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It has been well established that pro-inflammatory cytokines produced by the adipose tissue in obesity affect normal nutrition-related signalling, establishing the progression to MetS and ultimately to T2D [125]
However, because folate, riboflavin, and vitamin B-6 deficiencies result in elevations of tHcy, as do renal insufficiency and hypothyroidism, it is not a specific biomarker for B12 status especially in populations with poor micronutrient status
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