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An elevated methylmalonic acid (MMA) level has been thought to be the most direct, metabolic indicator of B12 deficiency because B12 is the only cofactor required by the enzyme that degrades MMA

Researchers should avoid contamination during handling procedures to maintain solution integrity during repeated laboratory use

This combination makes it a so-called triple agonist , with each of these receptors involved in the regulation of metabolism, energy expenditure, and glucose homeostasis