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2,155 participants), each year of metformin use was associated with a 13% higher risk of B12 deficiency (odds ratio 1.13 per year)
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Additionally, the NNMT substrate nicotinamide 12 is metabolized by the microbiome 56,57 , and thus NNMTi may modulate substrate availability, potentially influencing microbial metabolic capacity to drive the NNMTi-mediated weight loss
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