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High levels of homocysteine, with the slowing of GPx1 blood vessel activity, promote a higher concentration of intracellular peroxides that enhances oxidative stress and causes damage to endothelial cells in the pathogenesis of atherogenesis

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In a retrospective study, it was observed that subjects receiving doses of metformin higher than 2000 mg/day or for more than 4 years had low levels of vitamin B 12 [18]