’s thyroiditis and the role of selenium. Current concepts //Hellen. J. Nucl. Med.2007. V. 10. N 1. P. 6–8.
64. McCully KS. Vascular pathology of homocysteinemia: implications for the pathogenesis of arteriosclerosis // Am. J. Pathol. 1969. V. 56. N 1. P. 111–128.
65. Mendall M.A., Strachan D.P., Butland B.K. et al. C-reactive protein: relation to total mortality, cardiovascular mortality and cardiovascular risk factors in men // Eur. Heart J. 2000. V. 21. N 19. P. 1584–1590.
66. Meyerovitch J., Rotman-Pikielny P., Sherf M. et al. Serum thyrotropin measurements in the community: five-year follow-up in a large network of primary care physicians // Arch. Internal. Med. 2007. V. 167. N 14. P. 1533–1538.
67. Miller M.J., Pan C., Barzel U.S. The prevalence of subclinical hypothyroidism in adults with low-normal blood thyroxine levels // N.-Y. Stat. J. Med. 1990. V. 90. N 11. P. 541–544.
68. Moat S.J., Lang D., McDowell I.F., Clarke Z. L. et al. Folate, homocysteine, endothelial function and cardiovascular disease // J. Nutrition. Biochemistr. 2004. V. 15. N 2. P. 64–79.
69. Monzani F., Del Guerra P., Caraccio N. et al. Subclinical hypothyroidism: neurobehavioral features and beneficial effect of L-thyroxine treatment // Clin. investigat. 1993. V. 71. N 5. P. 367–371.
70. Moshal K.S., Camel C.K., Kartha G.K. et al. Cardiac dys-synchronization and arrhythmia in hyperhomocysteinemia // Current. Neurovascul. Research 2007. V. 4. N 4. P. 289–294.
71. Nakagomi A., Freedman S.B., Geczy C.L. Interferon-gamma and lipopolysaccharide potentiate monocyte tissue factor induction by C-reactive protein: relationship with age, sex, and hormone replacement treatment // Circulat. 2000. V. 101. N 15. P. 1785–1791.
72. Nystrom E., Caidahl K., Fager G. et al. A double-blind cross-over 12-month study of L-thyroxine treatment of women with ‘subclinical’ hypothyroidism // Clin. Endocrino. 1988. V. 29. N 1. P. 63–75.
73. Parle J.V., Maisonneuve P., Sheppard M.C. et al. Prediction of all-cause and cardiovascular mortality in elderly people from one low serum thyrotropin result: a 10-year cohort study // Lancet. 2001. V. 358. N 9285. P. 861–865.
74. Ponte E., Ursu H.I. Overt and subclinical hypothyroidism and atherosclerotic arteriopathy of the lower limbs (clinical and subclinical) // Roman. J. Endocrinol. 1993. V. 31. N 1–2. P. 71–79.
75. Ridker P.M. High-sensitivity C-reactive protein: potential adjunct for global risk assessment in the primary prevention of cardiovascular disease // Circulat. 2001. V. 103. N 13. P. 1813–1818.
76. Romijn J.A., Smit J.W., Lamberts S.W. Intrinsic imperfections of endocrine replacement therapy // Eur. J.Endocrinol. 2003. V. 149. N 2. P. 91–97.
77. Ross R. Atherosclerosis is an inflammatory disease // Am. Heart J. 1999. V. 138. N 5 (Pt. 2). P. S419–420.
78. Ross R. Atherosclerosis—an inflammatory disease // N. Eng. J. Med. 1999. V. 340. N 2. P. 115–126.
79. Samuels M.H. Subclinical thyroid disease in the elderly // Thyroid 1998. V. 8. N 9. P. 803–813.
80. Sawin C.T. Subclinical hypothyroidism in older persons // Clin. Geriatr. Med. 1995. V. 11. N 2. P. 231–238.
81. Selhub J., Jacques P.F., Bostom A.G. et al. Relationship between plasma homocysteine, vitamin status and extracranial carotid-artery stenosis in the Framingham Study population // J. Nnutrit. 1996. V. 126. N 4. P. 1258S–1265S.
82. Selhub J., Jacques P.F., Bostom A.G. et al. Relationship between plasma homocysteine and vitamin status in the Framingham study population. Impact of folic acid fortification // Public. Health Reviews. 2000. V. 28. N 1–4. P. 117–145.
83. Shastry S., Tyagi N., Hayden M.R., Tyagi S.C. Proteomic analysis of homocysteine inhibition of microvascular endothelial cell angiogenesis // Cell. Molecul. Bbiol. (Noisy-le-Grand, France) 2004. V. 50. N 8. P. 931–937.
84. Solberg H.E. International Federation of Clinical Chemistry (IFCC), Scientific Committee, Clinical Section, Expert Panel on Theory of Reference Values, and International Committee for Standardization in Haematology (ICSH), Standing Committee on Reference Values. Approved Recommendation (1986) on the theory of reference values. Part 1. The concept of reference values // J. Clin. Chem. Clin. Biochem. 1987. V. 25. N 5. P. 337–342.
85. Solberg H.E. International Federation of Clinical Chemistry. Scientific committee, Clinical Section. Expert Panel on Theory of Reference Values and International Committee for Standardization in Haematology Standing Committee on Reference Values. Approved recommendation (1986) on the theory of reference values. Part 1. The concept of reference values // Internation. J. Clin. Chemistr. 1987. V. 165. N 1. P. 111–118.
86. Spielhagen C.B.K., Krebs A., Wallaschofski H. Reference values for thyroid function tests during pregnancy // Labor. Med. 2009. V. 33. N 1.
87. Stampfer M. J., Malinow M.R. Can lowering homocysteine levels reduce cardiovascular risk? // N. Engl. J. Med. 1995. V. 332. N 5. P. 328–329.
88. Strandberg T.E., Tilvis R.S. C-reactive protein, cardiovascular risk factors, and mortality in a prospective study in the elderly // Arterioscler. Thrombos. Vascul. Biol. 2000. V. 20. N 4. P. 1057–1060.
89. Surks M.I., Goswami G., Daniels G.H. The thyrotropin reference range should remain unchanged // J. Clin. Endocrinol. Metab. 2005. V. 90. N 9. P. 5489–5496.
90. Surks M.I., Ortiz E., Daniels G.H. et al. Subclinical thyroid disease: scientific review and guidelines for diagnosis and management / JAMA. 2004. V. 291. N 2. P. 228–238.
91. Tawakol A., Omland T., Gerhard M. Hyperhomocyst(e)inemia is associated with impaired endothelium-dependent vasodilation in humans // Circulat. 1997. V. 95. N 5. P. 1119–1121.
92. Toruner F., Altinova A.E., Karakoc A. et al. Risk factors for cardiovascular disease in patients with subclinical hypothyroidism //.Advanc. Therapy. 2008. V. 25. N 5. P. 430–437.
93. Torzewski M., Rist C., Mortensen R.F. et al. C-reactive protein in the arterial intima: role of C-reactive protein receptor-dependent monocyte recruitment in atherogenesis // Arterioscleros. Thrombos. Vascul. Biol. 2000. V. 20. N 9. P. 2094–2099.
94. Turhan S., Sezer S., Erden G., Guctekin A. et al. Plasma homocysteine concentrations and serum lipid profile as atherosclerotic risk factors in subclinical hypothyroidism // Ann. Saudi Med. 2008. V. 28. N 2. P. 96–101.
95. Tyagi N., Moshal K.S., Lominadze D. Homocysteine-dependent cardiac remodeling and endothelial-myocyte coupling in a 2 kidney, 1 clip Goldblatt hypertension mouse model // Canad. J. Physiol. Pharmacol. 2005. V. 83. N 7. P. 583–594.
96. Vanderpump MP., Tunbridge W.M., French J.M. et al. The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham Survey // Clin. Endocrinol. 1995. V. 43. N 1. P. 55–68.
97. Vanhaelst L., Neve P., Chailly P., Bastenie P. A. Coronary-artery disease in hypothyroidism. Observations in clinical myxoedema // Lancet. 1967. V. 2. N 7520. P. 800–802.
98. Volzke H., Alte D., Kohlmann T. et al. Reference intervals of serum thyroid function tests in a previously iodine-deficient area // Thyroid. 2005. V. 15. N 3. P. 279–285.
99. Volzke H., Robinson D.M., Schminke U. et al. Thyroid function and carotid wall thickness // J. Clin. Endocrinol. Metab. 2004. V. 89. N 5. P. 2145–2149.
100. Volzke H., Robinson D.M., Spielhagen T. et al. Are serum thyrotropin levels within the reference range associated with endothelial function? // Eur. Hheart J. 2009. V. 30. N 2. P. 217–224.
101. Walsh J.P., Ward L.C., Burke V. et al. Small changes in thyroxine dosage do

Hypothyroidism, Subclinical Hypothyroidism, High-normal TSH-level

A.V. Podzolkov, V.V. Fadeyev

The review of literature discusses the problems of diagnostics and therapy of subclinical hypothyroidism and reference ranges for thyroid stimulating hormone. Expediency of change of reference range for TSH and target TSH-level on L-thyroxine replacement therapy in patients with hypothyroidism is also discussed.

Keywords:
hypothyroidism, subclinical hypothyroidism, thyroid-stimulatein hormone.

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