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280 ZhangT.ZhangH

J Clin Invest 2015;125:1591-602

Both direct markers, including pyruvate, lactate, lactate-to-pyruvate ratio, alanine, alanine-to-lysine ratio, acyl-carnitines, and ubiquinone, and indirect markers, such as ammonia, carnitine, creatine kinase, alanine aminotransferase, and aspartate aminotransferase, have been used to identify these dysfunctions [91]

Therefore, some scientific societies have recommended measuring cellular vitamin B12 biomarkers, such as homocysteine and methylmalonic acid (MMA), to uncover intracellular vitamin B12 deficiency [14-16]

16 This multi-muscle activation pattern is necessary for effective dynamic knee stability, as it helps distribute the load across several muscle groups, reducing the stress on any single structure