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doi: 10.1080/16546628.2017.1377571 198 SaikatASHossainRMinaFBDasSKhanINMubarakMSet al

Lactobacillus casei reduces susceptibility to type 2 diabetes via microbiota-mediated body chloride ion influx

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Some studies suggest the quinolinium structure is sufficiently NNMT-selective that it should not broadly deplete SAM, but the wider metabolic picture remains an active research consideration