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Moreover, a US national study of 2,806 older women (≥50 years) found increased plasma concentration of methylmalonic acid — the metabolic indicator of vitamin B 12 deficiency — to be associated with increased risk of lumbar spine osteoporosis (115)
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Unlike the traditional approach whereby data are obtained from individuals deemed “healthy”, these investigators applied an indirect method designed to overcome the ethical and resourcing difficulties experienced when sampling apparently healthy individuals
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