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This is because active folate (methylfolate) is required for B12-dependent reactions, and MTHFR variants can reduce folate availability
10.1136/bmjdrc-2021-002595 144 Jay WidmerR.LermanA
Indeed, in cancer cells, the activation of the PKM gene and the synthesis of the PKM2 isoform of pyruvate kinase promotes glucose diversion into pathways conducive for biomass production
In DPPOS year 9, vitamin B 12 deficiency rates were 4.4%, 5.9%, and 4.9% for GG, AG and AA genotype groups in the placebo arm, vs 5.7%, 6.6%, and 18.7% in those respective genotype groups in the metformin arm (ESM Table 9)
