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Additionally, the gut microbiota plays a critical role in the de novo synthesis of essential vitamins including vitamin B12 and FA, and in sulfur metabolism, which significantly influences Hcy levels

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After adjusting for covariates age, sex, BMI, income, smoking status, alcohol consumption, physical activity, hypertension, type 2 diabetes, dyslipidemia and chronic kidney disease those in the fourth quartile of gamma-glutamyl transferase levels demonstrated the highest risk for SSc, compared with those in the first quartile (adjusted HR = 1.807