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Acknowledgments The authors would like to thank the Core Facilities Sharing Platform for Life and Environment Sciences of Shandong University, including Cheng-Jia Zhang and Nan-Nan Dong for providing the bacteriological incubator and Zhi-Feng Li for RT-qPCR instruction

It should be noted that the baseline vitamin B12 levels in this cohort were significantly higher than in the KEMU cohort ( p = 0.006), which may explain the faster exceeding of the vitamin B12 threshold