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It is used in research focused on fat metabolism, energy balance, and cellular health

Extracellular vesicles (EVs) are secreted by a variety of cells, including adipocytes (159), and increasing evidence suggests that they may mediate paracrine/endocrine effects (160, 161)

Nevertheless, use of metformin may decrease vitamin B 12 status: a meta-analysis of four short-term intervention trials (up to 4 months duration) in patients with type 2 diabetes found that metformin use decreased serum cobalamin concentrations by 57 pmol/L, which could have clinical implications if such patients have suboptimal vitamin B 12 status (146)

TNF can promote insulin resistance in adipocytes (177), and FAs can activate JNK to promote the additional release of pro-inflammatory cytokines from macrophages (178) and adipocytes (179), inciting a vicious cycle