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While the condition is the major cause of poor vitamin B 12 status in the elderly population, it is usually associated with atrophic gastritis, a chronic inflammation of the lining of the stomach that ultimately results in the loss of glands in the stomach (atrophy) and decreased stomach acid production (see Atrophic gastritis)

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They are linked through overlapping pathways including NF-B activation, elevated TNF-, and IL-6 that drive both gut permeability and systemic insulin resistance.13 Peptide therapies for insulin resistance increasingly recognize this connection