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This change may be associated with the depletion of carbohydrate reserves that occur during fasting 62

Once B12 levels are stabilised, the frequency typically reduces to every 2-3 months, although the exact frequency should be prescribed by a healthcare provider

Tools such as QIIME2, MetaPhlAn, and HUMAnN [125] (Tables 1 and 2) enable reproducible and high-resolution functional profiling of microbial communities, while multivariate integration platforms like MixOmics [126] (Table2) and MTD (Meta-Transcriptome Detector) [127] (Table 2) or matrix factorization approaches such as PLIER [128] (Table 2) and HONMF [129] (Table 2) have been developed to integrate heterogeneous omics data and uncover cross-kingdom associations

The retrieval of tissue and clinical data was approved by the Institutional Review Board of Ethics of Ningbo University (NBU-2022-123)