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If the provision of some of these vitamins is insufficient, then a compensatory shift in pathways within OCM may occur (Reference Fernndez-Roig, Cavall-Busquets and Fernandez-Ballart12) but also it might have a negative impact on SAM synthesis with impairment of transmethylation reactions (Reference Bottiglieri11)

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However, since the trial only included a subgroup of patients who responded well to an initial low-calorie diet, it remains unclear whether liraglutide with diet would benefit patients who do not respond to dietary interventions alone