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No formal PRISMA methodology, risk-of-bias assessment, or evidence grading system was applied, as the aim of this work was to provide a critical narrative synthesis of the current evidence rather than a systematic quantitative assessment

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However, recent studies of MMA patient metabolomes suggest that metabolic acidosis during AMD is driven by the accumulation of acidic intermediates of branched-chain amino acid (BCAA) metabolism rather than methylmalonic acid levels

Inoltre, il rischio di carenza maggiore per le persone con malattie come la cirrosi e le malattie renali