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In one crucial area called lipid metabolism, 34 genes (or 14% of the total) were upregulated by up to 41-fold and 19 genes (or 8% of the total) were downregulated by up to 3-fold

39 Consistently, this vicious cycle can further amplify the carcinogenic signal

However, in agreement with a causal role of moderately elevated circulating homocysteine levels in cardiovascular disease, some putative mechanisms have been identified that may explain the atherothrombogenicity of hyperhomo- cysteinemia