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. 2017 Sep 6;7:10721. doi: 10.1038/s41598-017-10817-w

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© The Author(s) 2017

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Overview showing normalized levels of selected metabolites in plasma of AVNFH patients (n = 14) and control (n = 14) individuals. Levels of spiked internal standard (see text) were used to normalize the data. P values were computed using Students T-test between the AVNFH (black bars) and control (open bars) groups. Overall levels of metabolites in the folate-methionine Pathway (A) Methionine, (B) S- adenosyl methionine (SAM), (C) S-adenosyl Homocysteine (SAH), (D) Homocysteine, and (E) Adenosine, were significantly elevated in AVNFH patients. Further levels of (F) Betaine, as well as cofactors vitamins (G) B₁₂ and (H) B₆ were significantly reduced in AVNFH samples compared to controls. Also, levels of polyamines namely (I) Spermine and Spermidine were significantly elevated in AVNFH samples compared to controls. P values for each comparison are included in each figure panel.