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Its core pathological feature is excessive accumulation of adipose tissue, accompanied by abnormal proliferation, differentiation, and metabolic dysfunction of adipocytes, which in turn induce a series of complications including insulin resistance, nonalcoholic fatty liver disease, and cardiovascular diseases

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[13] Chloramphenicol has been shown to blunt reticulocyte response to cyanocobalamin, while ethanol, colchicine, and nitrous oxide interfere with cobalamin metabolism or utilization, each warranting clinician awareness when evaluating suboptimal treatment outcomes