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However, many patients do present with consistently normal lactatepyruvate ratio especially in adults

doi:10.1093/eurheartj/ehaf207 Musunuru, K., Orho-Melander, M., Caulfield, M

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APOE-4 status may possibly influence HB consumption efficacy and may therefore be efficient in APOE 4 negative patients

MMA above 250 nmol/L combined with normal serum B12 is associated with 2.4 times higher all-cause mortality risk 4 compared to those with low MMA and adequate B12 serum B12 alone shows no significant mortality signal