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2.2 Increased Hcy levels and MetS Hyperhomocysteinemia (HHcy) stands as a well-established independent risk factor for cardiovascular and cerebrovascular diseases (Dubchenko et al., 2019)

Kidney Dysfunction: While the kidneys do not directly excrete vitamin B12 efficiently, impaired renal function may lead to elevated serum B12 levels by reducing the clearance of B12-binding proteins or altering their metabolism, thereby contributing to B12 accumulation 8